Gynecomastia, a benign enlargement of glandular tissue in the male breast, is caused by an imbalance between estrogen and androgen activity.
Gynecomastiacan be unilateral or bilateral. It appears as a palpable mass of tissue, up to 0.5 cm in diameter, and is usually located beneath the nipple (Braunstein, 200). This lump can be seen as a button-sized growth under the nipple.
You may be able to spot it as a lump in your breast or feel it when you press on the area. The lump can move freely within the breast tissue and be tender to the touch. Lumps and breast enlargement can occur in one or both breasts. However, the majority of breast lumps are caused by gynecomastia.
This is a common noncancerous condition in which male breast tissue enlarges. The first sign of gynecomastia may be a lump of adipose tissue under the nipple. Sometimes this lump is tender or sore. Serum testosterone levels are likely to decrease after 30 years of age, due to obesity, environmental exposures, systemic diseases, and medications that reduce testosterone concentrations (or effects) in breast tissue or increase estradiol concentrations (or effects) in the breast tissue.
Significant gynecomastia is seen in 50% of adolescents with Klinefelter syndrome; it is also seen in other conditions characterized by male undervirilization, such as partial androgen insensitivity syndrome and 17-ketosteroid reductase deficiency. Increased peripheral aromatase activity with greater conversion of androgens to estrogens in excessive amounts of adipose tissue is thought to cause mild to moderate gynecomastia in obese men. Mammographic radiograph of the typical characteristics of male gynecomastia, with radio-dense tissue extending from the nipple. Hospitalized patients have a higher prevalence of gynecomastia (up to 60 to 70% in men over 45 years of age) and ~ 20% have gynecomastia of ≥5 cm.
This chapter focuses on the prevalence, clinical presentation, physiology, histopathology, pathophysiology, diagnosis and treatment of gynecomastia. Gynecomastia is also seen in malnourished patients after restoring normal nutrition (feedback syndrome), which may be due to liver dysfunction or abnormal activation of the gonadotropin axis. Familial gynecomastia has occurred in several types as an X-linked or autosomal dominant trait limited by sex. Gynecomastia of ≥ 2 cm of palpable breast tissue is very common in normal outpatient adults and in hospitalized patients.
When you have gynecomastia, your doctor may refer you to an endocrinologist who specializes in hormone-related problems and their effects on the body. Gynecomastia can sometimes be a side effect of high-activity antiretroviral therapy used for HIV treatment. Gynecomastia cases have been reported in workers who manufacture estrogens and even in their children.