Gynecomastia question

[Lee Ju Hee]

Hello, Mr. Birdie. Thank you for the uploads.
I have always thought an appearance of hypoechoic tree roots behind a nipple is consistent with gynaecomastia; as you said in Q&A section.

What if you see hyperechoic glandular tissues in the retro areola regions in males, would you still consider it gynaecomastia?

[Stephen Bird]

Yes indeed I would also consider this to be gynaecomastia,

It just depends on what stage / severity the process is at.

In the early stages you get the tree root hypo echoic changes and as it becomes more severe the echogenic glandular tissue appears.

I am recording a part 2 of the breast webinar which will deal with the male breast and other topics like implants etc.

I hope you will enjoy it when it becomes available.

Happy Easter,

Steve

[Stephen Bird]

There is a grading system called the Tanner System.

It is a 5 step system,

I don’t see many radiologists reporting using the system, but it does exist.

Tanner I
(Preadolescent) No breast tissue
Ill-defined hyperechoic retroareolar tissue

Tanner Il
Areolar enlargement with palpable retroareolar bud
development
Hyperechoic retroareolar nodule with a central scar-shaped or linear
hypoechoic area

Tanner IlI
Enlargement and elevation of the entire breast
Hyperechoic glandular tissue is seen extending away from the retroareolar
area and a central spider shaped hypochoic region is noted

Tanner IV
Projection of the nipple and areola above the breast
Thissue
Hyperechoic, mostly periareolar, fibroglandular tissue is seen, showing a
prominent hypoechoic nodule in the central region

Tanner V
Regression of the areola to form a smooth contour with
the rest of the breast tissue
Hyperechoic glandular tissue is found, with increased subcutaneous
adipose tissue anteriorly and without the hypoechoic central nodule seen
in Tanner stages II, Ill and IV

Steve.

[Author]

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