Enlarged breasts in men (gynecomastia)

Diagnosis

To find out if you have gynecomastia, a member of your health care team starts by asking you some questions. For example, you'll likely be asked about your symptoms and any medicines you take. You're also given a medical exam to check your breast tissue, stomach area and genitals.

Tests

Your health care team likely will order tests. These can help find a possible cause of gynecomastia or look for conditions that can cause similar symptoms. Tests also may be done to check for breast cancer. You may need exams such as:

• Blood tests.
• Mammograms — This is an X-ray of the breast.
• Computerized tomography (CT) scans — This is a series of X-rays taken from different angles.
• Magnetic resonance imaging (MRI) scans — This imaging test uses a magnetic field and radio waves.
• Testicular ultrasounds — This uses sound waves to make images of the testicles and the tissue around them.
• Tissue biopsies — This procedure removes a tiny piece of tissue, which gets checked in a lab.

Conditions that cause similar symptoms

Your health care team will want to be sure that your breast swelling is gynecomastia and not another condition. Other conditions that can cause similar symptoms include:

• Fatty breast tissue. Another name for this is pseudogynecomastia. Some people, especially those with obesity, have breast fat that looks like gynecomastia. But it isn't the same as gynecomastia. For people diagnosed with this condition, more testing isn't needed.
• Breast cancer. Breast cancer is uncommon in men, but it can happen. Enlargement of one breast or the presence of a firm lump raises the concern for male breast cancer.
• Mastitis. This is inflamed breast tissue that sometimes involves an infection.
• Lipoma. This slow-growing, fatty lump is not cancer.

Treatment

Gynecomastia often goes away over time without treatment. But if gynecomastia is caused by a medical condition, that condition may need treatment.

If you take medicine that may be the cause of gynecomastia, ask your health care team about your choices. Your doctor may have you stop the medicine or try a different one.

Often, no treatment is needed for teenagers who have gynecomastia due to natural hormone changes during puberty. A teen's health care team may recommend checkups every 3 to 6 months to see if the condition is getting better on its own. Gynecomastia in teens often goes away without treatment in less than two years.

Treatment may be needed if gynecomastia doesn't get better on its own. Treatment also can help if the condition causes pain, tenderness or embarrassment.

Medications

Medicines used to treat breast cancer and other conditions may be helpful for some adults with gynecomastia. They include:

• Tamoxifen (Soltamox).
• Raloxifene (Evista).
• Aromatase inhibitors, such as anastrozole (Arimidex).

In the United States, these medicines are approved by the Food and Drug Administration. But they have not been approved specifically for use in people with gynecomastia.

Surgery to remove extra breast tissue

You may still have enlarged breasts after waiting for gynecomastia to go away on its own or after taking medicine for it. If your appearance or other symptoms bother you, surgery may be a treatment choice:

Two gynecomastia surgery options are:

• Liposuction. This surgery removes breast fat but not the breast gland tissue itself.
• Mastectomy. This type of surgery removes the breast gland tissue. With smaller amounts of gland tissue, mastectomy can be done using small incisions. This lessens the recovery time. Sometimes liposuction and mastectomy are combined.

Coping and support

For people with gynecomastia, having enlarged breasts can be stressful and embarrassing. The condition can be hard to hide. Sometimes, it can be a challenge to romantic relationships. During puberty, gynecomastia can make teens a target for teasing from peers as well. It can make activities such as swimming or changing in the locker room traumatic.

Whatever your age, if you have gynecomastia, you might feel unhappy with your body. But you can take steps that may help you cope:

• Get a checkup. Some people with gynecomastia worry that their symptoms are due to a more serious condition. It can be a relief to learn that gynecomastia is the cause.
• Get counseling. Talk therapy can help you manage anxiety or depression caused by gynecomastia. It also can help you talk with your partner or family members, so they understand what you're going through.
• Reach out to your family and friends. You may feel embarrassed to talk about gynecomastia with the people you care about. But if you explain your situation and ask for support, that could strengthen your relationships and ease stress.
• Connect with others who have gynecomastia. It might feel good to talk with people who understand what you're going through. Websites such as Gynecomastia.org can help you connect with others who have the condition.