This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
All of the following statements about Gynecomastia are TRUE, EXCEPT: 
Select and explain. 
A. It can be drug induced, B. It is seen in liver disease, C. Associated with an estrogen / testosterone imbalance, D. Subcutaneous mastectomy is the initial treatment of choice
D: Subcutaneous mastectomy is the initial treatment of choice
Answer: D: Subcutaneous mastectomy is the initial treatment of choice 
Explanation: Correction of the primary cause is the initial treatment of choice in gynecomastia. Indications for surgical treatment of gynecomastia includes: gynecomastia persisting for long duration, psychologic or cosmetic problems, continued growth, tenderness or suspicion of malignancy. Surgical treatment of choice in such cases includes simple liposuction with minimal glandular resection through a periareolar incision as necessary. Subcutaneous mastectomy is not the initial surgical approach. Ref: Harrison's Principles of Internal Medicine, 16th Edition. Page 2192; R Alagappan, Manual Of Practical Medicine, 3rd Edition, Page 602