What lifestyle modifications or pharmacological treatments are recommended for managing gynaecomastia in primary care?

Lifestyle Modifications: There are no specific lifestyle modifications detailed in the provided guidelines for managing gynecomastia in primary care. General advice may include reassurance and monitoring, but no direct lifestyle interventions are recommended.

Pharmacological Treatments: For people starting long-term bicalutamide monotherapy (longer than 6 months), prophylactic radiotherapy to both breast buds within the first month of treatment is recommended to prevent gynecomastia. This involves a single fraction of 8 Gy using orthovoltage or electron beam radiotherapy. If radiotherapy does not prevent gynecomastia, consider weekly tamoxifen treatment.

These recommendations are primarily from prostate cancer management guidelines where gynecomastia is a known adverse effect of hormone therapy.