ABSTRACT
Gynaecomastia is a common condition, particularly in neonates, at puberty and in older men. Obesity promotes gynaecomastia, either from fat deposition or glandular overgrowth due to reduced free testosterone. The Simon classification used for purposes of surgical correction is comprised of four subdivisions: Grade 1: visible breast enlargement without redundant skin; Grade 2A: moderate breast enlargement but no skin redundancy; Grade 2B: moderate enlargement with minor redundant skin; and Grade 3: gross enlargement with skin redundancy and breast ptosis. Tissue microarrays from 46 gynaecomastia specimens showed one myoepithelial and two epithelial cell layers with vertically oriented cuboidal/columnar cells in the intermediate luminal layer which were ER-positive/PR-positive and Bcl-2/cyclin D1-positive. Gynaecomastia is the result of an oestrogen/androgen imbalance of which there are three peaks. Because of transplacental steroid hormone transfer, it affects 90% of neonates and may persist for several months.
