Song Yan-Ni, Wang Yan-Bo, Huang Rui, He Xiao-Guang, Zhang Jin-Feng, Zhang Guo-Qiang, Ren Yan-Lv, Pang Jian-Hua, Pang Da
From the *Department of Breast Surgery, The Third Affiliated Hospital of Harbin Medical University; Departments of †Surgery, ‡Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University; and §Heilongjiang Institute for Cancer Research, Harbin, China.
Ann Plast Surg. 2014 Sep;73(3):275-8. doi: 10.1097/SAP.0b013e31827c7949.
Gynecomastia is a benign enlargement of the male breast. Yet enlarged breasts cause anxiety, embarrassment, psychosocial discomfort, and fear of breast cancer. The aim of this study was to assess the experience of gynecomastia patients undergoing mastectomy and liposuction surgery.
Seven hundred thirty-three patients were analyzed for age, chief complaint, position, grade, operation approach, biopsy, and complication between mastectomy group and liposuction group, from 1990 to 2010.
Four hundred two patients (436 breasts) were treated with mastectomy and 331 patients (386 breasts) were treated with liposuction techniques. Three hundred thirty (82%) patients complained of breast lump and lump with pain in mastectomy group, and 204 (61%) patients complained of enlargement breast and enlargement with pain in liposuction group (P < 0.05). All excision specimens were performed for routine histological analysis which showed pathologic diagnosis in patients with mastectomy (100%). One hundred fifty-nine (41%) patients with liposuction acquired pathologic diagnosis through fine needle aspiration and/or core biopsy (P < 0.05). The reoperation rates in mastectomy group and liposuction group were 1.4% and 0.5%, respectively. There were no nipple/areola necrosis and scars in liposuction group.
The surgical treatment of gynecomastia required an individual approach, depending on symptoms (lump or enlargement) and requirements of patients. Patients who chose mastectomy were looking for reassurance that their pathologic diagnosis was benign. The increase in the number of liposuction patients was reflected in our study because it was associated with superior esthetic results and few complications.
男性乳房肥大是男性乳腺的良性增大。然而，乳房增大可导致焦虑、尴尬、心理社会不适以及对乳腺癌的恐惧。本研究的目的是评估接受乳房切除术和吸脂手术的男性乳房肥大患者的经历。
分析了1990年至2010年间乳房切除术组和吸脂组733例患者的年龄、主要症状、部位、分级、手术方式、活检及并发症情况。
402例患者（436侧乳房）接受了乳房切除术，331例患者（386侧乳房）接受了吸脂手术。乳房切除术组330例（82%）患者主诉乳房肿块及伴有疼痛的肿块，吸脂组204例（61%）患者主诉乳房增大及伴有疼痛的增大（P<0.05）。所有切除标本均进行常规组织学分析，乳房切除术患者的病理诊断率为100%。159例（41%）吸脂患者通过细针穿刺抽吸和/或粗针活检获得病理诊断（P<0.05）。乳房切除术组和吸脂组的再次手术率分别为1.4%和0.5%。吸脂组未出现乳头/乳晕坏死及瘢痕。
男性乳房肥大的手术治疗需要个体化方法，取决于症状（肿块或增大）及患者需求。选择乳房切除术的患者寻求其病理诊断为良性的安心保证。吸脂患者数量的增加在我们的研究中得到体现，因为它与更好的美学效果及较少的并发症相关。
