Right Chest Nipple Lumps: Causes, Concerns, and Treatments

There is a lump on the right nipple, accompanied by discomfort and slight pain?

This issue has been troubling me for many years, starting from middle school, which has been almost 10 years now.
It has been intermittent, with periods of improvement and worsening.
Recently, the discomfort has returned; it doesn't quite feel like pain, but more like something is pressing there, which is very uncomfortable.
Additionally, my sternum is also hurting, and I'm not sure if there's a correlation.
A doctor previously mentioned that it could be gynecomastia.
I would like to know what options are available for a permanent solution.
Is surgery necessary? I'm particularly concerned that if I wait too long, it could become malignant or lead to other issues.
Is there a risk of not detecting something serious if I keep attributing it to gynecomastia? I initially thought this condition would disappear after puberty, so is it normal for it to persist for this long?

Carlos, 20~29 year old female. Ask Date: 2012/04/29

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear Carlos,
Hello.
The curative method can be surgical excision.
Whether liposuction is an option should be discussed with a plastic surgeon.
There are very few cases of breast cancer that are referred to as gynecomastia in men, but this is generally associated with older age.
Wishing you peace and health.
Sincerely,
Dr.
Chou Chia-Cheng
Director of Surgery, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2012/04/29

More Info

Understanding lumps in the right chest nipple area can be a source of concern for many individuals, especially when they persist over a long period. In your case, it seems that you have been experiencing discomfort and pain in that area for nearly a decade, with fluctuations in symptoms. Let's delve into the potential causes, concerns, and treatment options for this condition.

Potential Causes
1. Gynecomastia: This is a common condition in males characterized by the enlargement of breast tissue. It can occur due to hormonal imbalances, particularly an increase in estrogen or a decrease in testosterone. Gynecomastia can be physiological (related to puberty) or pathological (due to underlying health issues).

2. Lumps or Cysts: These can form in the breast tissue and may be benign. They can cause discomfort and may feel like a lump under the skin. Cysts can fluctuate in size and may become painful.

3. Fibroadenomas: These are benign tumors made up of glandular and connective tissue. They are more common in younger individuals and can be mobile and painless.

4. Infections or Inflammatory Conditions: Conditions such as mastitis (inflammation of breast tissue) can cause pain and lumps. This is more common in women but can occur in men as well.

5. Malignant Conditions: While less common, breast cancer can occur in men. It is essential to monitor any changes in the lump, such as size, shape, or associated symptoms like skin changes or discharge.

Concerns
Your concern about the possibility of the lump being malignant is valid, especially given the duration of your symptoms. While gynecomastia itself is not cancerous, any persistent lump should be evaluated to rule out malignancy. The pain you are experiencing, along with the discomfort in the sternum, could be related, but it is essential to consult a healthcare professional for a thorough evaluation.

Diagnosis
To determine the exact nature of the lump, a healthcare provider may recommend:
- Physical Examination: A thorough examination of the breast tissue.

- Imaging Studies: Ultrasound or mammography can help visualize the lump and determine its characteristics.

- Biopsy: If there is any suspicion of malignancy, a biopsy may be performed to obtain tissue for histological examination.

Treatment Options
1. Observation: If the lump is diagnosed as gynecomastia and is not causing significant discomfort, a "watchful waiting" approach may be taken, especially if it is expected to resolve on its own.

2. Medications: In some cases, medications that address hormonal imbalances may be prescribed.

3. Surgery: If the gynecomastia is persistent, painful, or causing psychological distress, surgical options such as liposuction or mastectomy may be considered to remove excess breast tissue.

4. Addressing Underlying Conditions: If the lump is due to an underlying condition (e.g., hormonal imbalance, medication side effects), addressing that condition may alleviate the symptoms.

Conclusion
It is crucial to consult a healthcare provider for a proper diagnosis and treatment plan tailored to your specific situation. Given the duration of your symptoms and the recent increase in discomfort, it would be prudent to seek medical attention sooner rather than later. Early evaluation can help rule out serious conditions and provide peace of mind. Remember, while gynecomastia is common and often benign, any persistent lump should be taken seriously to ensure appropriate management.

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