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Breast Disorders in Men

by Irvin H. Hirsch, MD

Breast disorders occur infrequently in men. Breast disorders include

  • Breast enlargement

  • Breast cancer

Breast enlargement in men

Breast enlargement in males is called either gynecomastia or pseudogynecomastia.

Gynecomastia is enlargement of the breast tissue itself, which consists of glands.

Pseudogynecomastia is the appearance of enlarged breast in overweight men. However, this enlargement is because of an increase in fat tissue around the breasts, not an enlargement of the gland tissue in the breast.

Gynecomastia sometimes occurs during infancy and puberty. The enlargement is usually normal and transient in puberty, lasting a few months to a few years. Breast enlargement also commonly takes place after age 50.

Did You Know...

  • Boys sometimes develop temporary breast enlargement during puberty.

In men, breast enlargement may be caused by

  • Certain disorders (including some liver disorders)

  • Certain drug therapies (including the use of female sex hormones and anabolic steroids and some drugs used to treat an enlarged prostate gland or prostate cancer)

  • Herbal products (such as lavender oils and tea tree oils in skin products)

  • Heavy use of marijuana, beer, alcohol, or heroin

Less commonly, male breast enlargement results from a hormonal imbalance, which can be caused by rare estrogen -producing tumors in the testes or adrenal glands.

One or both breasts may become enlarged. An enlarged breast may be tender. If tenderness is present, cancer is probably not the cause. Breast pain in men, as in women, is not usually a sign of cancer.

The doctor does a thorough interview and physical examination. Sometimes other tests such as blood tests or mammography are needed.

Generally, no specific treatment is needed. Breast enlargement often disappears on its own or after its cause is identified and treated. Surgical removal of excess breast tissue is effective but rarely necessary. Liposuction, a surgical technique that removes tissue through a suction tube inserted through a small incision, is the preferred surgical option and sometimes is followed by additional cosmetic surgery.

Breast cancer in men

Men can develop breast cancer, although 99% of all breast cancers develop in women. In the United States, about 2,360 men develop breast cancer each year, and about 430 die. Because male breast cancer is uncommon, it may not be suspected as a cause of symptoms. As a result, male breast cancer often progresses to an advanced stage before it is diagnosed. The prognosis is the same as that for a woman whose cancer is at the same stage.

As in women, breast cancer in men causes breast lumps that should be evaluated. Diagnostic techniques are the same as those used in women.

As in women, treatment options for breast cancer in men include surgery, radiation therapy, and chemotherapy. However, in men, conserving the breast after surgery is not a concern.

Estrogen makes some breast cancers grow. Estrogen is the main female sex hormone, but it is present in males in low amounts. If an examination of tissue samples shows that estrogen is making the cancer grow, estrogen is suppressed with drugs such as tamoxifen.

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  • NOLVADEX