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OVERVIEW

What is gynecomastia?

Gynecomastia is a condition in which firm breast gland tissue forms in males. The breast tissue is usually less than 3-4 cm (3-4 cm 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.

Could the breast lump be cancer?

Probably not. Breast cancer is very rare in males. Lumps caused by cancer are usually not underneath the nipple—where breast tissue from gynecomastia grows. Breast cancer feels different than the breast tissue of gynecomastia. Breast cancer may also cause dimpling of the skin or a bloody discharge from the nipple. Your healthcare provider will probably be able to tell whether your breast lump is cancer. If there is any question that you have cancer, you will need to have a mammogram and a biopsy.

CAUSES & RISK FACTORS

What causes gynecomastia?

Gynecomastia is usually caused by changes in hormones at birth, puberty or as part of aging. Gynecomastia may be caused by changes in the balance of 2 hormones: estrogen and testosterone. In adults, the balance of hormones may be affected by:

• Aging
• Disease, such as:
  • Tumors of the adrenal glands, testes or pituitary glands
  • Hyperthyroidism
  • Hypogonadism
  • Kidney disease
  • Liver failure
• Medicines, such as:
  • AIDS medicines
  • Anti-anxiety medicines
  • Antibiotics
  • Chemotherapy
  • Some medicines for cardiovascular disease
  • Tricyclic antidepressants
  • Ulcer medicines
• Illegal drugs, such as:
  • Anabolic steroids
  • Amphetamines
  • Heroin
• Marijuana
• Alcohol

DIAGNOSIS & TESTS

Are tests needed to find the cause of gynecomastia?

Sometimes tests are needed, and sometimes they’re not. Your healthcare provider 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 healthcare provider will also ask you about any illnesses you may have had in the past, 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 healthcare provider learns from your history and physical examination.

Gynecomastia is common in teenage boys. As many as 65% of 14-year-old boys have gynecomastia. If you are a teenager, you probably will not need tests. Your breast enlargement will probably go away on its own in 2 or 3 years. However, younger boys and adult men who have gynecomastia may need to have some tests. In these cases, it is possible that some kind of disease may be causing the problem.

TREATMENT

How is gynecomastia treated?

In most cases, no treatment is needed. Your healthcare provider 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.

If gynecomastia is caused by a disease or a tumor, treatment is necessary. If gynecomastia is caused by a disease, the disease itself will need to be treated.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• Is there any treatment that will help?
• How long will my treatment last?
• How long will it be before the breasts go away?
• Is there anything I can do to make my breasts stop hurting?
• Is there anything I can do to feel normal until the breasts go away?
• Do I have a disease that is causing the breasts?