Breast Pain and Swelling in Young Men: When to Seek Help

Chest issues?

I am an 18-year-old male and have recently noticed pain and slight swelling in my right nipple when pressed, which has been ongoing for the past 4-5 months.
The left nipple does not have any issues.
I visited Taipei Mackay Memorial Hospital, and the doctor said there shouldn't be any major problems, possibly related to liver issues or excess female hormones.
He mentioned that if I wanted further evaluation, I could have blood tests done, but he also indicated that the blood tests would likely show no problems, so I did not proceed with the tests.
However, I am concerned about a potential misdiagnosis since this situation has persisted for 4-5 months.
Is this condition normal? Should I schedule another appointment for consultation? What further detailed examinations should I consider at the hospital?

Niming, 10~19 year old female. Ask Date: 2009/12/04

Dr. Lin Kecheng reply Surgery

Dear Mr.
Anonymous,
In young males, sudden chest swelling and pain can often be attributed to unintentional exposure to female hormones or liver dysfunction.
As stated by the physician at Mackay Memorial Hospital, there should not be any significant issues.
However, since the condition has persisted for 4-5 months and is causing you considerable distress, it would be advisable to undergo liver function tests at a hospital to determine if liver abnormalities are leading to elevated female hormone levels.
Alternatively, you could also visit a breast surgeon for an ultrasound examination to check for any abnormalities.
Wishing you good health,
Dr.
Lin Ke-Cheng

Reply Date: 2009/12/04

More Info

Breast pain and swelling in young men can be concerning, especially when symptoms persist for several months. In your case, you have been experiencing pain and slight swelling in your right nipple for the past 4-5 months, while the left side remains unaffected. It is understandable to feel anxious about your condition, particularly after receiving a diagnosis that may not fully address your concerns.

Firstly, it is important to note that breast pain in males, particularly during adolescence and young adulthood, is often related to a condition known as gynecomastia. This condition is characterized by the enlargement of breast tissue in males and can be caused by hormonal imbalances, particularly an increase in estrogen or a decrease in testosterone. Hormonal changes during puberty can lead to temporary gynecomastia, which usually resolves on its own. However, persistent symptoms warrant further investigation.

The physician you consulted suggested that your symptoms might be linked to liver function issues or hormonal imbalances. While these are valid considerations, it is crucial to ensure that other potential causes are ruled out. For instance, breast pain can also be associated with conditions such as mastitis, cysts, or even, though rare, male breast cancer. Although male breast cancer is uncommon, it is not impossible, especially if there are changes in the breast tissue or if there is a family history of breast cancer.

Given that your symptoms have persisted for several months, it would be advisable to seek a second opinion or return to your healthcare provider for further evaluation. A thorough examination by a healthcare professional, preferably a specialist in breast health or an endocrinologist, can provide more insight into your condition. They may recommend imaging studies, such as an ultrasound, to assess the breast tissue and check for any abnormalities. Additionally, blood tests can help evaluate hormone levels and liver function, which may provide clues to the underlying cause of your symptoms.

It is also important to communicate your concerns clearly to your healthcare provider. Expressing your fear of misdiagnosis and the impact of your symptoms on your daily life can help them understand the urgency of your situation. If you feel that your concerns are not being adequately addressed, do not hesitate to seek care from another provider or a specialized clinic.

In summary, while breast pain and swelling in young men can often be benign and related to hormonal changes, persistent symptoms should not be ignored. Seeking further evaluation and possibly additional tests can help ensure that any underlying issues are identified and managed appropriately. Your health and peace of mind are paramount, and it is always better to err on the side of caution when it comes to unexplained symptoms.

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