Lump in the man's chest
introduction
In men, due to the lack of awareness of breast diseases, a lump is usually noticed late.
Very few men conduct self-examinations on a regular basis and then mostly only because their doctor has advised them of the risk of a tumor because of a family history of breast cancer.
For more information see also: Breast cancer in men
Breast cancer in men really does exist. He is though very rarely, but because it is considered a typical women's disease, it is often recognized late.
The 70,000 new cases of women per year in Germany are about 600 new cases per year in men across from.
However, due to the serious consequences, there is also growing attention among experts for male patients.
As disease-promoting factors are in women and men Breast cancer genes such as BRCA (Breast Cancer Gene) that increase the likelihood of developing a tumor of the breast or other tumors (in women, for example, ovarian tumors).
Also the lifestyle seems to determine the likelihood of the disease in both sexes. So applies a long-term or intensive Radiation exposure of the upper body, as it can occur with radiation therapy of previous tumors, as risk-increasing.
Also the Hormonal balance is seen as a possible risk factor. This is the case with a metabolic condition such as that shown in Obese can occur, increased estrogen is formed. In men, this can increase the risk of breast cancer.
The influence is also discussed Hormones to increase performance.
causes
Not every lump in a man's breast means cancer. As with women, there are many benign causes in men for the formation of such an unsettling mass. What is certain, however, is that a finding in men must also be clarified by a doctor and a malignant disease ruled out.
In addition to breast cancer, the numerous causes of a lump in the male breast also include a large number of benign masses such as cysts, lipomas and fibroadenomas or diseases such as gynecomastia and mastopathy.
Read more on the subject below benign breast tumors
Gynecomastia is the name given to breast growth in men. The real gynecomastia, the benign proliferation of breast tissue, must be differentiated from the false gynecomastia, which is caused by fat deposits in people who are very overweight.
The most common causes of real gynecomastia are found in the hormonal balance and are benign in the majority of cases.
A malignant cause, such as the presence of a testicular tumor, should be ruled out by a doctor.
Occasionally, true gynecomastia is also caused by drug side effects. The blood pressure lowering drug spironolactone is a common trigger.
As in women, cysts can develop in the breast tissue of men. Due to predisposition, these fluid-filled, mostly benign cavities can also occur several times in a patient.
Using ultrasound, a cyst can be easily recognized and differentiated from other causes. In unclear cases, advanced imaging measures or a Breast biopsy will help diagnose.
Another cause of breast lumps in men can be lipomas. Lipomas are benign adipose tissue tumors that occur in many people and usually do not require treatment.
The exact origin of lipomas has not yet been conclusively clarified, but it is clear that it is an abnormal development of adipose tissue cells, as can also occur in the breast.
Fibroadenomas are common benign neoplasms of the mammary gland that mostly appear in younger women.
It affects up to a third of pre-menopausal women.
Fibroadenomas arise from the connective tissue in which the mammary glands are embedded. They can occur on one or both sides, as well as in several places in a breast at the same time.
Their formation and growth are favored by estrogens.
Fibroadenomas are a common cause of a palpable, firm lump in the breast in men.
In medicine, the term mastopathy encompasses a large number of proliferative and degenerative remodeling processes in the breast.
The symptoms consist of palpable lump formation in the chest, chest pain (Mastodynia) and discharge from the nipple.
In men, mastopathy is usually based on a disruption of the hormonal balance.
Another cause in men is the formation of tiny accumulations of calcium (microcalcifications) in the breast tissue with subsequent enlargement of the individual glandular lobules and reactive hardening of the surrounding connective tissue.
While the symptoms mostly subside in women beyond menopause, they can persist in men. Here, too, the focus is on clarifying the type of tumor, as malignant diseases require immediate, intensive treatment.
Symptoms
Lumps in the chest are mostly noticed by chance and not as part of a regular self-examination. Sometimes are here great findings expected, which are already visible when viewed from the outside.
Occasionally lead too Pain for a detailed examination of the breast, which reveals newly created masses.
The warning signs are next to palpable indurations also Fluid discharge from the nipple or Redness and inflammation of the skin over the chest.
diagnosis
The basis for diagnosing a lump in a man's chest is always the Palpation examination.
The doctor will try to classify the findings more precisely by palpation. Besides Size and consistency of the node too Tenderness and his Movability checked against the skin or underlying muscle tissue.
Following the physical exam, a X-ray examination of the breast (mammography) be performed. The soft breast tissue is x-rayed, which means that any other lumps that were not detected in the palpation examination can be seen on the x-ray film.
Based on the structure of the nodes shown on the film, conclusions can be drawn about the Type of illness to be pulled.
Another imaging examination method is Ultrasonicwhich, however, does not bring the desired clarity in all clinical pictures.
To establish a final diagnosis and to check whether the mass found is a malignant or benign disease acts, a Punch biopsy be performed. To do this, a fine hollow needle is pierced through the skin into the knot and the tissue removed is examined under a microscope.
therapy
The therapy of a lump in the chest depends of course on its cause. A lump in the breast does not mean you have cancer. There is also with men a variety of benign causesthat do not require surgical removal.
Gynecomastia
If a malignant tumor of the breast tissue is excluded, a real gynecomastia must be observed not necessarily operational removed. In some cases, however, it can cosmetic be so annoying that the person concerned wishes to be removed.
Then, after exhausting conservative methods, such as Diet and medication changes, removal of excess glandular or fatty tissue through a small incision on the nipple.
Cysts
In the presence of Cysts If the findings are benign, surgical removal is usually not indicated.
However, it is a cyst painful or if the person concerned is psychologically impaired by their presence, they can be checked under ultrasound dotted and the liquid contained in it is withdrawn.
A cyst forms as a result of a malicious process, a decision must be made about surgical removal and about an individual further procedure.
Lipoma
Because lipomas benign tumors are is a treatment for cosmetic reasons only necessary. Also can through Pressure on surrounding tissue, vessels or nerves, Pain arise.
Removal is only possible surgically and must result in the complete removal of the lipoma, since remaining cells of the tumor can grow again.
The surgical removal should be carefully considered, as the inevitable surgical scars are usually more noticeable than the tumor itself.
Fibroadenoma
Usually there is one at diagnosis Fibroadenoma no indication for surgery, but even with this clinical picture, a possibly malignant finding must urgently be clarified.
The diagnosis is made after a palpation examination, sonography (ultrasound) and a punch biopsy, which allows an assessment of the malignancy of the previously discovered mass.
Whether an operation is necessary is determined according to the criteria Breast size, age, rate of growth and location of the lump decided.
In the case of women and men, the main focus is on cosmetic impairment.
It should be noted that a rapidly growing lump should be operated on at an early stage in order to keep the soft tissue defect caused by the operation to a minimum.
Local problems usually arise from the displacing growth of the space occupation and the associated aesthetic problems, as well as from Paincaused by pressure on surrounding structures.
Mastopathy
It is different from women No specific treatment possible for mastopathy in men. A Pain management can through Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or by Paracetamol respectively.
In mastopathy with lump formation, the tissue should be examined using biopsy or even that complete removal of the knot be considered with a subsequent tissue examination.
In cases with pronounced symptoms or if there is a tendency to recurrent mastopathies the entire mammary body surgically removed become. The decision about an operative procedure is made in a detailed doctor-patient consultation.
Which doctor is responsible?
When a new mass in the female breast is discovered, it is usually easy to decide which doctor to consult. Of the Gynecologist is definitely the right contactwhen it comes to diagnosis, advice and treatment.
It looks different with a man's chest lump. As explained in the previous section, masses in the chest can have a wide variety of causes.
Of those favored by obesity fake Gynecomastia about those influenced by hormonal factors and drugs real gynecomastia up to malignant diseases of the breast tissue and male gonads, numerous possible triggers must be considered.
If a man discovers a newly appeared lump in his chest, it is advisable that he first look at his Family doctor introduces. This can go through thorough palpation of the breast make an initial assessment and after a detailed anamnesis, in addition to the question of Previous illnesses, family history of breast cancer and the determination of medication taken and certain risk factors includes, initiate further investigations.
This can be done, for example, in a sonographic (ultrasound) or X-ray examination of the breast by the radiologist or a Clarification of diseases of the male genital organs by the urologist / andrologist consist.
Disorders of the hormonal balance are the responsibility of the Endocrinologist. When deciding on a surgical procedure, an idea is usually given in the general Surgeons or one Plastic surgery specialist necessary.
What to do in case of pain
Male chest pain associated with palpable lumps can indicate serious medical conditions and should be taken seriously and clarified accordingly.
Once a diagnosis has been made, treatment can be initiated that does not have to include surgical removal of the mass in all clinical pictures. Rather, in a large number of cases, a conservative, i.e. non-operative, approach is sought.
This of course depends on the cause of the disease and should also be adequate if pain occurs Pain therapy include.
are hormonal factors cause of a disease of the chest, can already through Hormone therapy a relief of the symptoms can be achieved. This also applies if pathological processes in the chest are caused by the use of medication. A significant improvement is achieved here simply by changing the medication.
Do the changes mentioned do not lead to sufficient pain relief or are the triggers of the disease in an area that cannot be regulated by medication additional measures taken to provide pain relief.
Suitable drugs come from the group of non-steroidal anti-inflammatory drugs. Especially Ibuprofen is a well-tolerated and effective preparation. Paracetamol from the group of non-opioid analgesics is an equally effective pain medication and is suitable for treating pain in the context of diseases of the chest.
In gynecomastia, bras can help prevent tension-related pain. Especially in the case of the fake gynecomastia caused by obesity, there is one Weight reduction by restricting calorie intake and regular physical exercise on.
In individual cases, particularly painful findings can be removed by surgery. This approach is particularly important for Lipomas or Fibroadenomas makes sense, as they grow tissue-displacing.
puberty
Pain in the area of the male breast are not uncommon during puberty. In very few cases is there a cause for concern. The body and hormone balance of adolescents are subject to constant changes during puberty.
So it can be with some boys Breast growth come. One speaks of Puberty gynecomastia. The reason for this are changes in the household of sex hormones, in the course of which there is also education female sex hormones can come.
Sometimes the rapid breast growth can even painful be and worry those affected.
In very few cases, however, treatment is necessary, as gynecomastia usually resolves on its own after the age of twenty.
However, if the excess breast tissue remains, surgical removal may be considered for cosmetic reasons.
Not necessarily pain and palpable indurations cause puberty gynecomastia of the breast. Rather, palpably hardened, sore nipples are in many cases part of the development of the male breast and are completely harmless.
Anabolic steroids
Anabolic steroids are substances that the Building body tissue by strengthening the body's own protein synthesis. The best known preparations of anabolic steroids are the so-called Steroidswhich in their effect the male sex hormone testosterone resemble.
In weight training, they are used for the rapid build-up of muscle tissue with simultaneous intensive training.
The numerous side effects from steroid use include Acne, cardiovascular problems and liver damage. Occasionally, in men Shrinkage of testicular tissue with cessation of sperm production as well as a Gynecomastia, i.e. excessive breast growth can be observed.
