Which of the following statement(s) is/are associated with gynecomastia?

b. The standard surgical treatment is subcutaneous mastectomy

Gynecomastia is defined as palpable enlargement of the male breast. Pathologic causes of estrogen excess or testosterone deficiency are associated with gynecomastia. In many cases, no cause is found. Clinically significant gynecomastia has been associated with the use of a number or drugs including cimetidine, digoxin, spironolactone and tricyclic antidepressants. The use of marijuana has also been associated with gynecomastia. Drug-related gynecomastia is often unilateral or unequal between the two breasts, and discontinuation of the offending drug does not always lead to resolution of the condition. A formal endocrine evaluation is not indicated for gynecomastia unless some other sign of hormonal imbalance is found on routine evaluation. The standard surgical treatment of gynecomastia consists of subcutaneous mastectomy performed under local anesthesia. The presence of gynecomastia is not associated with the subsequent development of cancer, yet protracted hyperestrogenemic states, which are associated with gynecomastia are linked to breast cancer development.