When making any diagnosis, the doctor performs the so-called differential diagnostics, i.e. a process during which all other, apart from the suspected, causes of the disease present in a patient are excluded. In the case of enlargement of male breasts, the most common reason for this condition is gynecomastia, but it may also occur as a result of the development of a rare breast tumor in men. Both pathologies have numerous common features, but there are also some aspects that allow them to be distinguished.
Large breasts can be an advantage of a woman, in men, however, usually arouse reluctance and feelings of self-restraint. Enlargement of the breast glands can be a temporary, physiological phenomenon – this is the case, for example, in infants and adolescents in adolescence.
The most common cause of enlargement of male breasts is gynaecomastia – is it its true figure, associated with hypertrophy of mammary gland tissue, or the so-called pseudogynecomastia, which is caused by excess body fat in the body. The rare cause of the condition described is breast cancer – although in the vast majority of cases this disease affects women, it can also appear in men.
Similarities and differences: gynecomastia and breast cancer
Both hormones typical of women have an impact on the appearance of both pathologies: estrogens. In men’s bodies, these substances also arise, however, in normal conditions, they are less than the dominant in androgens. When hormone imbalances occur and the levels of female hormones begin to dominate over men, breast tissue cells can be stimulated to grow excessively.
The mechanism described above is responsible for the occurrence of gynecomastia and for breast cancer in men. Excess estrogens appear in the case of liver disease or the use of certain drugs (eg ketoconazole or antiandrogens used in the treatment of prostate diseases), it is also associated with aging processes.
Gynecomastia itself is not a life-threatening factor , it is different in breast cancer. So how can you distinguish between these two states? Cancer usually occurs only in one gland, in the surrounding skin can cause redness, ulceration and leakage of various types of content. A hard, irregular change is usually palpable. Gynecomastia, however, is characterized by a tendency to occupy both male breasts, does not cause any skin lesions, and touches the tissue of the normal gland with a touch. The mentioned features allow one of two diagnoses to be directed, however, certainty can only be obtained by performing a histopathological examination of breast tissue, eg taken during a biopsy.
The frequency of the described states is significantly different. Gynecomastia, according to medscape.com, is found in up to 6 out of 10 men aged 50-60. In turn, the risk that a man develops breast cancer during his life , according to the Seattleroundup.com, is around 0.1%.
There is a group of patients whose risk of developing breast cancer is increased and in these people the change in the dimensions of these structures should be of concern. This applies to men with Klinefelter syndrome, but also people with a positive history of breast cancer in the family. The cause of the multiple appearance of mammary tumor may be gene mutations, the most well-known in this case are those that include the BRCA1 and BRCA2 genes. The first defect increases the risk of breast cancer to 1%, having a second is even more dangerous, because it increases the risk of cancer development to 6%.