Why do boys' breasts grow bigger?

Some male friends find that their breasts are getting bigger in life, and they are puzzled and worried about what diseases they have. There are two reasons for male breast enlargement. One is the accumulation of local fat in the breast, which causes breast enlargement. This is more common in obese patients. The second is breast development syndrome, which is a developmental abnormality caused by physiological or pathological factors.

1. What causes male breast enlargement?

Male breast enlargement can occur in two ways:

(1) Local fat accumulation in the breasts causes the breasts to become symmetrically larger, which is more common in obese people;

(2) Gynecomastia: It is a clinical disease caused by abnormal development of male breast tissue and abnormal proliferation of breast connective tissue due to physiological or pathological factors. It often manifests as painless, progressive enlargement of one or both breasts or the appearance of a tender lump in the subareolar area.

50% of male breast development is physiological, which is most common in neonatal period and adolescence. It can usually disappear on its own and is usually benign. However, if it occurs before adolescence, youth and middle age, it is often considered abnormal. Its common causes include: ① Increased estrogen levels (testicular tumor, adrenal tumor, liver cirrhosis, alcoholism, chromosomal abnormality); ② Insufficient androgen secretion; ③ Androgen receptor insensitivity; ④ Other diseases (thyroid dysfunction, chronic renal failure, malnutrition); ⑤ Drugs (estrogen and its analogs, human chorionic gonadotropin, androgen antagonists, etc.); ⑥ Idiopathic: Currently, most cases of male breast hyperplasia in clinical practice cannot find a clear cause, and various hormone tests are normal, which is called idiopathic male breast hyperplasia.

2. Will male breast development turn into cancer?

There is still controversy as to whether gynecomastia is a precancerous lesion. It is generally believed that untreated gynecomastia patients may have a 1% to 5% cancer rate, which may be slightly higher than female patients. Currently, most scholars believe that this disease is one of the high-risk factors for male breast cancer.

3. How to identify male breast development and male breast cancer?

Gynecomastia and male breast cancer can generally be identified in three ways:

(1) Symptoms: The breast tissue of male breasts is tough and elastic. Most patients have bilateral breast cancer, which may be accompanied by tenderness and rarely nipple discharge. Male breast cancer is more common in elderly men. It is often a solitary lump in one breast. The lump is firm, has unclear boundaries, and is often painless. There may be adhesions between the areola skin and enlarged axillary lymph nodes. There are often skin changes such as nipple discharge, depression or deviation. If there is a local ulcer or enlarged lymph nodes nearby, it is a manifestation of advanced breast cancer.

(2) Breast ultrasound examination: The ultrasound manifestation of male breast cancer is often that the mass is separated from the areola, the border is unclear, and there is attenuation at the back. The ultrasound manifestation of breast development is an image with high and low echoes, with the nipple as the center and the high echo as the main feature.

(3) Breast molybdenum target radiography: Molybdenum target radiography of male breast cancer often shows a mass shadow in the upper 1/4 of the breast, which is eccentric, has unclear edges, and stretches in a spicule-like manner. Molybdenum target radiography of breast development shows a glandular density shadow behind the nipple.

(4) Pathological diagnosis: Patients who are highly suspected of breast cancer should undergo core needle biopsy as soon as possible to confirm the diagnosis.

4. How to treat male breast development?

Male breast development symptoms in adolescence and neonatal period can usually disappear on their own and do not require treatment. However, other male breast development symptoms usually require clinical intervention. First of all, the cause should be treated. Generally, for patients with definite pathogenic factors, breast hyperplasia symptoms will disappear after the primary disease is removed. For those caused by drugs, the relevant drugs should be stopped and most of them can recover on their own. However, for those who are clinically accompanied by breast pain or tenderness, and the continued existence of larger breast development affects the patient's physical beauty and psychology, clinical intervention is required. Common treatment methods include drug therapy and surgical treatment: ① Drug therapy: Commonly used drugs include androgen preparations and estrogen antagonists, but because hormone therapy may cause endocrine disorders, the choice must be cautious; ② Surgical treatment: Indications include: males who are in the late puberty or have passed puberty and still have breast development, and drug treatment is ineffective; those who seriously affect their appearance or are suspected of having malignant changes.