Male Breast Cancer and Gynecomastia
Male breast cancer is a rare disease. According to American society of clinical oncology in the United States black men have the highest incidence rates of breast cancer (2.7 out of every 100,000 men), followed by white men (1.9 out of every 100,000 men).
A study published in Indian Journal of Surgery in September 2019 showed that male breast cancer accounts for 0.6% to 0.7% of all breast cancer. It also showed man breast cancer account for 0.35% to 1.5% of all male cancer.
Gynecomastia is a common problem of a young man and it is noncancerous. Enlarged breast in man is called gynecomastia because it looks like that of women. Some of these young men have painful breasts at the age of puberty but the pain is not the sign of cancer.
Anatomy of Breast gland
Anatomy of breast in man is same as that in women but it is not as developed in man. It has breast glands and these glands have their external opening at the nipple. These glands are surrounded by fat or adipose tissue.
In Gynecomastia there is enlargement of both side glands due to hormones.
In Cancer there is uncontrolled growth in some part of gland. It is a myth that breast glands grow in size after eating chicken. It has no correlation with the breast nodule enlargement.
Difference between features of Gynecomastia and male breast cancer
| Male Breast Cancer | Gynecomastia |
| Usually in older age | Start at teen age |
| Rapidly growing lump usually on one side | Breast enlargement on both sides. Size stable |
| Irregular, uneven enlargement | Uniform enlargement |
| only Lump is palpable, breast not enlarged | Lump present in central part of breast |
| Lump is hard, irregular | Lump is smooth and firm |
| The skin over lump is irregular | Skin is smooth |
| This lump may be fixed to skin or deeper muscles | Lump is mobile never fixed |
| The skin may have wound | No wound in skin |
| Nipple may be fixed with lump | nipple not fixed |
| Painful | Painless |
Underarm Lymph nodes
Lymph nodes in the underarm area must be examined if there is suspicion of breast cancer. These nodes are small lumps that can be felt in the underarm area. They increase in size and are easily palpable in cancer. If anybody has lumps in breast and underarm he should consult with a doctor as early as possible
Lymph nodes do not increase in size in gynecomastia.
How to confirm diagnosis of breast cancer and gynecomastia
Gynecomastia is usually diagnosed by clinical examination. Ultrasound may be supportive in diagnosis in such cases.
Male Breast cancer is diagnosed by specific clinical features.Diagnosis is confirmed by ultrasound and FNAC or biopsy.
FNAC is examination of cells that are taken out with the help of a needle. These cells are examined by histopathologist. histopathology gives detail information about the presence of cancer, type of cancer etc.
Other investigations like chest X ray, CT scan and MRI rae done to identify the spread of cancer in other tissue like lung or bone
Treatment of man breast cancer and gynecomastia
Treatment of gynecomastia and man breast cancer is absolutely different. Gynaecomastia surgery is simpler in comparison to breast cancer surgery. In gynaecomastia only breast gland tissue and surrounding fat is removed and chest reshaping is done.
Breast cancer treatment depends upon the stage or extent of disease. In cancer whole of breast tissue, overlying skin and deeper muscle or other involved structures are removed along with underarm lymph nodes.