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Gynecomastia in men

Gynecomastia in men

Gynecomastia is the enlargement of one or both breasts in an adult male. Most commonly, both breasts are enlarged and the tissue feels somewhat nodular. Enlargement of only one breast needs to be looked at very carefully to rule out cancer, especially if the enlargement is firm and off to the side of the nipple.

What causes gynecomastia?

  • It may be seen in men being treated for cancer with female hormones
  • It may be seen in men with liver disease — especially cirrhosis
  • It may be caused by a number of medications (see medications that cause gynecomastia)
  • Marijuana abuse can cause breast enlargement
  • Tumors of the testicle may cause gynecomastia
  • It may be caused by hormonal imbalances including decreased testosterone
  • In men who are obese, enlargement of the breast may simply be fatty tissue in this area
  • In older men, cancer of the breast can occur and must be ruled out

Examination for gynecomastia:

  • Careful history and physical exam including discussion of medications
  • Testicular exam to rule out masses
  • Examination of the breast and arm pit
  • Mammograms or sonograms may be recommended
  • A needle biopsy may be recommended if cancer is suspected
  • An open biopsy may be recommended to remove the lump and rule out cancer

Treatment:

  • Cancer must be ruled out
  • Medications that are causing the gynecomastia may be changed if possible
  • Illnesses that can cause gynecomastia are ruled out or treated if present
  • Close observation of the gynecomastia is reasonable if the above is ruled out
  • If there is serious concern about the appearance, then a small area of gynecomastia may simply be removed.
  • A larger area of gynecomastia may require a cosmetic operation which could include removal and tightening of the skin as well as removal of the gynecomastia. Typically a plastic surgeon performs this type of operation