I found only the abstract online. However, I have found other abstracts as well. The point is it is effective...but not for everyone. You may be one of those that require surgery. In either case, having had a small gynecomastia lump myself from puberty that enlarged around the age of 20, I had it removed. About 3 years later it grew back, and I had it removed again. About 4 years after that it grew back again and I went the tamoxifen route...I have been lump free and pain free since with no recurrence even after having been off tamoxifen for many months.