Gynecomastia

Gynecomastia is the growth of breast gland tissue in males. It is different from fat deposits in the chest; it involves actual glandular tissue, which may feel like a firm, rubbery lump under the nipple and can be tender. It is common and often temporary during infancy and puberty, and it can also appear in older men.

The usual cause is an imbalance between estrogen and testosterone, or a rise in the hormone prolactin. Causes include normal hormonal changes, certain medical conditions such as liver or thyroid disease, anabolic steroids, some prostate cancer drugs, and a range of medications. Persistent gynecomastia may not go away on its own, and some patients need surgery, such as a mastectomy, to remove the tissue.

Gynecomastia is best known in litigation because of Risperdal (risperidone), an atypical antipsychotic. Risperdal can raise prolactin levels. The current Risperdal prescribing information reports that in clinical trials of 1,885 children and adolescents, gynecomastia occurred in 2.3% of patients treated with Risperdal. Thousands of young men and their families sued Janssen, a Johnson and Johnson company, alleging the company downplayed the risk and promoted the drug for children before it was approved for them. The company denied wrongdoing. Several cases went to trial in Philadelphia with large verdicts, and many others were resolved through confidential settlements.

If gynecomastia developed while taking a medication, ask a doctor whether a hormone test is appropriate, and keep prescription records and any surgical records. Our guide on class actions versus mass torts explains how drug injury claims are handled.