Male Breast Development During Adolescence

When it comes to breasts, people tend to think that it is a female issue and has nothing to do with men. In fact, in recent years, the incidence of male breast problems has also been on the rise, and male friends paying attention to their breast health has become a daily social topic. During puberty, female breasts develop, which is a natural thing. But some men's breasts also develop and grow larger. Today we will talk about this topic!

Male puberty breast development refers to the enlargement of one or both breasts due to benign hyperplasia of breast tissue during male puberty. It usually occurs between the ages of 12 and 16. The enlarged breast tissue is usually no larger than 3 cm, may be asymmetrical, and slightly painful. Most cases last for 12 to 18 months, and gradually shrink to disappear as the male's sexual development matures. Some cases last for 2 to 3 years, or even persist for a long time.

Causes

Male puberty breast development is generally believed to be caused by a transient imbalance of estrogen and androgen during puberty, with estrogen reaching adult levels first and androgen reaching adult levels later. However, the following diseases need to be identified:

1. Testicular tumor and feminizing adrenal cortex tumor

Patients may also have male breast development, which is caused by excessive estrogen production by the tumor tissue and enhanced aromatization of the surrounding tissues.

2. Hypogonadism and androgen insensitivity syndrome

Abnormal testicular function due to congenital developmental abnormalities or testosterone biosynthetic enzyme defects, infection, chemotherapy, or trauma is often accompanied by male breast development. One of the important causes is Klinefelter syndrome.

3. Enhanced aromatization of estrogen precursors by extragonadal tissues

It can be seen in many diseases, such as obesity, liver disease, hyperthyroidism, etc.

4. Drug factors

Such as androgens, synthetic steroid hormones, estrogens, ketoconazole, etc.

Clinical manifestations

Boys during puberty often develop breast feminization without obvious hormonal abnormalities, which can sometimes last after puberty. If there are other causes, there may be corresponding clinical manifestations. For example, patients sometimes have feminine signs, such as a high-pitched voice, no beard, no Adam's apple, wide buttocks, etc., accompanied by genital malformations, such as pseudohermaphroditism, hypospadias or cryptorchidism.

Check

Patients with mild symptoms and no other accompanying clinical manifestations generally do not need to undergo too many examinations. If necessary, various hormone tests and biochemical tests should be performed, including liver and kidney function, thyroid hormone, LH, FSH, prolactin, testosterone and estradiol. If necessary, testicular B-ultrasound and adrenal CT or MRI examinations should be performed to exclude tumors in tissues such as the testicles and adrenal glands.

1. During the physical examination, pay attention to the signs of thyroid gland, testicles, vulva and abdominal tumors;

2. Draw blood to measure liver and kidney function;

3. Measure hormone levels in the body: blood LH, FSH, prolactin, testosterone, estradiol, β-HCG and thyroid hormone, etc.;

4. Perform sex chromatin examination;

5. Adrenal gland CT scan;

6. MRI of sella turcica;

7.Breast and testicular ultrasound.

Diagnosis

A detailed history includes nutritional history, growth rate, weight gain, when breast development began, use of medications or certain beverages, and family history. Physical examination includes measurement of height, weight, upper/lower mass, and development of secondary sexual characteristics during puberty. Breast tissue is uneven and irregular in texture.

treatment

Physiological ones can usually resolve on their own and generally do not require treatment. Those caused by drugs will disappear after stopping the drugs, while those caused by pathology focus on treating the primary disease.

1. Drug treatment

(1) Selective estrogen receptor antagonists such as tamoxifen.

(2) Androgen therapy can reduce breast development in patients with androgen deficiency, but it is not recommended for patients with normal androgen levels because androgens are often converted into estrogen in the body and aggravate breast development.

(3) Aromatase inhibitors such as testosterone can inhibit the aromatization of androgens in the body, thereby reducing the production of estrogen.

2. Surgical treatment

If a man's breasts are too large, bloating and discomfort cause mental burden, and drug treatment is ineffective or there is a suspected tumor, and the breast development exceeds 12 months and the testicle size has reached adult size, surgical treatment can be considered. Surgery can be performed through a subareolar incision to perform a subcutaneous mastectomy. However, after the operation, the nipple may be inverted or distorted with reduced sensation and obvious scars. Liposuction can be used for treatment. After the operation, the breast shape is natural and the scars are small and hidden.