In life, some men find that their breasts are getting bigger, which makes them very worried, because apart from the pectoral muscles from exercise, it is very unsightly for men to get bigger breasts. Many men worry that their breasts are getting bigger because they have changed some kind of disease. What's wrong with a man's chest getting bigger?

1, reasons for male breast enhancement

Male breast enhancement can be seen in two situations:

(1) The local fat accumulation in the breast leads to the increase of bilateral breast symmetry, which is more common in obese people.

(2) Male mammary dysplasia: it is a clinical disease caused by physiological or pathological factors, such as abnormal development of male mammary tissue and abnormal hyperplasia of mammary connective tissue. Usually, it is painless, progressive enlargement or tender mass in one or both breasts.

50% of male gynecomastia is physiological, and it is the most common in neonatal period and adolescence, generally it will spontaneously subside and is generally benign. However, if it occurs before puberty, adolescence and middle age, it is considered abnormal. The common reasons include: ① the increase of estrogen level (testicular tumor, adrenal tumor, liver cirrhosis, alcoholism, chromosome abnormality); ② Androgen secretion is too low; ③ androgen receptor is insensitive; ④ Other diseases (thyroid dysfunction, chronic renal failure, malnutrition); ⑤ Drugs (estrogen and its analogues, chorionic gonadotropin, androgen antagonist, etc.). ); ⑥ Idiopathic: At present, most male mammary gland hyperplasia can't find a clear cause, and all kinds of hormones are normal, which is called idiopathic male mammary gland hyperplasia.

2. Will breast development become cancerous?

Whether male mammary dysplasia belongs to precancerous lesions is still controversial. It is generally believed that the canceration rate of male patients with breast development may be 1% ~ 5% without treatment, which may be slightly higher than that of female patients. At present, most scholars believe that this disease is one of the high risk factors of male breast cancer.

3. Breast development and differentiation of breast cancer

Male breast development and male breast cancer can usually be identified by three methods:

(1) Symptoms: The breast tissue of male patients with breast development is tough and elastic, and most patients are bilateral, which may be accompanied by tenderness and less nipple discharge; Male breast cancer is more common in elderly men, and it is often an isolated lump on one side of the breast. The mass has solid texture, unclear boundary and no tenderness. It may have areola skin adhesion and axillary lymph node enlargement, and there are many skin changes such as nipple galactorrhea, depression or deviation. If there is a local ulcer or adjacent lymph gland enlargement, it is the manifestation of advanced breast cancer.

(2) Breast ultrasound examination: The ultrasound manifestations of male breast cancer are that the mass deviates from the areola, the boundary is unclear, and the posterior part is attenuated. Breast development ultrasound shows a high echo interlaced image centered on nipple.

(3) Mammography: Mammography of male breast cancer mostly shows the mass shadow on the upper and lateral sides of the breast at 1/4, which is eccentric, with unclear edges and a burr-like extension. The molybdenum target of breast development shows a gland density shadow behind the nipple.

(4) Pathological diagnosis: For patients who are highly suspected of breast cancer, coarse needle biopsy should be done as soon as possible to make a definite diagnosis.

4. How to treat male breast development?

Most of the gynecomastia in adolescent and newborn males can subside without treatment. However, other male gynecomastia needs clinical intervention. We must first treat the cause. Generally speaking, for patients with definite pathogenic factors, the symptoms of mammary gland hyperplasia will subside after removing the primary disease. Those caused by drugs should stop taking related drugs and recover on their own. However, clinical intervention should be given to patients with breast pain or tenderness, breast development is large, and the physical beauty and psychology of patients are continuously affected. Commonly used treatment methods include drug therapy and surgical treatment: ① drug therapy: commonly used drugs include androgen preparations and estrogen antagonists, but hormone therapy may cause endocrine disorders, so the choice must be careful; ② Surgical treatment: indications include: men who still have breast development at the end of adolescence or after puberty and are ineffective in drug treatment; Those who seriously affect the appearance or are suspected of malignant transformation.

5, prevention and treatment methods

1. Etiology treatment

The cause of this disease is complicated, so correct diagnosis and treatment should be made according to the cause. Adolescent primary male breast hypertrophy tends to heal itself and can return to normal within about 6 months. Primary male breast hypertrophy in adults and the elderly, some can heal themselves, and some need medical treatment. However, secondary male breast hypertrophy should be treated according to its etiology after a clear diagnosis. When the primary disease is cured, enlarged breasts can often gradually recover.

2. Drug therapy

(1) selective estrogen receptor antagonists, such as tamoxifen.

(2) Androgen therapy can reduce breast development in patients with androgen deficiency, but it is not recommended that patients with normal androgen level aggravate breast development, because androgen is converted into estrogen in the body.

(3) Aromatase inhibitors such as testosterone can inhibit the aromatization of androgens in vivo, thus reducing the production of estrogen.

3. Surgical therapy

In addition to etiological treatment and drug treatment, male breast hypertrophy can be treated by surgery.

(1) Indications ① Male breasts with a diameter greater than 4cm that cannot be solved for a long time; (2) Breast hypertrophy obviously affects beauty; (3) those who have no obvious curative effect after routine drug treatment; (4) Patients are suspicious of malignant transformation and have psychological anxiety.

(2) Surgical methods ① Subcutaneous mastectomy (preserving nipple and areola), suitable for young patients; ② Simple mastectomy (excluding nipple and areola) is most suitable for elderly patients. Specimens were taken out by operation and confirmed by pathological biopsy.