Breast lumps in men are uncommon but cause great concern when they do occur. A lump may be found in both breasts but usually occur in only one. Breast swellings are common in newborns because of the high levels of oestrogen received from their mothers before birth.
Lumps also often occur in young men in early adolescence because of the conversion of androgens to oestrogen. This swelling may be tender. It may be of short duration, lasting up to 18 months and, rarely, the lump persists throughout the adolescent's life.
Certain drugs, such as spirolactone, are known to cause increases in the size of the breasts. Men who receive drugs similar to oestrogen for the treatment of prostate cancer will experience growth in the size of the breasts.
Men can also have a breast lump which is cancerous. Fortunately, these cancers are rare. A third of men with breast cancer have family members who had breast cancer. There is also a familial form of breast cancer where both genders are at risk of the breast cancer. Sadly, breast cancers in men are often far advanced because of delays in taking action by both patient and physician.
Cancerous lumps
A rock-hard lump which may be fixed to the chest or cause changes to the overlying skin could be a breast cancer. Any man with a breast lump should visit his doctor for an examination. Most times, the doctor can differentiate between a non-cancerous swelling and a possible cancer.
A definite diagnosis is made using fine-needle aspiration or by removing the lump guided by ultrasound. Men with breast lumps should have a mammogram. As in the case of women, mammograms are 90 per cent effective in determining whether the lump is cancerous. Ultrasound may be used to detect cysts in the breast but these are also rare in men.
Breast self-examination
Men, too, should examine their breasts once monthly. This may be done standing in front of the mirror, lying down or in the shower. Look at both breasts for size, any turning in of the nipples, bulging or dimpling of the skin. With one hand behind your head, use the other hand to press against the breast on the other side. Check the entire breast with your finger pads. Use small circles as you move your fingers up and down the breast.
Breast lumps in men and women require evaluation and should be dealt with as soon as they are discovered. Most of these lumps are not serious but all of them should be evaluated for cancer.
Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.
