Surgery During Florid Phase?

[fguss01]

Hello Doctors,

I have either idiopathic or drug induced gyne which started to develop after a short course of domperidone.

I have been off all drugs for a long time now, hormones are stable with low normal test and high normal E2. Energy levels good and libido OK.

My Gyne is growing slowly and  has been  for a year now, Tamoxifen slowed it but killed my libido due to high SHBG caused by the Tamox. I am now at the point where I need to buy new shirts and certain T-shirts cannot be worn (thin fabric).

I know that no-one can tell me when the Gyne will stop growing or how big it will get, mine is painful daily (usually late afternoon and early evening)which is pretty unpleasant.

Is surgery ever indicated during the florid phase? If so what is likely to happen afterwards?

I am happy to wait for the gyne to stabilise but not if it takes 5 years, by which time I will have female sized breasts and problems with stretched skin etc.

Not looking for a silver bullet , just an opinion based on experience.

Many thanks.

[Litlriki]

It's difficult to know when the "florid" phase has subsided, since some patients have pain long after they have had any stimulation of growth of their breast tissue.  Also, growth can be related to increases in body fat, rather than increased proliferation of glandular tissue, and that's not really something that can be determined easily from a description, photos, and often even physical exam.  With that in mind, if "a long time" is more than six months to a year, and your numbers are normal, I would think you'd be fine to proceed with surgery, and you may find that your pain resolves or improves, and that you don't have a problem with recurrence.  Alternatively, for patients who are experiencing similar findings with ongoing use of medication, steroids or pro-hormones, I would not be so enthusiastic about proceeding, since the stimulus remains.  Obviously, there's no way to guarantee that you're in the clear.

Rick Silverman

[fguss01]

Doctor Silverman,
Many thanks for the considered reply - it is good to hear that  surgery may be a possibility in the near future.

My gyne is still growing but very slowly - I am sure it's not fat as my diet and exercise regime are both pretty stable - also there is the pain....

I go back to see the endo in Sept by which time I will have been off any hormone influencers for around six months (we previously tried Adex to no avail - removed the pain but caused terrible arthralgia).

Thanks again for the reply, you have given me hope!

Best regards.