Dr. MJ Bazos MD,
Patient Handout
Gynecomastia: When
Breast Form in Males
What is gynecomastia?
Gynecomastia is a condition in which firm breast
tissue forms in males. The breast tissue is usually less than 1-1/2 inches
across and is located directly under the nipple. Gynecomastia may be present on
one side or on both sides. This condition may make the breast tender.
Some men and boys have fat on their chests that
makes it look like they have breasts. This condition is called
pseudogynecomastia (false gynecomastia). It is not the same thing as
gynecomastia.
What causes gynecomastia?
Gynecomastia is usually caused by changes in
hormones at puberty or as part of aging. Hormones are chemicals produced by the
glands of the body, such as the thyroid gland, the testes and the ovaries.
Gynecomastia may be caused by changes in the balance of 2 hormones, estrogen and
testosterone. In rare cases, gynecomastia is caused by prescription drugs,
over-the-counter medicines, illegal drugs, tumors or disease.
Are tests needed to find the cause
of gynecomastia?
Sometimes tests are needed, and sometimes
they're not. Your doctor will ask you questions about your symptoms, such as how
long you've had the breast tissue, and whether or not the area is tender. Your
doctor will also ask you about the illnesses you have had in the past, the
medicines you take, and other matters relating to your health. Then you will
have a physical examination.
Whether you need tests depends on your age and
what your doctor learns from your history and physical examination. If you are a
teenager, you probably will not need more tests, since gynecomastia is very
common in the teen years. As many as 65% of 14-year-old boys have gynecomastia.
The breast enlargement usually goes away on its own in 2 or 3 years. However,
boys and adult men with gynecomastia may need to have some tests, because
it is more possible in young boys and men that some kind of disease is causing
the problem.
How is gynecomastia treated?
In most cases, no treatment is needed. Your
doctor will probably want to check the size of your breast tissue every few
months. In 90% of teenage boys, gynecomastia goes away in less than 3 years.
Sometimes the problem can be solved if you stop
taking a medicine that is causing gynecomastia or stop using an illegal drug
that is causing the problem.
Occasionally, medicines may be used to treat
gynecomastia, especially if tenderness is a problem. The medicine will make the
extra breast tissue go away. Rarely, surgery may be necessary to remove the
extra breast tissue.
Treatment is necessary if gynecomastia is caused
by a disease or a tumor. If it is due to a disease, the disease itself will need
to be treated.
Could the breast lump be cancer?
Probably not. Breast cancer is very rare in
males. Your doctor will probably be able to tell whether the lump is cancer.
Lumps caused by cancer are usually not underneath the nipple, but breast tissue
from gynecomastia grows in this area. Breast cancer feels different than the
breast tissue of gynecomastia. With cancer, there sometimes is dimpling of the
skin or a bloody discharge from the nipple. If there is any question that you
have cancer, you will need to have a mammogram and a biopsy.