Diagnostic Tests for Gynecomastia
Gynecomastia Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Gynecomastia:
- Menopause: Related Home Testing:
- Vaginal Health: Home Testing:
- Breast Cancer: Related Home Tests:
Gynecomastia Diagnosis: Book Excerpts
Diagnostic Tests for Gynecomastia: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the diagnostic tests for Gynecomastia.
GYNECOMASTIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
A urine drug screen and thyroid profile should be done at the outset. Liver function studies, liver biopsy, and serum iron and iron-binding capacity will help rule out hemochromatosis and cirrhosis of the liver. A serum FSH, LH, HCG, and estradiol will help diagnose testicular tumors, Klinefelter's syndrome, and testicular feminization syndrome. Further evidence of Klinefelter's syndrome is obtained by a buccal smear (Barr bodies). Normal gonadotropin and sex hormone levels make serious pathology unlikely. A serum cortisol, cortisol suppression test, and rapid adrenocorticotropic hormone (ACTH) test will help diagnose Cushing's syndrome and Addison's disease. There is a specific beta-HCG assay that can be done to rule out an HCG-secreting tumor such as carcinoma of the lung.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
BREAST DISCHARGE:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
If there is a bloody discharge, one should not hesitate to refer the patient to a general surgeon, who will probably order mammography and perform a biopsy. The type of biopsy may be either a fine-needle aspiration or fine-needle biopsy or excisional biopsy, but the general surgeon can decide which is appropriate for any given patient. A unilateral nonbloody discharge may be studied further by ordering tests for occult blood, cytology, and mammography before referral. Remember that exploratory surgery may be the only way to get a diagnosis.
If the discharge is bilateral and milky, a serum prolactin should be ordered. If the prolactin is high, referral to an endocrinologist is probably the best step to take next. The endocrinologist will probably order a CT scan of the brain and pituitary and do further workup studies based on his examination.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Gynecomastia:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
Begin the history by asking the patient when he first noticed his breast enlargement. How old was he at the time? Since then, have his breasts gotten progressively larger, smaller, or stayed the same? Does he also have breast tenderness or discharge? Have him describe the discharge, if any. Ask him if he’s ever had his nipples pierced. If so, were there any complications due to the piercings? Next, take a thorough drug history, including prescription, over-the-counter, herbal, and street drugs. Then explore associated signs and symptoms, such as testicular mass or pain, loss of libido, decreased potency, and loss of chest, axillary, or facial hair.
Focus the physical examination on the breasts, testicles, and penis. As you examine the breasts, note asymmetry, dimpling, abnormal pigmentation, or ulceration. Observe the testicles for size and symmetry. Then palpate them to detect nodules, tenderness, or unusual consistency. Look for normal penile development after puberty, and note hypospadias.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Breast nodule [Breast lump]:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient reports a lump, ask her how and when she discovered it. Does the size and tenderness of the lump vary with her menstrual cycle? Has the lump changed since she first noticed it? Has she noticed other breast signs, such as a change in breast shape, size, or contour; a discharge; or nipple changes?
Is she breast-feeding? Does she have fever, chills, fatigue, or other flulike signs or symptoms? Ask her to describe any pain or tenderness associated with the lump. Is the pain in one breast only? Has she sustained recent trauma to the breast?
Explore the patient's medical and family history for factors that increase her risk of breast cancer. These include a high-fat diet, having a mother or sister with breast cancer, or having a history of cancer, especially cancer in the other breast. Other risk factors include nulliparity and a first pregnancy after age 30.
CULTURAL CLUE: Breast cancer incidence and mortality are about five times higher in North America and northern Europe than in Asia and Africa.
Next, perform a thorough breast examination. Pay special attention to the upper outer quadrant of each breast, where one-half of the ductal tissue is located. This is the most common site of malignant breast tumors.
Carefully palpate a suspected breast nodule, noting its location, shape, size, consistency, mobility, and delineation. Does the nodule feel soft, rubbery, and elastic or hard? Is it mobile, slipping away from your fingers as you palpate it, or firmly fixed to adjacent tissue? Does the nodule seem to limit the mobility of the entire breast? Note the nodule's delineation. Are the borders clearly defined or indefinite? Does the area feel more like a hardness or diffuse induration than a nodule with definite borders?
Do you feel one nodule or several small ones? Is the shape round, oval, lobular, or irregular? Inspect and palpate the skin over the nodule for warmth, redness, and edema. Palpate the lymph nodes of the breast and axilla for enlargement.
Observe the contour of the breasts, looking for asymmetry and irregularities. Be alert for signs of retraction, such as skin dimpling and nipple deviation, retraction, or flattening. (To exaggerate dimpling, have your patient raise her arms over her head or press her hands against her hips.) Gently pull the breast skin toward the clavicle. Is dimpling evident? Mold the breast skin and again observe the area for dimpling.
Be alert for a nipple discharge that's spontaneous, unilateral, and nonmilky (serous, bloody, or purulent). Be careful not to confuse it with the grayish discharge that can be elicited from the nipples of a woman who has been pregnant. (See Breast nodule: Common causes and associated findings, page 106.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Gynecomastia:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Begin the history by asking the patient when he first noticed his breast enlargement. How old was he at the time? Since then, have his breasts gotten progressively larger, smaller, or stayed the same? Does he also have breast tenderness or discharge? Have him describe the discharge, if any. Ask him if he ever had his nipples pierced and, if so, if he developed any complications. Next, take a thorough drug history, including prescription, over-the-counter, herbal, and street drugs. Then explore associated signs and symptoms, such as testicular mass or pain, loss of libido, decreased potency, and loss of chest, axillary, or facial hair.
Focus the physical examination on the breasts, testicles, and penis. As you examine the breasts, note any asymmetry, dimpling, abnormal pigmentation, or ulceration. Observe the testicles for size and symmetry. Then palpate them to detect nodules, tenderness, or unusual consistency. Look for normal penile development after puberty, and note hypospadias.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Breast nodule [Breast lump]:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If your patient reports a lump, ask her how and when she discovered it and whether its size and tenderness vary with her menstrual cycle. Has the lump changed since she first noticed it? Has she noticed any other breast signs, such as a change in breast shape, size, or contour; a discharge; or nipple changes?
Is she breast-feeding? If so, does she have fever, chills, fatigue, or other flulike signs or symptoms? Ask her to describe any pain or tenderness associated with the lump. Is the pain in one breast only? Has she sustained recent trauma to the breast?
Explore the patient’s medical and family history for factors that increase her risk of breast cancer. These include a high-fat diet, having a mother or sister with breast cancer, or having a history of cancer, especially cancer in the other breast. Other risk factors include nulliparity and a first pregnancy after age 30.
Cultural Cue: Breast cancer incidence and mortality are about five times higher in North America and northern Europe than in Asia and Africa.
Next, perform a thorough breast examination. Pay special attention to the upper outer quadrant of each breast, where one-half of the ductal tissue is located. This is the most common site of malignant breast tumors.
Carefully palpate a suspected breast nodule, noting its location, shape, size, consistency, mobility, and delineation. Does the nodule feel soft, rubbery, and elastic or hard? Is it mobile, slipping away from your fingers as you palpate it, or firmly fixed to adjacent tissue? Does the nodule seem to limit the mobility of the entire breast? Note the nodule’s delineation. Are its borders clearly defined or indefinite? Does the area feel more like a hardness or diffuse induration than a nodule with definite borders?
Do you feel one nodule or several small ones? Is the shape round, oval, lobular, or irregular? Inspect and palpate the skin over the nodule for warmth, redness, and edema. Palpate the lymph nodes of the breast and axilla for enlargement.
Observe the contour of the breasts, looking for asymmetry and irregularities. Be alert for signs of retraction, such as skin dimpling and nipple deviation, retraction, or flattening. (To exaggerate dimpling, have your patient raise her arms over her head or press her hands against her hips.) Gently pull the breast skin toward the clavicle. Is dimpling evident? Mold the breast skin and again observe the area for dimpling.
Be alert for a nipple discharge that’s spontaneous, unilateral, and nonmilky (serous, bloody, or purulent). Be careful not to confuse it with the grayish discharge that can be elicited from the nipples of a woman who has been pregnant. (See Breast nodule: Causes and associated findings.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Gynecomastia:
Physical examination (PE)
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
True gynecomastia is confirmed with the PE. With the patient supine, the breast is grasped between thumb and forefinger and the digits are moved toward the nipple. A firm, rubbery, mobile, disk-shaped mass of tissue beneath the nipple indicates true breast tissue enlargement. A focused PE can help exclude cancer of the breast or testes and some medical or endocrine disorders (Chapter 11.2).
A. Pseudogynecomastia. Adipose tissue deposition produces the soft and poorly defined breast enlargement of pseudogynecomastia.
B. Breast cancer. A unilateral, eccentric mass that is hard or firm, fixed to underlying tissue or associated with overlying skin dimpling, nipple discharge, or retraction, or axillary lymphadenopathy may represent breast cancer.
C. Testicular examination. Congenital anorchia is a rare cause of gynecomastia. Bilateral small testes suggest gonadal failure. Testicular atrophy can result from alcohol abuse, mumps, leprosy, or other granulomatous disorders. Asymmetry or a palpable mass suggests testicular cancer (Chapter 10.7).
Testing
Most patients with physiologic gynecomastia can be readily identified and no further evaluation is required. If pathology is suspected, additional testing may be needed.
A. Clinical laboratory testing. Liver, kidney, and thyroid function should be assessed, if clinically indicated.
B. Diagnostic imaging. Neither mammography nor ultrasound of the breast is usually helpful.
C. Special tests. If an underlying endocrine disorder is suspected, serum HCG, testosterone, estradiol, and luteinizing hormone (LH) levels should be checked. Fine needle aspiration of a mass may be considered to diagnose breast cancer.
Diagnostic assessment
The medical history and PE may be sufficient for diagnostic assessment. The directed PE should focus on detecting breast cancer, testicular tumors, and endocrine disease. Further evaluation is indicated if these conditions are suspected. In cases of gynecomastia that do not resolve, progressive or rapid onset of gynecomastia, or history and PE suggestive of a possible endocrine disorder, measure the levels of serum LH, estradiol, testosterone, and HCG, which constitutes a reasonable screening evaluation for underlying endocrinopathies.
A. Benign gynecomastia. If true gynecomastia appears in one of the expected age ranges and neither the history nor PE suggests an underlying medical or endocrine disorder, then only reassurance and observation are required. Gynecomastia will resolve in 1 to 2 years in most patients; however, those cases that progress or fail to resolve may require further evaluation.
B. Medications. Drugs that cause gynecomastia should be discontinued, if possible, and the patient followed for the resolution of gynecomastia.
C. Testicular insufficiency results in an elevated LH serum level and a normal to low testosterone serum level.
D. Klinefelter’s syndrome. This abnormality is associated with small, firm testes, behavioral abnormalities or mental retardation, an elevated estradiol level, and a diagnostic chromosome analysis.
E. Androgen resistance. Elevated LH and testosterone levels suggest this syndrome.
F. Neoplasia. High HCG levels may indicate a HCG-secreting tumor of the lung, stomach, liver, or kidney, or a testicular or extragonadal germ cell tumor. An elevated HCG should prompt a search for one of these cancers with a detailed PE, a radiograph of the chest, and a computed tomographic scan of the abdomen.
References
1. Braunstein GD. Gynecomastia. N Engl J Med 1993;328:490–495.
2. Frantz AG, Wilson JD. Disorders of breasts in men. In: Wilson JD, Foster DW, eds. Williams textbook of endocrinology, 9th ed. Philadelphia: WB Saunders; 1998:885–900.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Gynecomastia:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
In true gynecomastia, a ridge of glandular tissue is palpable symmetrically beneath the areola. Gynecomastia must be distinguished from breast cancer, which is an eccentric firm mass with fixation, overlying skin dimpling, or nipple retraction, and regional adenopathy. Gynecomastia may be unilateral in one-third of cases, and it may be tender or painful.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Breast Mass/Discharge:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
Breast Mass: Breast lumps should be approached with a high index of suspicion for breast cancer, as approximately 20% of solitary or dominant breast masses are breast cancers. The physical examination is an important part of the diagnostic “triple test,” which includes mammography and fine needle aspiration cytology. When all three are positive, 99.4% have breast cancer. When all three tests suggest a benign lesion, only 0.7% have breast cancer.
Screening clinical breast examination detects approximately 50% of breast cancers. There is some but not total overlap with mammography; about 10% of screen-detected cancers are detected by physical examination and missed by mammography, while about 40% are detected by mammography and missed by physical examination. Techniques which increase the sensitivity of the examination include flattening of the breast against the chest wall (arm overhead), circular motions using the pads of the fingers, and spending greater time with the examination.
Cyclical pain and tenderness are usually due to fibrocystic disease. Although breast cancer can present with pain, it is often atypical and there is usually no tenderness. Characteristics of pain with alternative diagnoses include the following: heavy or full of milk (fibrocystic), sharp and radiating (radiculitis), itching, burning, drawing (duct ectasia), burning and stinging (mastodynia), sore, bruised, stabbing (trauma), throbbing (infectious), aching, and locally tender (costochondritis). Benign cysts are more prominent premenstrually and become smaller during the follicular phase of the menstrual cycle. Palpation characteristics suggestive of cancer include a mass that is firm, has indistinct borders, and has attachments to the skin or deep fascia. Dimpling of the skin, retraction of the nipple, bloody discharge from the nipple, and axillary nodal enlargement are all important clues to breast cancer.
Breast Discharge: Galactorrhea occurs when high levels of prolactin act upon a breast primed by estrogen and progesterone. Therefore, it is extremely rare in men unless there is a feminizing state. Milky discharge can usually be visually differentiated from a serous or bloody discharge. If confirmation is needed, microscopic examination for oval fat bodies (or use of Sudan stain) can be performed.
Bloody discharge is due to an ductal carcinoma (in situ or invasive) in one third of patients, a bleeding intraductal papilloma in another third, and fibrocystic breasts with an intraductal component (e.g. ductal ectasia, intraductal hyperplasia) in the remainder. All require further evaluation. When expressed by exam, discharge coming from one duct is more worrisome than discharge from multiple ducts. Bilateral multiductal discharge that is guaiac negative is usually benign regardless of color (milky, brown, green, yellow, blue, or clear), and due to an endocrine or physiologic process.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Gynecomastia:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Focus the physical examination on the breasts, testicles, and penis. As you examine the breasts, note any asymmetry, dimpling, abnormal pigmentation, or ulceration. Observe the testicles for size and symmetry. Then palpate them to detect nodules, tenderness, or unusual consistency. Look for normal penile development after puberty, and note hypospadias.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Breast nodule:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Perform a thorough breast examination. Pay special attention to the upper outer quadrant of each breast, where one-half of the ductal tissue is located. This is the most common site of malignant breast tumors.
Carefully palpate a suspected breast nodule, noting its location, shape, size, consistency, mobility, and delineation. Does the nodule feel soft, rubbery, and elastic or hard? Is it mobile, slipping away from your fingers as you palpate it, or firmly fixed to adjacent tissue? Does the nodule seem to limit the mobility of the entire breast? Note the nodule’s delineation. Are the borders clearly defined or indefinite? Does the area feel more like a hardness or diffuse induration than a nodule with definite borders?
Do you feel one nodule or several small ones? Is the shape round, oval, lobular, or irregular? Inspect and palpate the skin over the nodule for warmth, redness, and edema. Palpate the lymph nodes of the breast and axilla for enlargement.
Observe the contour of the breasts, looking for asymmetry and irregularities. Be alert for signs of retraction, such as skin dimpling and nipple deviation, retraction, or flattening. (To exaggerate dimpling, have your patient raise her arms over her head or press her hands against her hips.) Gently pull the breast skin toward the clavicle. Is dimpling evident? Mold the breast skin and again observe the area for dimpling.
Be alert for a nipple discharge that’s spontaneous, unilateral, and nonmilky (serous, bloody, or purulent). Be careful not to confuse it with the grayish discharge that can be elicited from the nipples of a woman who has been pregnant.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Breast Enlargement:
Diagnostic Approach
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
Historyand physical exam are diagnostic in many cases of breast enlargement.Important features are gender, ageof onset, history of drug ingestion, signs of infection, whetherphysical and sexual development are normal, stage of sexual development,and presence of breast mass. Girls
Before puberty,except for the newborn, premature thelarche and precocious puberty aremost common causes of breast enlargement.Girls with unilateral subareolar massesin early puberty usually have normal enlarging breast bud, and excisionalbiopsy should be avoided.In pubertal girl suspected of havingfibrocystic disease, clinical observation for 3 menstrual cyclesis appropriate.Nature of discrete palpable mass (solidvs cystic) can be determined by U/S. Needle aspirationcan be considered if mass persists.Palpable mass that cannot be delineatedby imaging should be followed and excisional biopsy should be considered. Boys
Before puberty,breast enlargement is rare.In obese boys, breasts seem to be enlargedbut no breast tissue is palpable.In pubertal boys, most common causeof breast enlargement is physiologic.Body habitus and testicular size shouldbe noted. If testes are small and serum concentrations of FSH andLH are elevated, diagnosis is almost certainly Klinefelter syndrome.Chromosomal karyotype confirms diagnosis.Drugs, chronic liver disease, and neoplasmsare rare causes of breast enlargement in boys during childhood andadolescence.
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Scrotal Enlargement:
Diagnostic Approach
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
Cause ofscrotal enlargement often can be determined clinically based onhistory and physical exam. Age of child, type of presentation (acuteor chronic, unilateral or bilateral), and presence of scrotal ortesticular pain or testicular enlargement are distinguishing featuresuseful in diagnosis.Torsion of testis, torsion of appendixtestis, and epididymitis often can be distinguished clinically earlyin clinical course. With progression of disease process, this maynot be possible. If diagnosis is uncertain, U/S with colorflow Doppler should be performed. Surgical exploration is indicatedwhenever there is high suspicion of torsion of testis.Transillumination can help distinguishsolid or cystic lesions, but incarcerated inguinal hernia also cantransilluminate.U/S can determine whethermass is testicular or nontesticular and can distinguish solid from cysticlesions.Nontesticular cystic lesions are usuallybenign and can be managed according to specific diagnosis. Testicularmass is assumed to be malignant tumor until proven otherwise.
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Gynecomastia:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Begin the history by asking the patient when he first noticed his breast enlargement. How old was he at the time? Since then, have his breasts gotten progressively larger, smaller, or stayed the same? Does he also have breast tenderness or discharge? Have him describe the discharge, if any. Ask him if he's ever had his nipples pierced. If so, were there any complications due to the piercings? Next, take a thorough drug history, including prescription, over-the-counter, herbal, and street drugs. Then explore associated signs and symptoms, such as testicular mass or pain, loss of libido, decreased sexual potency, and loss of chest, axillary, or facial hair.
Focus the physical examination on the breasts, testicles, and penis. As you examine the breasts, note asymmetry, dimpling, abnormal pigmentation, or ulceration. Observe the testicles for size and symmetry. Then palpate them to detect nodules, tenderness, or unusual consistency. Look for normal penile development after puberty, and note hypospadias.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Breast nodule [Breast lump]:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If the patient reports a lump, ask her how and when she discovered it. Does the size and tenderness of the lump vary with her menstrual cycle? Has the lump changed since she first noticed it? Has she noticed other breast signs, such as a change in breast shape, size, or contour; a discharge; or nipple changes?
Is she breast-feeding? Does she have fever, chills, fatigue, or other flulike signs or symptoms? Ask her to describe any pain or tenderness associated with the lump. Is the pain in one breast only? Has she sustained recent trauma to the breast?
Explore the patient's medical and family history for factors that increase her risk of breast cancer. These include having a mother or sister with breast cancer or having a history of cancer, especially cancer in the other breast. Other risk factors include nulliparity and a first pregnancy after age 30.
Next, perform a thorough breast examination. Pay special attention to the upper outer quadrant of each breast, where one-half of the ductal tissue is located. This is the most common site of malignant breast tumors.
Carefully palpate a suspected breast nodule, noting its location, shape, size, consistency, mobility, and delineation. Does the nodule feel soft, rubbery, and elastic or hard? Is it mobile, slipping away from your fingers as you palpate it, or firmly fixed to adjacent tissue? Does the nodule seem to limit the mobility of the entire breast? Note the nodule's delineation. Are the borders clearly defined or indefinite? Does the area feel more like a hardness or diffuse induration than a nodule with definite borders?
Do you feel one nodule or several small ones? Is the shape round, oval, lobular, or irregular? Inspect and palpate the skin over the nodule for warmth, redness, and edema. Palpate the lymph nodes of the breast and axilla for enlargement.
Observe the contour of the breasts, looking for asymmetry and irregularities. Be alert for signs of retraction, such as skin dimpling and nipple deviation, retraction, or flattening. (To exaggerate dimpling, have your patient raise her arms over her head or press her hands against her hips.) Gently pull the breast skin toward the clavicle. Is dimpling evident? Mold the breast skin and again observe the area for dimpling.
Be alert for a nipple discharge that's spontaneous, unilateral, and nonmilky (for example, serous, bloody, or purulent). Be careful not to confuse it with the grayish discharge that can be elicited from the nipples of a woman who has been pregnant.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Anthracyclines are becoming an increasingly important part of adjuvant therapy for breast cancer, with new data demonstrating its significant...
Anthracycline-based therapy is often recommended following surgery for breast cancer to reduce the risk of recurrence. This strategy has proved...
Certain breast cancers mean different things. Learn what tests can determine the type of breast cancer you have, and how this information can affect...
There are many options for treating breast cancer, including surgery, hormonal treatments, radiation and chemotherapy. All of these treatments have...
See full list of 29 related videos
» Next page: Diagnosis of Gynecomastia
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
