The male breast is composed of a mixture of tissue types, any of which may give rise to a mass or swelling. Cancerous breast tumors in men are rare, but do occur. Men can also develop benign, or non-cancerous breast disorders, causing breast lumps. According to Cancer.org., gynecomastia, a non-cancerous disorder, is a condition characterized by an increase in tissue in a man's breast and can present as a disk-like growth. The characteristics of a lump and the patient's age are important criteria in evaluating any breast mass.
Male Breast Anatomy
The male breast consists mostly of fat and fibrous tissue covered by skin. An interconnecting system of breast ducts with lining epithelial cells extends through this tissue to the nipple. Normal male breast tissue does not include lobules, which are responsible for milk production in the female. Small lymph nodes may occasionally be present, most often in the outer portion near the underarm.
Gynecomastia
Gynecomastia is the most common male breast lesion, according to "Sternberg's Diagnostic Surgical Pathology." It usually occurs around the age of puberty or in older men, and is associated with hormonal or medication effects. Gynecomastia appears as a swelling or lump in one or both breasts, is generally centrally located and may be tender. The lump is formed by a proliferation of breast ducts and fibrous tissue. In most cases, it resolves without treatment.
Breast Cancer
Breast cancer in men is uncommon, making up less than 1 percent of all breast cancers, according to the Centers for Disease Control and Prevention. It occurs most often between the ages of 60 and 70, but may appear at any age. Typically, breast cancer in men presents as a hard painless lump, often under the nipple. Overlying skin discoloration, puckering or nipple changes may be present. Almost all cancers arise from the ductal component of the breast. Treatment is similar to that for women's breast cancer.
Other Lumps of Breast Tissue
Although rare, simple fluid-filled cysts or fibroadenomas of the male breast may occur. FamilyDoctor.org describes fibroadenomas as being soft to rubbery tumors rather than hard. Cysts may be tender. Both lesions tend to be easily movable within the surrounding breast tissue. Neither represents cancerous abnormalities.
Miscellaneous Lumps
The surrounding tissues of the male breast can also give rise to a variety of lesions. Skin cysts, or tumors, inflammatory masses, or abscesses, may present as breast lumps. Fatty or fibrous tumors may arise in the soft tissue of the breast. Enlarged lymph nodes may also develop either in response to inflammatory conditions or malignancy.
Evaluation
Patients with any persistent breast lump or swelling should consult a health care practitioner. Your age, medical history, and examination of the breasts are important initial steps in the evaluation. Possible additional tests include mammogram and breast ultrasound. A needle aspiration or biopsy may be necessary to further characterize a lump and reach a final diagnosis.
References
- "Sternberg's Diagnostic Surgical Pathology", Fourth Edition; Stacey E. Mills M.D., Senior Editor; 2004: Section II. Breast (pg 384)
- Centers for Disease Control and Prevention: Fast Facts
- FamilyDoctor.org: Breast Problems in Men
- Cancer.org.: Male Breast Cancer
