Male Breast Pain: A Guide to Diagnosis and Treatment

Male breast swelling and pain?

Hello Dr.
Zhou, I went to the hospital and saw a general surgeon who performed an ultrasound.
The tissue around my nipple is swollen, forming a hard area about 3-4 cm square.
Sometimes the nipple experiences sharp pain.
The doctor advised observation and did not prescribe any medication.
Later, I was referred to the endocrinology and metabolism department.
The doctor suggested a blood test because my nipple has been hurting continuously for the past few days.
Additionally, I have two swollen and painful lumps under my left ear, which might be related to the salivary glands or lymph nodes.
I was concerned it could be due to hormonal imbalance, so I went to another hospital.
The doctor there examined me and said everything was fine.
I still returned to see the general surgeon/breast surgeon, who asked if I wanted a blood test, but the doctor said it wasn't necessary.
The lymph node swelling could be due to a cold or fatigue.
I was advised not to take anti-inflammatory medication and to drink plenty of water.
I insisted on the blood test because I had a health check at this hospital, and some of my levels were elevated and needed monitoring.
I only managed to get the blood drawn after some effort.
It's frustrating that the hospital seems unsure how to address my health issues and keeps passing me around.
The endocrinologist suggested icing the swollen area, while the general surgeon advised me to continue monitoring the situation.
I guess I will have to wait for the blood test results before proceeding.
Thank you.

Axiang, 40~49 year old female. Ask Date: 2012/06/08

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear Ah Xiang,
1.
The most common cause of breast swelling and pain in males is "gynecomastia," which is caused by an imbalance of female hormones in the body.
It is often seen in adolescent males and patients with liver disease.
Some cases are attributed to medications and environmental factors, while others may have no identifiable cause.
2.
In terms of treatment, the primary approach is to monitor whether symptoms persist or worsen, and to check for any ongoing lumps.
If symptoms continue and the lump increases in size, surgical intervention may be considered.
Wishing you safety and health,
Director of Surgery, Taoyuan Hospital, Department of Health
Zhou Jiazheng

Reply Date: 2012/06/08

More Info

Understanding male breast pain can be complex, as it may arise from various underlying conditions, including gynecomastia, hormonal imbalances, or even more serious issues like breast cancer, although the latter is rare in men.
Gynecomastia, a condition characterized by the enlargement of breast tissue in males, is often linked to hormonal imbalances, particularly an increase in estrogen or a decrease in testosterone. This condition can occur during puberty, due to certain medications, or as a result of liver or kidney disease. Symptoms typically include tenderness, swelling, and sometimes pain in the breast area. In your case, the ultrasound findings of a hypoechoic structure in the subareolar region suggest gynecomastia, which is generally benign.

The pain you are experiencing, particularly the intermittent sharp pain in the nipple area, could be related to the gynecomastia itself or possibly due to other factors such as inflammation or irritation of the breast tissue. It is important to note that while gynecomastia is usually harmless, persistent symptoms warrant further investigation to rule out other potential issues.

Given your situation, where you have experienced breast pain and swelling for several months, it is advisable to follow up with a healthcare provider. While some doctors may suggest observation, it is crucial to ensure that there are no underlying conditions that require treatment. Blood tests can be useful in assessing hormone levels, liver function, and other relevant parameters. If hormonal imbalance is suspected, endocrinological evaluation may provide insights into the cause of your symptoms.

In terms of treatment, if gynecomastia is confirmed and is causing significant discomfort or psychological distress, surgical options such as liposuction or mastectomy may be considered. However, surgery is typically reserved for cases where the condition is persistent and bothersome, as many cases of gynecomastia resolve on their own over time.

Additionally, the swollen lymph nodes you mentioned could be indicative of an infection or other benign conditions, but they should not be overlooked. If they persist or are accompanied by other symptoms such as fever, night sweats, or unexplained weight loss, further evaluation is necessary to rule out more serious conditions.

In summary, while male breast pain is often benign and related to gynecomastia, persistent symptoms should not be ignored. It is essential to maintain open communication with your healthcare providers, seek second opinions if necessary, and advocate for the appropriate tests to ensure a comprehensive evaluation of your condition. Regular follow-ups and monitoring of any changes in symptoms will help in managing your health effectively.

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