Male Boobs: Embarrassing but harmless Part 6

Diagnosis

In the majority of cases, the diagnosis of gynecomastia is made by the physician by just simple observation and the presenting history. The breast is always palpated (felt with hands) to ensure there are no hard masses present. Infection of the male breast is almost unheard of, except in those males who pierce their nipples.

However, the physical examination should also be done to ensure that the scrotum does not have any abnormal mass that may be responsible for the gynecomastia. There are a few testicular cancers that can make female sex hormones and Gynecomastia may be initial presenting feature.

In some cases, there is no real breast tissue and the breast is infiltrated with a fatty tissue. In these cases a diagnosis of pseudo-gynecomastia is made. This is a common finding in obese individuals. Breast cancer in males does occur but is seen in the older males and typically presents as a hard mass in a single breast. Both breasts having a cancer is very unusual.

The majority of the younger individual do not require any tests, either radiological or blood tests.

Mammogram has no role in the evaluation of breast mass in males. Unless the male has undergone a sex change and undergone a size 44 C breast enlargement, it is impossible to place a male breast on a mammogram machine. A mammogram requires fairly decent sized breasts to be placed between two metal plates.

A chest x ray of an ultrasound of the scrotum may be obtained in the rare individual with Gynecomastia.

Biopsy of the breast is very unusual and is only done if there is a great suspicion of a breast cancer, or if the physician is clueless