Understanding Causes of Male Breast Pain and Swelling

Gynecomastia, Breast Cancer, and Other Male Breast Concerns

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What are the causes of breast pain and swelling in males?. Matthew Leete/Digital Vision/Getty Images

While we usually think of women when we talk of breasts, men have breasts, too. And like women, they at times have to cope with breast pain, breast enlargement, nipple pain, and even breast cancer.

Unfortunately, in our breast-fixated society, it can be embarrassing for a man to bring up concerns he has about his breasts. And, most of the time, men don't sip a cup of tea and talk to other men about their breast pain.

Let's take a close look at some of the potential causes of breast pain or swelling in men, including when men may need to be concerned about male breast cancer.

Male Breast Development

Before puberty begins and hormone levels shift and rise, female and male breasts look very much alike. Children's breasts in both genders are primarily skin, fat, and connective tissue supporting a nipple and areola.

In the early teen years, the gender-specific hormones begin to transform our bodies for adulthood. In men, testosterone encourages testicular growth and usually prevents breast development. In women, estrogen signals developing milk-producing glands and increases breast size. Pregnancy completes female breast development.

Causes of Male Breast Swelling

You men often experience breast growth during adolescence. This is a normal process caused by hormonal changes and can produce breast swelling and tenderness, but probably won't cause breast pain.

This growth in breast tissue—known by the medical term gynecomastia—may also occur in men who are older, especially those over the age of 50, and has many possible causes.

Secondary Causes of Male Breast Swelling

Gynecomastia may cause breast pain in some people. In addition to being a normal process, it can also be due to:

  • Liver disease
  • Alcohol abuse
  • Certain medications
  • Kidney disease
  • Diseases of or involvement of the testes (i.e., testicular torsion or trauma, hemochromatosis
  • A hereditary chromosomal trisomy known as Klinefelter syndrome
  • Tumors, HIV, and hyperparathyroidism

Common Causes for Male Breast Pain

Most causes of male breast pain are relatively benign.  A few of the more common causes of male breast pain include:

  • Breast injury - An injury to the breast may occur from sports, automobile accidents, or work-related activities. When these injuries cause the death of fatty tissue in the breast, something called breast fat necrosis, a firm lump or dimpling of the breast may occur. This can be frightening as the symptoms of breast fat necrosis often mimic those of breast cancer.
  • Runner's nipple - It's not uncommon for men to develop irritated or bloody nipples from jogging. Just as friction over other areas of the body can cause discomfort, friction over the nipples can result in pain and bleeding.
  • Mastitis - An infection of breast tissue called mastitis can occur in men as well as women.
  • Breast cyst - A breast cyst is a fluid-filled sac in the breast and may occur in men as well as women. 
  • Fibroadenoma - While uncommon in men, a benign breast tumor composed of glandular and fibrous breast tissue known as a fibroadenoma may occur.

    Male Breast Pain From Other Sources

    A very important point to consider for men experiencing breast pain—especially men who are over the age of 50—is whether the pain is actually originating in your breast or could be coming from somewhere else. Again, while not common, men have brushed aside symptoms of a heart attack thinking it was simply an unknown pain beneath their nipples. While you don't need to be worried every time you notice breast pain, everyone should be familiar with the symptoms of a heart attack and realize that there are many symptoms other than a "cow sitting on your chest" which should be heeded.

    Help With Male Breast Pain

    If you have breast pain, start by examining the painful area and try to determine what is causing the pain. If you have a bruise or runner's nipple, try hot or cold packs, acetaminophen, ibuprofen, or aspirin.

    Mastitis, a cyst, or a fibroadenoma will all require a doctor's examination and prescription drugs or surgical intervention. You should always see a doctor if you discover a breast lump.

    Male Breast Cancer

    Breast cancer in men is certainly much less common than in women—there are 100 cases diagnosed in women for every case diagnosed in men—but considering how common breast cancer is in women, male breast cancer does occur.

    Most men who are diagnosed with breast cancer usually do not feel breast pain, but this is not a hard and fast rule. For men with a family history of breast cancer, doing a male breast self-exam is an easy way to be aware of any changes in your breast. Changes to watch out for include:

    • A  lump or swelling  
    • Breast skin dimples or puckers that don't resolve
    • Red, scaly skin on breast, areola, or nipple
    • Nipple retraction 
    • Swollen lymph nodes in your armpit

    Men who carry the mutated BRCA1 or BRCA2 gene are at increased risk of developing breast cancer. It is important for men as well as women to know their family health history so they can be proactive about screening and living a healthy lifestyle.

    Bottom Line on Breast Symptoms in Men

    Doing your male breast exam is a good way to recognize changes in your breast tissue so you can be proactive in the case of any male breast pain—and of course, see your doctor for a proper diagnosis and physical examination. If you're experiencing breast pain, it's also important to think of other structures that may be responsible, such as your heart.

    Sources:

    Kasper, Dennis L.., Anthony S. Fauci, and Stephen L.. Hauser. Harrison's Principles of Internal Medicine. New York: Mc Graw Hill education, 2015. Print.

    National Cancer Institute. Male Breast Cancer Treatment (PDQ) – Health Professional Version. Updated 05/25/2017. https://www.cancer.gov/types/breast/hp/male-breast-treatment-pdq

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