- NEW YORK (Reuters
Health) - Many teenage boys experience some degree of enlargement of the
breasts around the time of puberty. When the condition is troublesome,
anti-estrogen drugs seem to be a safe and effective means of reducing breast
size, according to a new study.
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- Pubertal gynecomastia, as the condition is called, occurs
in up to 65 percent of boys, and about 10 percent of cases of do not resolve
on their own within three years, researchers at the University of Ottawa
explain in the Journal of Pediatrics.
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- "Even for those persons in whom the condition is
self-limiting, it can be a troubling and at times psychologically disabling
condition," write Dr. Sarah E. Lawrence and colleagues.
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- They conducted a chart review of boys treated at their
clinic with either tamoxifen or raloxifene, two drugs that block estrogen
receptors, or who were not given any drug treatment.
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- Included in the review were 15 patients treated with
tamoxifen for an average of 5.2 months, 10 with raloxifene for an average
of 4.9 months, and 13 with no specific therapy other than reassurance.
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- Before treatment, the diameter of the breast nodule in
these three groups averaged 4.6 centimeters, 3.8 cm and 4.7 cm, respectively.
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- Tamoxifen treatment led to an average decrease of 2.1
cm (45 percent) in breast diameter, compared with 2.5 cm (66 percent) in
the raloxifene group. A 50 percent or greater reduction in size occurred
in 41 percent and 86 percent of individuals in each group, respectively.
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- There appeared to be no adverse events, and no significant
changes in hormone levels or liver enzymes.
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- The authors contacted subjects three years after the
study period. None of those who had been treated reported a relapse, but
40 percent "were not completely satisfied with the response to treatment
and went on to have surgery."
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- Among those treated only with reassurance, 50 percent
reported spontaneous resolution.
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- Lawrence's team concludes that anti-estrogen treatment
can be effective for pubertal gynecomastia, "with a better response
to raloxifene than tamoxifen."
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- However, they say, a clinical trial "using standardized
measurements of glandular tissue, such as breast ultrasonography, is needed
to further evaluate the use of estrogen inhibitors as medical therapy for
boys troubled by persistent pubertal gynecomastia."
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- SOURCE: Journal of Pediatrics, July 2004.
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