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Aim: New onset gynaecomastia is a relatively common present ation to breast surgical services. The main aim of clinical and radiological evaluation is to exclude the presence of concurrent breast cancer. There exists much variability in the clinical assessment of male patients presenting with new onset gynaecomastia. Materials and Methods:In the presented pilot study, all the male patients presenting with new onset gynaecomastia to our department over a period of two years were studied.Results: Fifty three patients presented with new onset gynaecomastia during the study period. Clinical examination allied with ultrasonography confirmed benign breast disease in 50 patients with only three patient requiring breast biopsy to exclude malignancy. We detail the efficacy of utilising clinical examination in conjunction with ultrasonography to evaluate new onset gynaecomastia. Conclusion:We show that clinical examination used in conjunction with ultrasonography is both highly sensitive and specific for detecting male breast cancer in patients presenting with new onset gynaecomastia.

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Drug-induced pancreatitis is uncommon, and is estimated to account for between 0.1% and 5% of cases. Tamoxifen is commonly used in the management of oestrogen receptor-positive breast cancer. We present a rare case of tamoxifen-related hyperlipidaemia resulting in repeated episodes of pancreatitis, which, to the best of our knowledge, has only been documented a few times in the literature. A 36-year-old woman with familial hypertriglyceridaemia presented with recurrent episodes of abdominal pain, modest increases in serum amylase levels and normal liver function tests. The patient had recently been diagnosed with breast carcinoma and was managed with wide local excision (WLE), adjuvant radiotherapy and tamoxifen. On each admission, the patient's symptoms were confirmed either biochemically and/or radiologically. Analysis of the case led to a diagnosis of precipitation of familial hypertriglyceridaemia from tamoxifen use resulting in pancreatitis. Management was altered with tamoxifen cessation and initiation of second-line hormonal therapy. Tamoxifen use needs consideration, especially in those with familial hyperlipidaemia.

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