Assessing adolescent gynecomastia: The role of shear wave ultrasound elastography

Objectives: Pubertal gynecomastia (PG) is defined as benign proliferation of male breast tissue. Ultrasonography is frequently used for follow-up of symptomatic gynecomastia. Shear wave elastography (SWE) is an auxiliary tool for the diagnosis of breast disorders. Our aim is to evaluate SWE properties of breast tissue in PG. Methods: Fifty consecutive adolescents, aged 10-18 with a diagnosis of gynecomastia were prospectively included in the study. Following clinical and laboratory evaluation, participants underwent B-mode ultrasound and classified as nodular, dendritic, and diffuse pattern. SWE and hormonal values of all groups were recorded. Then, statistical analysis was performed. Results: Briefly, 92 breasts (43 left and 49 right; 42 bilateral and 8 unilateral) were included in the analyses. There were no significant differences in clinical parameters including age, BMI-SDS, estradiol (E2), testosterone (T), and E-2/T levels within groups (p > 0.05). Breast volume and SWE levels were significantly different in all groups (p < 0.05). SWE values were significantly lower for those of dendritic pattern than in nodular pattern (p < 0.05). ROC analysis revealed that for the best the cut-off value of 13.7 kPa, area under the curve value was 0.922 with 84% sensitivity and 87% specificity. Conclusions: SWE values were significantly lower in patients with dendritic gynecomastia than those with nodular gynecomastia. Knowledge of the SWE values for the initial diagnosis and follow-up values could help avoid unnecessary interventions.