Gynecomastia

All males have a small amount of breast tissue beneath their nipples. Occasionally, this breast tissue will grow and cause enlargement of the breast on one or both sides. This is called gynecomastia. This most commonly occurs in the teen years, but can also occur at younger or older ages. Most often it is believed to be related to hormone changes in the body. There is usually no danger to this condition. Gynecomastia does not turn into cancer or predispose and individual to getting cancer.

Cancer of the breast in males is very unusual. It presents with a non-tender lump off to the side of the areola (rather than symmetrically located directly underneath the areola). It may be en stuck to surrounding tissue not be easily moved by the fingers. The lump is usually hard (rather than firm and rubbery).

Causes of gynecomastia

• Puberal: This kind occurs during the teen years, and usually resolves without treatment in 1-2 years. This accounts for about 25% of cases.

• Idiopathic: Idiopathic means that no actual reason for the gynecomastia is found. This accounts for 25% of cases.

• Medication related: There are various medications that can cause gynecomastia. This accounts for about 15% of cases. Usually the gynecomastia resolves when these medications are stopped, but this may take a month or longer. Some of the more commonly used medications that can cause this are: Tagamet, Zantac, Prilosec, Digoxin, Various cardiac medications, Various hormone medications.

• Other causes: Liver disease, nutritional problems, kidney disease, lung disease, thyroid disease and other hormonal problems account for the rest of the cases. One of these conditions is a tumor of the testicle that produces hormones. This is a very rare situation and is often accompanied by a noticeable lump in the scrotum.

Treatment of Gynecomastia
Usually gynecomastia will resolve on its own. If the gynecomastia  is related to taking a medication, changing medications may speed resolution. 

In the teen years, we usually do not recommend surgical removal unless the enlargement remains for over two years because it will usually resolve by itself. If after two years it does not resolve,  surgical removal can be considered. Surgical treatment is indicated if the breast tissue is painful or cosmetically unacceptable.