Male Breast

Male breast Basics

  • Only has a rudimentary breast system

  • The ducts end as terminal buds, no lobules

    • Therefore cannot get lobular related disease

    • No cysts

    • No lobulated carcinoma (ILC)

    • No fibroadenoma

  • Always need a mammogram to tell whats going on

  • Males, even if getting hormones from gender changes do not get screening mammograms

    • Kelinfelters do not get screening mammograms either

Gynecomastia

  • Symmetric

  • Breast tissue with intermixed fatty tissue

  • Physiologic in

    • Boys <13 yo

    • Men > 65

  • Causes

    • Psych meds

    • Spironolactone

    • Marijuana use

    • Cirrhosis

    • Testicular cancer

  • Types (3)

    • Nodular

      • Most common

      • Retroareolar

      • Can be tender

      • Stays for a year after initial presentation

    • Dendritic

      • Chronic fibrotic type

      • Non-painful/tender

    • Diffuse glandular

      • Looks like a woman with small boobs

      • Type you get with estrogen therapy

Pseudogynecomastia (Bitch tits)

  • Basically boobs because you are fat and have fat deposition in your boob area but no actual breast tissue

  • No focal palpable mass

References:

Breast Cancer

  • Skin thickening with asymmetric breast mass

  • Always ductal cancer

  • Usually a spiculated mass

  • Calcifications may be present

  • Fat does not intercalate with the mass as much

  • Usually in men ~70 yo

  • RF

    • BRCA-2

    • Kleinfelters