Gynecomastia

To the Editor: Dr. Carlson's excellent review of gynecomastia in the October 2 issue neglected one important clinical situation. Patients taking estrogen for advanced adenocarcinoma of the prostate obviously cannot be treated with androgens or antiestrogens if they have symptomatic gynecomastia. Orthovoltage irradiation of the male breast (e.g., 1500 rads given in three treatments) has been 90 per cent effective in preventing symptomatic gynecomastia when given before the initiation of estrogen therapy.* Such treatment is without known acute or late side effects, but it seems to be ineffective once painful gynecomastia is present. No extract is available for articles shorter than 400 words.