Drugs for boys with breast enlargement
For boys with some degree of breasts enlargement, anti-oestrogen drugs seem to be a safe and effective means of reducing the size.
Many teenage boys experience some degree of enlargement of the breasts (
gynaecomastia) around the time of puberty. When the condition is troublesome, anti-oestrogen drugs seem to be a safe and effective means of reducing breast size, according to recent research.
Researchers from the University of Ottawa, Canada, conducted a chart review of boys treated at their clinic with either tamoxifen or raloxifene, two drugs that block oestrogen receptors or who were not given any drug treatment. 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. Before treatment, the diameter of the breast nodule in these three groups averaged 4.6 centimetres, 3.8 cm and 4.7 cm, respectively. 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.
There appeared to be no adverse events, and no significant changes in hormone levels or liver enzymes. The researchers contacted the 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. Among those treated only with reassurance, 50 percent reported spontaneous resolution.
The researchers concluded that anti-oestrogen treatment could be effective for pubertal gynaecomastia, with a better response to raloxifene than tamoxifen. However, a clinical trial using standardised measurements of glandular tissue, such as breast ultrasonography, is needed to further evaluate the use of oestrogen inhibitors as medical therapy for boys troubled by persistent pubertal gynaecomastia.
Journal of Pediatrics ,
August 2004
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