There is a disease that often leaves men speechless, and that is gynecomastia, a medical condition referring to abnormal breast development in boys or adult men.
Currently, it is believed that male breast development is caused by an increase in estrogen secretion, a decrease in testosterone/estrogen ratio, or an increased sensitivity to estrogen. Gynecomastia can be classified into physiological, pathological, drug-induced, and idiopathic types based on its causes, with physiological being the most common. Physiological breast development in male infants and adolescent boys usually resolves naturally.
For males with continued breast development, common predisposing factors include:
Continued breast development during puberty, medications, unpredictable abnormal growth, liver cirrhosis or malnutrition, hypogonadism, testicular tumors, hyperthyroidism, chronic kidney insufficiency, and more.
During examination, patients may exhibit unilateral or bilateral breast hypertrophy and swelling; firm disc-like nodules can be palpated deep to the nipple; tenderness on palpation; relatively firm texture; and in some cases, squeezing the nipple may produce white discharge.
Of course, there is also pseudo-gynecomastia, more common in obese individuals; breast appearance resembling female breasts; local breast swelling due to localized fat accumulation; and no significant glandular development in the breasts.
Treatment for Gynecomastia
Whether treatment is necessary for gynecomastia depends on the underlying cause, duration of symptoms, severity, and impact on the patient.
Conservative observational treatment: Typically, it will resolve spontaneously within 1-3 weeks, occasionally persisting for several months or even years. If a patient’s breasts enlarge rapidly or local pain is significant, medical evaluation and treatment are required. Treating the underlying diseases that may have triggered the breast abnormality or discontinuing relevant medications can often lead to spontaneous resolution of early breast development abnormalities.
Surgical treatment: If breast development has persisted for over a year and medical treatment is ineffective, surgery may be necessary. Adult patients with the following conditions are recommended for surgical treatment: breast abnormality persisting for 12-24 months; ineffective medical treatment; breast swelling and pain symptoms; suspicion of malignancy; aesthetic concerns causing psychological distress and desire for surgery.
Prior to selecting a specific surgical method, plastic surgeons should consider the patient’s aesthetic preferences. The surgical correction methods for male breast development include excision, liposuction, and liposuction combined with excision. Combining mastectomy, liposuction, and chest contouring procedures can yield superior results.
Men Can Also Get Breast Cancer
Breast cancer is not exclusive to women; men can also develop breast cancer. However, male breast cancer is a rare disease, accounting for less than 1% of all breast cancer cases.
Male breast cancer patients generally tend to be older, have long disease durations, late-stage discoveries, and poor prognoses. Hence, male patients with gynecomastia, especially elderly patients, should be vigilant about the possibility of malignant lesions and seek timely medical examination.
The risk of male breast cancer increases with age, especially in men over 50 years old. If first-degree relatives (such as parents or siblings) have a history of breast cancer, the risk of male breast cancer may also increase. Certain genetic mutations, such as mutations in the BRCA1 and BRCA2 genes, may raise the risk of male breast cancer. Elevated levels of estrogen in men, such as in hypogonadism, long-term use of estrogen replacement therapy, or exposure to exogenous estrogen, can also elevate the risk of male breast cancer. Obesity is associated with an increased risk of developing breast cancer. Men who have undergone chest radiation therapy in the past may have an increased risk of developing breast cancer. Certain occupations may involve exposure to carcinogens like chemicals or radioactive materials, which can also raise the risk of male breast cancer.
The symptoms of male breast cancer are similar to those of female breast cancer, including breast lumps, nipple discharge, and changes in breast skin. Compared to female breast cancer, male breast cancer is often diagnosed at a late stage because men typically pay less attention to changes in their breasts.
Diagnosing male breast cancer typically involves breast X-rays, breast ultrasound, fine-needle aspiration biopsy, and other tests. Doctors also consider factors such as age, family history, hormone levels, etc.
The treatment for male breast cancer is similar to that for female breast cancer, including surgery, radiation therapy, chemotherapy, hormonal therapy, etc. Surgery is the primary treatment for male breast cancer, usually involving mastectomy or breast-conserving surgery. Radiation and chemotherapy can help kill remaining cancer cells, hormonal therapy can lower hormone levels and reduce the risk of recurrence.
The prognosis of male breast cancer is similar to that of female breast cancer, depending on factors such as tumor size, lymph node involvement, tumor grade, etc. Early diagnosis and treatment can improve prognosis.
In conclusion, men should also pay attention to breast health, undergo regular check-ups, especially those with a family history or other risk factors. If any abnormalities are detected, prompt medical attention is advised.
Reviewed by Wang Fei
