Male breast lesions

Abstract

This chapter deals mainly with the two most important causes of enlargement of the male breast, namely, gynecomastia and breast cancer. Gynecomastia is the commonest cause of male breast lump. Most of the lesions are idiopathic, but enlargement due to various physiological and pathological causes may occur. The lesions histologically show fl orid epithelial proliferation within a cellular stroma in the early (active) phase and fi brosis with minimal epithelial proliferation in the late (fi brous) phase. Male breast cancer is a rare disease, but the incidence has been increasing worldwide. Several factors have been implicated including BRCA2 mutations, old age, liver cirrhosis, and testicular disorders. Many predisposing factors are related to increased estrogen levels relative to androgen. Male breast cancer is commonly of the ductal no special type with a high proportion of papillary carcinoma. Lobular carcinoma is extremely rare in the male breast. Management strategies are similar to and derived from the female disease.