What are the causes of enlarged male breast tissue. How is gynecomastia diagnosed and treated. Can hormonal imbalances lead to breast tissue growth in men. What surgical procedures are available for male breast reduction. Are there non-surgical treatments for gynecomastia.

Understanding Gynecomastia: Causes and Symptoms

Gynecomastia is a condition characterized by the enlargement of male breast tissue. This common medical issue results from an imbalance between the hormones testosterone and estrogen. While both males and females possess breast glands, they are typically not noticeable in males. However, when gynecomastia occurs, these glands become swollen and unusually large.

The condition can affect males of all ages, including:

• Newborns
• Adolescents during puberty
• Older adults

It’s important to note that gynecomastia involves the growth of actual breast tissue, not just an accumulation of fat. This distinction is crucial, as it means that exercise or weight loss will not reduce the enlarged breast tissue.

Key Symptoms of Gynecomastia

The primary symptoms of gynecomastia include:

• Swelling of breast gland tissue
• Tenderness in one or both breasts
• Uneven development of breast lumps
• Possible nipple discharge

Is gynecomastia a serious condition? In most cases, gynecomastia is not a severe medical problem. However, persistent swelling, pain, or nipple discharge should prompt a consultation with a healthcare professional to rule out more serious underlying conditions.

Hormonal Imbalances and Gynecomastia Development

The primary cause of gynecomastia is an imbalance between testosterone and estrogen. While both hormones are present in males and females, their ratios differ significantly between the sexes. Estrogen promotes breast tissue growth, while testosterone typically inhibits this process.

Several factors can contribute to this hormonal imbalance:

• Natural hormonal fluctuations during development
• Age-related changes in hormone production
• Certain medications and herbal products
• Medical conditions affecting hormone levels

Do all cases of gynecomastia require treatment? Many instances of gynecomastia, especially in newborns and adolescents, resolve on their own without intervention. The condition typically disappears within 6 months to 2-3 years. However, if an underlying medical condition is present, treatment may be necessary.

Medications and Substances That Can Trigger Gynecomastia

Various medications and substances have been linked to the development of gynecomastia. These include:

1. Anabolic steroids
2. Certain antibiotics
3. Ulcer medications
4. Chemotherapy drugs
5. Tricyclic antidepressants
6. Anti-anxiety medications like diazepam
7. Some HIV medications, including efavirenz
8. Anti-androgens
9. Certain heart disease drugs, such as calcium channel blockers

Additionally, some herbal products have been associated with gynecomastia. It’s crucial for individuals to discuss all medications and supplements they’re taking with their healthcare provider if they notice breast tissue enlargement.

Diagnostic Approaches for Gynecomastia

When a patient presents with symptoms of gynecomastia, healthcare providers typically follow a comprehensive diagnostic approach:

1. Medical history review: The doctor will inquire about symptoms, medical background, drug history, and possibly family history.
2. Physical examination: This includes an assessment of breast tissue and may extend to the genitals and abdomen.
3. Hormone level testing: Blood tests may be ordered to check for hormonal imbalances.
4. Imaging studies: In some cases, mammograms or ultrasounds might be necessary.
5. Biopsy: If the lump is unusually large, tender, or one-sided, a biopsy may be performed to rule out breast cancer.

How can doctors differentiate gynecomastia from other breast conditions? Additional tests may be conducted to eliminate other potential causes, such as cysts, abscesses, benign tumors, mastitis, hematomas, or metastatic cancer.

Non-Surgical Treatment Options for Gynecomastia

While many cases of gynecomastia resolve without intervention, some situations may call for treatment. Non-surgical options include:

Medication Adjustments

If the condition is linked to a particular medication, switching to an alternative drug may be recommended. For short-term medication use, the gynecomastia may be temporary and resolve once the drug is discontinued.

Hormone Therapy

Several medications can be used to address hormonal imbalances:

• Tamoxifen: This drug blocks the action of estrogen in the body and can reduce breast pain and enlargement.
• Aromatase inhibitors: Typically used for breast and ovarian cancer treatment, these drugs may also prevent or treat gynecomastia.
• Testosterone replacement: For older males with low testosterone levels, this therapy can help address gynecomastia.

Are there any side effects associated with hormone therapy for gynecomastia? As with any medication, these treatments can have potential side effects, and their use should be carefully monitored by a healthcare professional.

Surgical Interventions for Gynecomastia

In cases where non-surgical treatments are ineffective or the gynecomastia is severe, surgical options may be considered. The two primary surgical approaches are:

Liposuction

This procedure involves removing excess fatty tissue through a small tube inserted via an incision. Liposuction is particularly effective for cases where fat accumulation is the primary issue.

Excision

This technique involves cutting out excess glandular tissue with a scalpel. It’s often necessary when significant glandular tissue needs to be removed. The procedure typically leaves a scar around the edge of the nipple.

In cases requiring substantial tissue and skin removal, a larger incision and resulting scar may be necessary.

What is the recovery process like after gynecomastia surgery? Post-surgery, patients can expect:

• Bruising and swelling of the chest
• The need to wear an elastic pressure garment to reduce swelling
• A recovery period of about 6 weeks before returning to normal activities

While complications from gynecomastia surgery are rare, potential risks include insufficient tissue removal, uneven chest contour, reduced nipple sensation, and the formation of blood clots requiring drainage.

Pseudogynecomastia: A Related Condition

It’s important to distinguish gynecomastia from a related condition called pseudogynecomastia. While gynecomastia involves the growth of actual breast tissue, pseudogynecomastia is characterized by fat accumulation in the breast area, often associated with being overweight or obese.

How can one differentiate between gynecomastia and pseudogynecomastia? The key distinction lies in the type of tissue involved:

• Gynecomastia: Involves firm, dense glandular tissue
• Pseudogynecomastia: Primarily consists of softer fatty tissue

Understanding this difference is crucial for determining the most appropriate treatment approach. While gynecomastia may require hormonal interventions or surgery, pseudogynecomastia can often be addressed through weight loss and lifestyle changes.

Living with Gynecomastia: Psychological and Social Impacts

Beyond the physical symptoms, gynecomastia can have significant psychological and social impacts on those affected. Many men with this condition experience:

• Embarrassment or self-consciousness about their appearance
• Decreased self-esteem
• Anxiety in social situations, particularly those involving shirtless activities
• Avoidance of intimate relationships

How can individuals cope with the emotional challenges of gynecomastia? Coping strategies may include:

1. Seeking support from friends, family, or support groups
2. Consulting with a mental health professional
3. Focusing on overall health and well-being
4. Exploring treatment options with healthcare providers

It’s essential for those affected by gynecomastia to understand that it’s a common and treatable condition. Open communication with healthcare providers can help address both the physical and emotional aspects of living with gynecomastia.

Preventive Measures and Lifestyle Considerations

While not all cases of gynecomastia can be prevented, certain lifestyle choices may help reduce the risk or manage the condition:

• Maintaining a healthy weight
• Avoiding anabolic steroids and illicit drugs
• Limiting alcohol consumption
• Being cautious with soy products and herbal supplements, as some may have estrogenic effects
• Discussing medication side effects with healthcare providers

Can dietary changes help manage gynecomastia? While diet alone cannot cure gynecomastia, a balanced diet rich in fruits, vegetables, lean proteins, and whole grains can support overall hormonal health. Some studies suggest that certain foods may help balance hormone levels:

• Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts)
• Foods high in zinc (oysters, beef, pumpkin seeds)
• Fatty fish rich in omega-3 fatty acids

It’s important to note that dietary changes should be part of a comprehensive approach to managing gynecomastia, developed in consultation with healthcare professionals.

Future Directions in Gynecomastia Research and Treatment

As medical understanding of gynecomastia continues to evolve, researchers are exploring new avenues for diagnosis, treatment, and prevention. Some areas of ongoing research include:

• Genetic factors contributing to gynecomastia susceptibility
• Novel hormone-modulating therapies with fewer side effects
• Improved surgical techniques for minimal scarring and faster recovery
• The role of endocrine-disrupting chemicals in the environment

What potential breakthroughs might we see in gynecomastia treatment? While it’s difficult to predict specific advancements, some promising areas include:

1. Personalized medicine approaches based on genetic profiles
2. Non-invasive treatments using targeted energy therapies
3. Advanced imaging techniques for early detection and monitoring
4. Combination therapies that address both hormonal imbalances and tissue growth

As research progresses, individuals affected by gynecomastia can look forward to potentially more effective and less invasive treatment options in the future.

Surgery, treatment, causes, and symptoms

Gynecomastia is when male breast tissue swells and becomes unusually large. It is a common condition that stems from a change in balance between the hormones testosterone and estrogen.

Males and females have breast glands, but they are not usually noticeable in males.

Breast gland enlargement may affect males of all ages, including newborns, during puberty, and older adults. Gynecomastia is the result of additional breast tissue rather than fat. Exercising or losing weight will not reduce the breast tissue in gynecomastia.

Pseudogynecomastia is a separate condition where fat builds up in the breasts, possibly due to a person being overweight or having obesity.

The breast consists of firm and dense glandular tissue and softer fatty tissue.

The ratio of glandular to fatty tissue in breasts varies between individuals. A male with gynecomastia may have too much of both types of tissue.

Liposuction can remove excess fatty tissue. It involves inserting a small tube through an incision. Excision involves cutting out tissue with a scalpel to remove excess glandular tissue. This will normally leave a scar around the edge of the nipple.

If a major reduction in tissue and skin is necessary, the incision and the scar will be larger.

After surgery, the chest will be bruised and swollen, and the person may have to wear an elastic pressure garment to reduce the swelling.

It will normally take about 6 weeks for people to return to a normal routine. Complications from surgery are rare. They include insufficient breast tissue removal, uneven chest contour, and reduced sensation of one or both nipples.

Excision may carry a risk of a blood clot forming, which may require draining.

Gynecomastia typically resolves without treatment between 6 months to 2–3 years. However, if there is an underlying condition, it may need treatment.

If the condition stems from a medication, the person may need to switch to a different drug. If the individual is using the medication for a short time, the condition will be temporary.

Treatment is rare but can include breast reduction surgery or hormone therapy to block estrogen.

Medications for the treatment of gynecomastia

Tamoxifen is a drug that blocks the action of the female hormone estrogen in the body. It is typically a treatment for breast cancer, but it can also reduce breast pain and breast enlargement symptoms in males.

Aromatase inhibitors are typical treatments for breast and ovarian cancer in post-menopausal people, but they could also prevent or treat gynecomastia.

Testosterone replacement can treat gynecomastia in older males with low testosterone levels.

Several factors can cause gynecomastia.

Gynecomastia can stem from an imbalance between the sex hormones testosterone and estrogen. Estrogen makes breast tissue grow, while testosterone stops estrogen from making breast tissue grow.

While both males and females have testosterone and estrogen, testosterone is typically higher in males and estrogen higher in females. Newborn and young boys may develop gynecomastia as their hormones fluctuate during development. However, it usually resolves on its own.

Swollen breasts can occur again in males approaching older age. Older men produce less testosterone and have higher body fat than younger men, which can increase estrogen levels.

Some males will develop the condition from herbal products or medications, such as:

• anabolic steroids
• antibiotics
• ulcer medications
• chemotherapy
• tricyclic antidepressants
• diazepam and other drugs for treating anxiety
• Some HIV medications, including efavirenz
• anti-androgens
• some heart disease drugs, including calcium channel blockers

Gynecomastia is not normally a serious problem.

Symptoms include swelling and tenderness in the breast gland tissue of one or both breasts. It may start as a lump or fatty tissue around a person’s nipples. In most cases, the lumps will develop unevenly.

If there is unusual and persistent swelling, pain, nipple discharge, or a combination of these, it is important for people to consult a physician.

The doctor will ask about a person’s symptoms, medical and drug history, and possibly family history. There will be a physical examination of the breast tissue, which may also extend to the genitals and abdomen.

If the cause appears to be a hormone imbalance, the doctor may suggest that the condition should resolve on its own without treatment.

If the lump is abnormally large, tender, or one-sided, the physician may order a biopsy or blood test to rule out breast cancer.

Further tests will seek to eliminate other causes, such as:

• cyst
• abscess or furuncle
• benign tumor such as lipoma or hamartoma
• mastitis, which is inflammation of breast tissue
• hematoma, a solid swelling of clotted blood
• metastasis, a cancer that has spread from elsewhere in the body
• fat necrosis or a lump resulting from damage to fatty breast tissue

The doctor may also order imaging tests that include:

• mammograms or breast ultrasounds
• chest X-rays
• MRI scans
• testicles ultrasounds

Gynecomastia is a condition that causes enlarged breast tissue. It can result from hormonal changes that promote breast tissue growth. Gynecomastia does not cause the accumulation of body fat and is unrelated to obesity.

A person who is overweight or with obesity will have fat around their body. This can result in enlarged breasts in men. However, this enlargement is due to fat rather than tissue growth, as in gynecomastia.

Cases of gynecomastia will typically resolve without the need for treatment. Newborns and young boys may experience symptoms decreasing over time and eventually ceasing.

In some cases, people may require treatment. This could involve liposuction or surgery. The treatments are typically safe and unrelated to long-term health risks.

Gynecomastia causes one or both breasts to grow in males due to enlarged or overdeveloped breast tissue. The condition could be due to hormonal changes or following certain medications. Symptoms will typically resolve without treatment.

Treatments are available for gynecomastia, such as liposuction. However, they are usually unnecessary in most people.

What Is Breast Cancer in Men?

Breast cancer occurs mainly in women, but men can get it, too. Many people do not realize that men have breast tissue and that they can develop breast cancer. Cells in nearly any part of the body can become cancer and can spread to other areas.

Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. 

To learn more about how cancers start and spread, see What Is Cancer?

Male breast tissue

Until puberty (on average around age 9 or 10), young boys and girls have a small amount of breast tissue consisting of a few ducts located under the nipple and areola (area around the nipple). At puberty, a girl’s ovaries make female hormones, causing breast ducts to grow and lobules to form at the ends of ducts. Even after puberty, boys and men normally have low levels of female hormones, and breast tissue doesn’t grow much. Men’s breast tissue has ducts, but only a few if any lobules.

Where breast cancer starts

Breast cancers can start from different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers). Men have these ducts and glands, too, even though they aren’t normally functional. There are also types of breast cancer that start in other types of breast cells, but these are less common.

A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers.

Although many types of breast cancer can cause a lump in the breast, not all do. There are other symptoms of breast cancer you should watch for and report to a health care provider.

It’s also important to understand that most breast lumps are benign and not cancer (malignant). Benign breast tumors are abnormal growths, but they do not spread outside of the breast and they are not life threatening. Any breast lump or change needs to be checked by a health care provider to determine whether it is benign or malignant (cancer) and whether it might impact your future cancer risk.

How breast cancer spreads

Breast cancer can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body. 

The lymph system is a network of lymph (or lymphatic) vessels found throughout the body. The lymph vessels carry lymph fluid and connect lymph nodes. Lymph nodes are small, bean-shaped collections of immune system cells. Lymph vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast. Lymph contains tissue fluid and waste products, as well as immune system cells. Breast cancer cells can enter lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:

• Lymph nodes under the arm (axillary nodes)
• Lymph nodes around the collar bone (supraclavicular [above the collar bone] and infraclavicular [below the collar bone] lymph nodes)
• Lymph nodes inside the chest near the breast bone (internal mammary lymph nodes)

If the cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have also traveled through the lymph system and spread (metastasized) to other parts of your body. The more lymph nodes with breast cancer cells, the more likely it is that the cancer may be found in other organs. Because of this, finding cancer in one or more lymph nodes often affects your treatment plan. Usually, surgery to remove one or more lymph nodes will be needed to know whether the cancer has spread.

Still, not all men with cancer cells in their lymph nodes develop metastases to other areas, and some men can have no cancer cells in their lymph nodes and later develop metastases.

Benign breast conditions

Men can also have some benign (not cancerous) breast disorders.

Gynecomastia

Gynecomastia is the most common male breast disorder. It is not a tumor but rather an increase in the amount of a man’s breast tissue. Usually, men have too little breast tissue to be felt or noticed. Gynecomastia can appear as a button-like or disk-like growth under the nipple and areola (the dark circle around the nipple), which can be felt and sometimes seen. Some men have more severe gynecomastia and they may appear to have small breasts. Although gynecomastia is much more common than breast cancer in men, both can be felt as a growth under the nipple, which is why it’s important to have any such lumps checked by your doctor.

Gynecomastia is common among teenage boys because the balance of hormones in the body changes during adolescence. It is also common in older men due to changes in their hormone balance.

In rare cases, gynecomastia occurs because tumors or diseases of certain endocrine (hormone-producing) glands cause a man’s body to make more estrogen (the main female hormone). Men’s glands normally make some estrogen, but not enough to cause breast growth. Diseases of the liver, which is an important organ in male and female hormone metabolism, can change a man’s hormone balance and lead to gynecomastia. Obesity (being extremely overweight) can also cause higher levels of estrogen in men.

Some medicines can cause gynecomastia. These include some drugs used to treat ulcers and heartburn, high blood pressure, heart failure, and psychiatric conditions. Men with gynecomastia should ask their doctors if any medicines they are taking might be causing this condition.

Klinefelter syndrome, a rare genetic condition, can lead to gynecomastia as well as increase a man’s risk of developing breast cancer. This condition is discussed further in Risk Factors for Breast Cancer in Men.

Benign breast tumors

There are many types of benign breast tumors (abnormal lumps or masses of tissue), such as papillomas and fibroadenomas. Benign tumors do not spread outside the breast and are not life threatening. Benign breast tumors are common in women but are very rare in men.

Types of Breast Cancer in Men

The most common types of breast cancer are ductal carcinoma in situ, invasive ductal carcinoma, and invasive lobular carcinoma.

Most breast cancers are carcinomas. In fact, breast cancers are often a type of carcinoma called adenocarcinoma, which starts in cells that make glands (glandular tissue). Breast adenocarcinomas start in the ducts (the milk ducts) or the lobules (milk-producing glands).

There are other, less common, types of breast cancers, too, such as sarcomas, phyllodes, Paget’s disease and angiosarcomas which start in the cells of the muscle, fat, or connective tissue.

Sometimes a single breast tumor can be a combination of different types. And in some very rare types of breast cancer, the cancer cells may not form a lump or tumor at all.

When a biopsy is done to find out the specific type of breast cancer, the pathologist also will say if the cancer has spread in to the surrounding tissues. The name of the breast cancer type will change depending on the extent of the cancer.

• In situ breast cancers have not spread.
• Invasive or infiltrating cancers have spread (invaded) into the surrounding breast tissue.

These general kinds of breast cancer can be further described with the terms outlined above.

Ductal carcinoma in situ

Ductal carcinoma in situ (DCIS; also known as intraductal carcinoma) is considered non-invasive or pre-invasive breast cancer. In DCIS (also known as intraductal carcinoma), cells that lined the ducts have changed to look like cancer cells. The difference between DCIS and invasive cancer is that the cells have not spread (invaded) through the walls of the ducts into the surrounding tissue of the breast (or spread outside the breast). DCIS is considered a pre-cancer because some cases can go on to become invasive cancers. Right now, though, there is no good way to know for certain which cases will go on to become invasive cancers and which ones won’t. DCIS accounts for about 1 in 10 cases of breast cancer in men. It is almost always curable with surgery.

Lobular carcinoma in situ

Lobular carcinoma in situ (LCIS) may also be called lobular neoplasia. In LCIS, cells that look like cancer cells are growing in the lobules of the milk-producing glands of the breast, but they haven’t grown through the wall of the lobules. LCIS is not a true pre-invasive cancer because it does not turn into an invasive cancer if left untreated, but it is linked to an increased risk of invasive cancer in both breasts. LCIS is rarely, if ever seen in men.

Infiltrating (or invasive) ductal carcinoma

This is the most common type of breast cancer. Invasive (or infiltrating) ductal carcinoma (IDC) starts in a milk duct of the breast, breaks through the wall of the duct, and grows into the fatty tissue of the breast. Once it breaks through the wall of the duct, it has the potential to spread to other parts of the body. Invasive (or infiltrating) ductal carcinoma (IDC) starts in a milk duct of the breast, breaks through the wall of the duct, and grows into the fatty tissue of the breast. At this point, it may be able to spread (metastasize) to other parts of the body through the lymphatic system and bloodstream. At least 8 out of 10 male breast cancers are IDCs (alone or mixed with other types of invasive or in situ breast cancer). Because the male breast is much smaller than the female breast, all male breast cancers start relatively close to the nipple, so they are more likely to spread to the nipple. This is different from Paget disease as described below.

Infiltrating (or invasive) lobular carcinoma

Invasive lobular carcinoma (ILC) starts in the milk-producing glands (lobules). Like IDC, it can spread to other parts of the breast and body. ILC is very rare in men, accounting for only about 2% of male breast cancers. This is because men do not usually have much lobular (glandular) breast tissue.

Paget disease of the nipple

This type of breast cancer starts in the breast ducts and spreads to the nipple. It may also spread to the areola (the dark circle around the nipple). The skin of the nipple usually appears crusted, scaly, and red, with areas of itching, oozing, burning, or bleeding. There may also be an underlying lump in the breast.

Paget disease may be associated with DCIS or with infiltrating ductal carcinoma. It is rare and accounts for about 1-3% of female breast cancers and a higher percentage (5%) of male breast cancers.

Inflammatory breast cancer

Inflammatory breast cancer is an aggressive, but rare type of breast cancer. It makes the breast swollen, red, warm and tender rather than forming a lump. It can be mistaken for an infection of the breast. This is very rare in men. See Inflammatory Breast Cancer for more information.

Special types of invasive breast carcinoma

There are some special types of breast cancer that are sub-types of invasive carcinoma. They are much less common than the breast cancers named above.

Some of these may have a better or worse prognosis than standard infiltrating ductal carcinoma.

• Adenoid cystic (or adenocystic) carcinoma
• Low-grade adenosquamous carcinoma (this is a type of metaplastic carcinoma)
• Medullary carcinoma
• Mucinous (or colloid) carcinoma
• Papillary carcinoma
• Tubular carcinoma
• Metaplastic carcinoma (including spindle cell and squamous, except low grade adenosquamous carcinoma)
• Micropapillary carcinoma
• Mixed carcinoma (has features of both invasive ductal and lobular)

In general, these sub-types are still treated like standard infiltrating carcinoma.

We determine gynecomastia in men by symptoms, find out the causes and perform treatment at the Constanta Clinic

Gynecomastia in men is a disease based on one- or two-sided enlargement of the mammary glands. The disease can progress both against the background of hormonal disorders, and in relatively healthy men who do not have problems with hormones, but are obese.

There are two forms of gynecomastia in men: physiological and pathological. The physiological variant of breast tissue enlargement occurs in newborns and adolescents, as well as in the elderly, in whose bodies the level of testosterone decreases sharply, and female sex hormones, estrogens, begin to predominate. Gynecomastia in the neonatal period occurs due to the influence of mother’s hormones that enter the child in utero.

At puberty, many adolescents suffer from bilateral breast enlargement, which usually resolves on its own without any treatment. The problem is associated with changes in the hormonal background, namely, with an increase in the amount of estrogens and their predominance over male sex hormones.

In most cases of gynecomastia in men, there is a bilateral increase in the volume of the mammary glands. At the Constanta Clinic, you can seek qualified medical assistance, make an appointment with experienced specialists who will conduct a comprehensive diagnosis and establish the true causes of the development of the disease. Doctors will develop individual tactics for the treatment of gynecomastia, in accordance with the diagnostic data obtained and the general well-being of the patient. Read more about the treatment of gynecomastia in men in our Clinic.

Main causes of gynecomastia in men

Normally, the mammary glands in men and adolescents are underdeveloped, formed by a small amount of glandular tissue. With obesity, adipose tissue begins to predominate. Breast volume is due to the influence of female sex hormones – estrogens, as well as prolactin – a pituitary hormone. When, for various reasons, the androgenic index decreases and the amount of estrogen increases, there is an excessive growth of the mammary glands in men according to the female type with a predominance of glandular cells.

Unlike physiological gynecomastia in men, which is considered a passing phenomenon and in most cases is eliminated on its own, the pathological form of the disease is often associated with organic pathology and serious internal disorders. It is often necessary to involve highly specialized specialists in treatment: therapists, endocrinologists, oncologists, and surgeons.

The main causes of true pathological gynecomastia:

• a similar condition is typical for neoplasms of the pituitary gland and testicles, primary hypogonadism, prostate adenoma and other hormonally active tumors;
• increase in the amount of prolactin – increased secretion is associated with neoplasms of the pituitary gland and a lack of thyroid hormones;
• treatment with drugs that stimulate the synthesis of estrogens and prolactin;
• taking steroids;
• infectious and inflammatory processes, immunodeficiency states;
• chronic intoxication;
• overweight;
• diseases of the liver and kidneys;
• diseases that are accompanied by metabolic disorders and dysfunction of the endocrine glands.

Drug dependence has an extremely unfavorable effect on the state of the liver and mammary glands. Potent drugs, especially of the opiate group, increase the synthesis of prolactin, disrupt the functional abilities of the liver, disrupt the course of metabolic reactions, change the state of the gonads and reduce the amount of testosterone produced. All this increases the synthesis of female sex hormones and leads to the development of gynecomastia.

Main symptoms of gynecomastia

The main symptom of gynecomastia is the overgrowth of the mammary glands. As a rule, in men, an increase in predominantly glandular tissue is observed. With an increase in the amount of adipose tissue in the chest area, specialists diagnose pseudogynecomastia. In addition to the appearance of mammary glands that are not characteristic of the male constitution, other signs of the disease may be present:

• abnormal discharge from the nipples;
• pain in the chest;
• nipple sensitivity;
• induration of breast tissue;
• Discomfort when rubbing the chest against clothing.

If abnormal growth of the mammary glands is detected, it is necessary to contact specialists as soon as possible. Only doctors, having wide diagnostic and therapeutic capabilities, can make an accurate diagnosis and choose an effective treatment regimen for gynecomastia in a man. Specialists are especially wary of a unilateral enlargement of the mammary gland, which can be observed with the development of a malignant pathology, as well as the appearance of bloody discharge from the nipple and suspicious seals. Sometimes, against the background of male gynecomastia, the axillary lymph nodes increase, which can also be considered an alarming symptom that requires a doctor’s consultation and a detailed examination of the breast and surrounding tissues.

Gynecomastia examination

To make a preliminary diagnosis, it is enough for the doctor to conduct a standard examination and palpation of the breast tissue and adjacent lymph nodes. But an accurate diagnosis of gynecomastia is carried out only on the basis of the results of modern research. Ultrasound is considered the main method of diagnosis. Specialists conduct an ultrasound examination of the mammary glands, organs of the scrotum, axillary lymph nodes.

Laboratory studies are actively used, which include the determination of the level of testosterone, hCG, estradiol and prolactin, as well as other hormones (if indicated). If you suspect the development of a malignant tumor, a biopsy of the mammary glands is prescribed. Additionally, magnetic resonance imaging and computed tomography of internal organs are used.

In the CONSTANTA Clinic, patients have access to many types of modern diagnostic and laboratory tests, which allow them to obtain the most reliable information about the patient’s condition and the work of all his internal organs, including the endocrine glands. We provide professional assistance to men with gynecomastia and provide both symptomatic and surgical treatment.

Gynecomastia is a serious disease that requires an integrated approach and the participation of experienced professionals. Delays in contacting the Clinic or the use of dubious home treatments for gynecomastia in men can lead to the development of serious complications. Our specialists have at their disposal modern therapeutic and surgical methods to combat this disease, which are highly effective and safe. You can discuss treatment options with your doctor. Do not hesitate to ask the specialist questions that interest you. The doctors of the Constanta Clinic are focused on respecting the interests of their patients and the maximum concentration of professional forces on solving the problems of each applicant.

Gynecomastia and steroids

Taking anabolic steroids often leads to the development of male gynecomastia. Steroid hormones contribute to the excessive formation of female sex hormones, in particular – estradiol. As a result of long-term use of anabolic steroids by athletes, there is a deposition of adipose tissue according to the female type and a bilateral increase in the mammary glands. Athletes taking steroids should take care of the prevention of gynecomastia in advance. It consists in taking special drugs that block estrogen receptors. Ideally, an athlete’s career should be built without the use of steroid drugs, which have a detrimental effect not only on hormonal status, but also on the entire male body.

Gynecomastia due to endocrine pathologies

Endocrine diseases often cause the development of gynecomastia in men. Various pituitary tumors lead to hyperprolactinemic hypogonadism. In this state, the synthesis of gonadotropins, testicular function are disturbed, spermatogenesis may decrease. As a result, men note a decrease in potency and the disappearance of libido. Adolescents in this state do not have a pronounced expression of secondary sexual characteristics.

Hyperprolactinemia is observed with the growth of prolactinoma, as well as with other pituitary adenomas and the presence of hormonally inactive adenomas. In childhood, gynecomastia can occur with hyperthyroidism. Thyroid hormones increase estradiol levels. To get rid of gynecomastia provoked by hyperthyroidism, it is first necessary to treat the underlying disease.

Gynecomastia and genetic pathologies

Genetic anomalies often underlie the development of gynecomastia. Most often, excessive growth of breast tissue is diagnosed in men with Klinefelter syndrome, in which an extra X chromosome is detected in the cells. These men are more sensitive to estrogen. With this disease, hyperprolactinemia occurs, which also enhances the manifestations of gynecomastia.

In Klinefelter’s syndrome, puberty may occur on time, but puberty is often delayed. Patients are predominately tall and have abnormal physiques, in which the lower torso is significantly larger than the upper. The size of the testicles is reduced. With chromosomal abnormalities, the treatment of gynecomastia is predominantly surgical. The nodular form of the disease requires constant medical supervision and a biopsy after surgery or at the diagnostic stage.

Reifenstein’s syndrome occurs with increased estrogen synthesis and the development of gynecomastia. Symptoms of the disease appear, as a rule, during adolescence, when hormonal changes in the body occur. At the same time, specialists identify signs of underdevelopment of the genital organs. Such patients require hormone replacement therapy with an individual selection of the dosage of funds.

True hermaphroditism also occurs with symptoms of gynecomastia. The patient usually learns about his problem at the beginning of the puberty, when the active growth of the mammary glands begins and other signs of the formation of a figure according to the female type appear.

Gynecomastia and liver disease

Some pathologies of the liver can lead to the development of gynecomastia. Important metabolic processes take place in the liver tissues. This organ is responsible for the metabolism of steroids. Therefore, in case of violation of its work, with the development of hepatitis, alcoholic cirrhosis, the risk of growth of the mammary glands in men increases. Specific renal enzymes lead to the destruction of prolactin and gonadotropins, as well as to a slowdown in the release of body tissues from metabolic products. All this often leads to an increase in the level of prolactin and estrogen, causing the progression of gynecomastia.

Gynecomastia and neoplasms of the mammary glands

Tumors in the mammary glands are often mistaken for true gynecomastia. The process is most often unilateral, but sometimes neoplasms cover two mammary glands at once. To the touch, the tumor has a dense texture, usually soldered to neighboring tissues and is distinguished by fuzzy contours. With neoplasms of the breast in men, sanious discharge from the nipples may appear, sometimes the lymph nodes in the armpit are noticeably enlarged.

When a neoplasm is detected, specialists refer the patient to mammography, ultrasound, MRI and prescribe a biopsy, the results of which can determine the nature of the tumor and make appropriate predictions for the future.

Iatrogenic Gynecomastia

Iatrogenic gynecomastia occurs while taking certain medications. The risk group includes patients who undergo hormonal treatment with estrogens, as well as other hormones (gonadotropins, glucocorticoids). Against the background of hypogonadism, specialists often prescribe testosterone, which is toxic to the liver and can cause signs of temporary gynecomastia. Cardiac glycosides have a similar effect, stimulating the active production of steroids and disrupting the functional abilities of the testicles.

Drug-induced gynecomastia is most often a reversible process that can be stopped after the drug is discontinued, which provoked excessive growth of the mammary glands. But it is necessary to stop the drugs as soon as possible. If you do not pay attention to the appearance of gynecomastia on the background of drug therapy for 6-12 months or more, irreversible fibrotic processes will begin to occur in the tissues of the mammary gland. The advanced form of the disease is mainly subject to surgical treatment.

Principles of treatment of gynecomastia

Treatment of gynecomastia in men can be therapeutic and surgical. The physiological form of the disease in adolescents and newborns usually disappears spontaneously and does not require the use of specific therapy. According to indications, specialists can carry out hormonal correction with drugs that reduce the level of female hormones. But any drugs used to treat gynecomastia in men are prescribed only by qualified specialists who are familiar with your clinical case. Self-administration of medications, without studying the hormonal status and diagnostic results, can lead to adverse health effects and an increase in the symptoms of the underlying disease.

Conservative therapy for gynecomastia is the appointment of hormonal agents containing testosterone. Such drugs are effective in the initial period of the development of the disease, in the first months, when cicatricial changes and other complications that require surgery have not yet occurred.

A severe form of gynecomastia is difficult to treat conservatively. It is extremely important to seek medical help in a timely manner, when it is possible to achieve high efficiency of drug therapy. If the doctor recommends surgical treatment, do not refuse it. Today, men with gynecomastia get the opportunity to undergo minimally invasive surgical interventions, after which there are no rough keloid scars in the mammary glands. It is these operations that are carried out at the Constanta Clinic. Excess tissue is removed through the subareolar approach or using an endoscopic method with access from the armpit. In the second case, absolutely no scars remain on the skin of the chest.

With false gynecomastia, liposuction is indicated. The surgeon sucks out excess fat through small punctures in the skin or removes it in a classic surgical way. The operation is performed under general or local anesthesia, depending on the patient’s condition and his wishes.

Preparation for surgical treatment of gynecomastia in men

No complex preparatory activities are carried out. The patient undergoes a comprehensive examination, which allows assessing his state of health and choosing the appropriate tactics for surgical intervention. Based on the diagnostic data, the doctor makes predictions for the future and selects the correct treatment regimen that prevents the development of complications, both during the operation and in the postoperative period.

The operation is carried out on an empty stomach. The doctor will tell you in detail about the features of the surgical stage and the recovery period. You must strictly follow the doctor’s prescriptions, in case of any questions or deterioration of health, it is recommended to contact your doctor without delay.

Recovery period after surgical treatment of gynecomastia

In most cases, surgical treatment of gynecomastia in men proceeds without complications. As a rule, long-term hospitalization is not required. The patient is discharged home, giving detailed recommendations on the rules of conduct and prevention of complications.

Gynecomastia in men can develop with many endocrine and non-endocrine pathologies, so treatment should first of all be directed to the cause of the increase in estrogen levels and excessive growth of breast tissue. Medical tactics should be strictly individual. It is necessary to determine the factors that provoke the development of the disease in order to eliminate their adverse effect on the body of a man. Then both medical and surgical treatment will be highly effective, and the risk of recurrence of the disease can be minimized.

If you have any questions or sign up for a consultation with a specialist, please call:
(4852) 37-00-85
Daily from 8:00 to 20:00

Breast cancer in men – symptoms, treatment methods, prevention and diagnosis

Oncology is so unpredictable that even specialists are not always ready to find answers to many people’s questions. Surprisingly, some types of cancer appear in those who are less susceptible to this pathology. What is it about? Let’s take a closer look.

Can men get breast cancer? This question is often asked by a strong half of humanity. Male oncology of the breast is found everywhere, although less often than female.

Breast cancer in men is a malignant neoplasm that develops against the background of a genetic predisposition, hormonal imbalance, and an unhealthy lifestyle.

Thanks to modern methods of treatment, male breast cancer is successfully treated today. However, for this it is necessary to consult a doctor in time and undergo a comprehensive examination of the body.

Classification of breast cancer in men

Whether breast cancer in men can be progressive and progressing to the development of metastases is a question that requires separate consideration. Doctors answer that the development of the disease in the male body is similar to the progression of the tumor in the female body. According to the signs of origin and structure, breast cancer in men is divided into the following types:

• infiltrative ductal carcinoma. This type of tumor occurs in 80% of cases. In the process of pathology development, cancer cells grow in fatty tissue, which leads to the formation of metastases;
• non-invasive type of ductal carcinoma. Tumor growth begins with the cells of the excretory ducts of the mammary gland. This breast cancer in men is considered the safest. Metastasis in this case is rare, and the likelihood of relapse after recovery is reduced to a minimum;
• lobular infiltrative cancer. Tumor growth begins in the lobules of the mammary gland, and then moves to fatty tissue. As the cancer progresses, it metastasizes to nearby lymph nodes, the spine, or the lungs;
• Paget’s cancer. A type of breast cancer in men that begins in the excretory ducts of the gland. As the pathology develops, it passes to the areola of the chest and the nearby skin;
• edematous-infiltrative cancer. In the process of development of the pathology in the patient, the mammary glands swell and deform. With this type of oncology, a man experiences retraction of the skin on his chest, loss of elasticity and shape of the glands.

Modern diagnostic procedures help determine the type of breast cancer in men. In our clinic, a complete examination of the male body is carried out.

Symptoms and signs of breast cancer in men

In the early stages of development, symptoms of breast cancer in men may be mild. Most often, the representatives of the stronger sex perceive their banal overstrain or stretching.

Is it possible for men to have breast cancer if there is a lump near the nipple – one of the most popular questions. Neoplasms that appear are not always indicative of oncology. You need to sound the alarm when the following signs of breast cancer in men appear:

• nipple retraction;
• the appearance of swelling in the area of ​​the areola;
• swelling in the chest area;
• appearance of lemon peel;
• peeling of the nipple.

In later stages, the patient may find enlarged axillary and supraclavicular lymph nodes, weeping sores with purulent expression.

Diagnosis of male breast cancer in the cancer center 10, they carry out high-class diagnostics of the body when symptoms of breast cancer are detected in men.

Ultrasound of the mammary glands

The procedure helps to detect the presence of a tumor in the body, determine its size and structure, assess the state of tissues, the presence of an inflammatory process. Ultrasound diagnostics is safe for the patient’s body.

Computed tomography

Computed tomography is a study that allows you to illuminate the connective tissue and internal organs. Detailing the obtained images helps to determine the presence of a tumor and metastases in the lymph nodes and internal organs.

MRI

The procedure helps to determine the presence of tumors in the mammary glands in men. In comparison with other diagnostic studies, this method shows a more accurate result.

Biopsy

The procedure is performed under a local anesthetic. A biopsy involves taking tissue from the breast of a sick person for pathomorphological examination.

Breast cancer tumor markers

Tumor markers are substances that appear in the patient’s body during the development of cancer. Oncomarker molecules are synthesized by the formed tumor in response to the formation of cancer pathology. These substances are used to detect malignant neoplasms in the human body.

Treatment of breast cancer in men at the Cancer Center

Sofia Oncology Center uses such modern methods of breast cancer treatment as chemotherapy, fractional radiotherapy and surgical therapy.

Chemotherapy

Chemotherapy occurs with the help of cytostatic drugs that affect the ability to mitoses in cancer cells. This leads to a decrease in the tumor and the prevention of the development of metastases. Chemotherapy is fraught with side effects.

Radiation therapy

Radiation therapy is used to treat cancer cells. Due to this, there is a decrease in the boundaries of the neoplasm and the prevention of the formation of metastases. Radiation therapy is usually used for advanced breast cancer in men.

Surgery

Surgical treatment is considered one of the most radical methods of therapy. In the process, the mammary gland, nipple and affected lymph nodes are removed.

Other treatments

At the discretion of the doctor, combined treatments, as well as large-fraction, fractionated radiation and hormonal therapy can be used.

Survival prognosis

The prognosis for timely treatment of breast cancer in men is considered favorable. The probability of recovery is kept at around 85%. If pathology is detected at later stages of development due to metastases and complications, the survival rate drops to 40%. In advanced cases, death occurs.

How to make an appointment with a specialist at the Sofia Cancer Center

The Sofia Cancer Center is located in Moscow near the Mayakovskaya metro station.