Can gyno turn into breast cancer

[Goddar]

Hey guys!

Since two years i have a slightly lump behind the nipple that seems gyno, and it appears and disappears. Now im experienced armpit sore ( started 1 week ago ). I was doing some research and it seems that there is some relation elevated estrógen levels and cáncer. What do you know about it ?

 

[Systemlord]

In men on TRT getting breast cancer caused by high estrogen, never heard of a single case. Gyno is rare in men on hormone replacement therapy and is more common in men, stopping hormone therapy and men with low testosterone.

I have a pee size lump behind my left nipple and it’s probably been there since puberty. I just never noticed and had no reason to check it until I went on TRT.

Your hormone levels are fluctuating right now and your body is trying to find balance. There’s most likely a bit of fluid retention going on and that’s what you’re noticing.

I went through the same thing.

Much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analysis, and fragment, conflict of interests, together with an obsession for pursuing fashionable trends of dubious importance.

-> Marcia Angell, editor of the New England Journal of medicine for 20 years.

 

[madman]

Hey guys!

Since two years i have a slightly lump behind the nipple that seems gyno, and it appears and disappears. Now im experienced armpit sore ( started 1 week ago ). I was doing some research and it seems that there is some relation elevated estrógen levels and cáncer. What do you know about it ?

Thread 'Gynecomastia, Male Breast Cancer, and Beyond'

Jun 30, 2024

Getting real deep here!


TEACHING POINTS

*In the appropriate clinical setting, mammography is diagnostic for gynecomastia, which is the most common reason for presentation with a palpable lump, an area of focal pain, or breast enlargement; and mammography is highly sensitive in the male breast due to the typically lower amount of fibroglandular tissue compared with that in women.

*Although ductal and stromal proliferation in these patients may be extensive, males with gynecomastia rarely have substantial lobular proliferation due to a lack of progesterone.

*Gynecomastia is the most...

• madman
• gynecomastia; male breast cancer; imaging
• Replies: 22
• Forum: Testosterone Side Effect Management

Gynecomastia

Gynecomastia is an increase in ductal and stromal tissue in male patients secondary to an increased ratio of estrogens to androgens (Fig 1). Gynecomastia may be physiologic (ie,related to an expected deviation from the normal hormonal balance in patients of specific age groups) or pathologic(ie, occurring when the inciting hormonal derangement is caused by extrinsic influences or intrinsic conditions resulting in a systemic increase in estrogen). Although ductal and stromal proliferation in these patients may be extensive, males with gynecomastia rarely have substantial lobular proliferation due to a lack of progesterone. Therefore, lobular abnormalities seen in women, such as fibroadenomas, phyllodes tumors, most fibrocystic changes, lobular carcinoma in situ, and invasive lobular carcinoma (ILC), are rarely seen in men (13,21,22).




Pathologic gynecomastia has a multitude of causes.

These include numerous medications, marijuana, and anabolic steroids; obesity; and common systemic conditions causing disordered metabolism and excretion of hormones, such as chronic kidney disease (23). Genetic abnormalities such as Klinefelter syndrome and hormone-producing neoplasms may be the culprit in other cases (24,25). All of these cause gynecomastia by increasing the ratio of estrogens to androgens. Table 1 lists common causes of pathologic gynecomastia. Pathologic gynecomastia can also be idiopathic (23,24).




Male Breast Cancer

MBC is rare, accounting for up to approximately 1% of cases of breast cancer and less than 1% of cancers in men. Authors of some reports (4–6) indicate that the incidence of MBC has been increasing, with the increase being greater than that of FBC according to Surveillance, Epidemiology, and End Results (SEER) data in recent decades. The average age at diagnosis is 65 years, higher than the average age at diagnosis of 60 years in women (9). Risk factors for MBC include advanced age, personal or family history of breast cancer, genetic mutations including BRCA1 and BRCA2 (BRCA2 more commonly than BRCA1) (3,33); genetic syndromes including Klinefelter syndrome, Ashkenazi Jewish heritage and other ethnicities (34); and conditions including cirrhosis, obesity, testicular abnormalities, hyperprolactinemia, HIV infection, radiation therapy to the chest, treatment of prostate cancer, and environmental exposures (13) (Table 2). Many of these conditions involve an increased estrogen to androgen ratio, as is present in gynecomastia, and gynecomastia may coexist with MBC in up to 40% of patients (35). However, a similar percentage of gynecomastia has been seen in males without MBC, and a causal link between MBC and gynecomastia has not been established (26,36).

Patients with MBC most commonly present with a palpable abnormality but may also present with nipple discharge (a symptom that is more commonly related to cancer in men,when present, than it is in women), nipple or skin retraction, skin changes including ulceration, and palpable axillary adenopathy (17,27,37). Axillary US should be performed in all male patients with breast masses suspicious for cancer because approximately one-half of MBCs involve the axillary lymph nodes (10,11).

In women, breast cancer typically arises in the terminal ductal lobular unit and most commonly occurs in the upper outer quadrant, where the greatest amount of fibroglandular tissue is present (38,39). In comparison, male breast tissue is predominantly located in the subareolar breast, and MBCs typically arise in the central ducts (11). Therefore, MBC is usually roughly subareolar, though it can be seen elsewhere in the male breast, most commonly in the upper outer quadrant (11,37,40). In comparison with gynecomastia, which is subareolar and usually concentric to the nipple, subareolar MBC is more likely to be eccentric to the nipple (13). MBC is typically not painful, a fact that may help to distinguish it from gynecomastia, which is often painful in its earliest phase (17). Differences in the clinical manifestations of MBC and gynecomastia are shown in Figure 7.

Men with MBC tend to present at a later stage than do women with FBC. A recent large population-based study by Weir et al (9) of male and female patients with breast cancer showed that MBC tumors are, on average, larger than FBC tumors and more frequently involve regional lymph nodes. This is likely due in part to the fact that men often delay pursuing medical attention for breast symptoms. In addition, the relatively smaller male breast size results in MBC more commonly involving surrounding structures such as the skin or chest wall, contributing to a higher stage at diagnosis (13). Although some studies have shown equivalent survival among patients with stage-matched MBCs and FBCs, other recent large studies have shown a worse prognosis in patients with MBC when compared with patients with age- and stage-matched FBC (9,41). In addition, although breast cancer mortality rates have improved for both men and women in recent decades, this has occurred to a lesser degree in male versus female patients (42).




Figure 7. Illustration shows the clinical and imaging differences between MBC and gynecomastia.

Thread 'Gynecomastia: Approach to Evaluation and Management of a Common Disorder'

Dec 14, 2023

Dr. Sathya Krishnasamy gave a comprehensive overview of gynecomastia, covering its definition, prevalence, hormonal regulation, pathogenesis, differentials, and management options. He discussed the role of androgen receptor and aromatase in breast development, as well as the impact of various drugs, tumors, and environmental factors on gynecomastia. The session also included a case study and highlighted the importance of a thorough evaluation to determine the underlying cause, along with potential treatment options.


Highlights:

• ...

• madman
• gynecomastia evaluation and management
• Replies: 33
• Forum: Testosterone Side Effect Management

post #6

Thread 'Approach to Gynecomastia in Primary Care Clinics'

Aug 26, 2022

An Approach to Gynecomastia in Primary Care Clinics (2022)
Kavya Bharathidasan, MD, Jordan Curl, BS, Vedesh Kumar Babu, MD, Shaili Felton, MD, and Kenneth Nugent, MD


Abstract

Gynecomastia is a more common finding in primary care clinics than is recognized. Because this finding can be easily overlooked, appropriate investigation and management often are missed. The workup of gynecomastia is highly individualized, based on the patient’s presentation and related factors. It should be guided by thorough history taking and physical examination. Unless the patient has...

• madman
• gynecomastia; male breast cancer
• Replies: 7
• Forum: Testosterone Side Effect Management

 

[Jonny35]

It's understandable to be concerned, but gynecomastia (gyno) in men, while common, is rarely linked to breast cancer. Gyno is usually caused by hormonal imbalances, particularly elevated estrogen, and typically presents as a lump or soreness in the chest area. While it's true that gynecomastia can coexist with male breast cancer (MBC), the risk is low. MBC is rare, and most men with gyno don't develop cancer. If you're concerned, it's always a good idea to get a professional opinion to rule out anything serious.

 

[Vince]

As we all know men can and do get breast cancer. It's rare but does happen. If you're concerned, please see your doctor, have it checked.

Breast cancer in men is rare — less than 1 percent of all breast cancer occurs in men.

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About Breast Cancer in Men | Johns Hopkins Medicine​