Gynecomastia is an over-development of breast tissue in men. It results when there is swelling of the tissue either due to too much estrogen or too little testosterone. The glandular tissue of the breast swells and forms a breast bud. It can be fairly common during puberty and in kids and teens, it tends to go away within several months. In adult men, however, it can be indicative of an underlying medical problem or result from certain medications. Some use of alcohol or certain drugs, such as marijuana, methamphetamine, and heroin can also cause gynecomastia.
There are many medical conditions that can cause, usually through alterations in testosterone production, that can cause gynecomastia. These include:
- Hypogonadism
- Klinefelter Syndrome
- Pituitary insufficiency
- Pituitary tumors
- Hyperthyroidism
- Aging
- Kidney failure
- Liver failure and cirrhosis
- Malnutrition
- Tumors of the testes or adrenal glands
While gynecomastia can be quite distressing to men, it can also prove deadly when it is misdiagnosed instead of breast cancer. Despite the fact that over 400 men die every year in the US, there are many people who are still unaware that breast cancer can even happen in men. Because of this, many men delay going to a medical doctor when they develop a lump. In fact, a breast tumor in a man is often misdiagnosed as gynecomastia. It is very important to keep this fact in mind and to understand that the earlier breast cancer is diagnosed, the better chance there is to cure it.
There are several risk factors for breast cancer in men. One of these would be age. The average age of breast cancer in men is 68 years. However, even young men can develop breast cancer. About 1 out of every 5 men have a close relative (either male or female) who have had breast cancer. Certain genetic mutations, such as BRACA 1 or BRACA 2, raise the risk for breast cancer in men. Less commonly, CHEK2 and PTEN mutations are also found to be risk factors. Among men with Klinefelter Syndrome, about 1 out of every 100 will develop breast cancer at some point in their lives. Additional risk factors include, previous radiation exposure, alcohol, liver disease, estrogen treatment, obesity, testicular disorders, and certain occupations.
It is very important that when a man discovers a breast lump, it should be examined by a doctor even if a patient doesn’t have any other risk factors. Further diagnostic tests include diagnostic mammograms and ultrasounds. Unfortunately, the healthcare community has done such a good job recognizing the fact that breast cancer is not a disease exclusive to women. Many mammogram facilities are “women” healthcare centers. It is very stigmatizing for men to go for medical care in these places. But, no one should put off a diagnosis because of this. And healthcare workers at all levels need to do a better job making male patients feel comfortable when they need these medical services.
Increasingly, obesity is being linked to many different types of cancers. Trying to adapt a healthy lifestyle has never been more important. Since patients who are clinically obese, have higher circulating levels of estrogen and higher levels of estrogen have been linked to breast cancer, it is clear to see why this is a risk factors. There have been studies done which demonstrated that reducing weight can lead to a reduction in breast cancer risk. Additionally, excess estrogen can lead to gynecomastia complicating the clinical picture, as well as being a distressing problem for men. If you do have gynecomastia, there are work-outs that can reduce it. A healthy lifestyle is helpful in decreasing the risk of both gynecomastia and male breast cancer.
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