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What if it Isn’t Gynecomastia?

What if it Isn’t Gynecomastia?

Is this you? You’ve fretted about your man boobs for a long time and struggled to disguise them in whatever ways you could dream up. Then, you decide to do some research and the horrible thought occurs to you: what if your enlarged breasts indicate something else is going on? What if it’s worse than gynecomastia?

New York guys who visit us to discuss their chest indeed have a case of moobs nearly 100% of the time. They may not know why they grew man boobs, but they know they have them and they are aware that surgery is the solution. Once in a while, though, a patient wants our help in figuring out if there might be something else “in there.”

Male Breast Cancer

If there’s a worry, most often it’s about male breast cancer, or MBC. According to the Susan B. Komen organization, about 1% of breast cancer cases in the U.S. occur in men. That translates to around 2,000 new diagnoses each year. Signs of MBC are similar to those in women: changes to breast skin, a lump or mass, a change in size or shape, nipple changes or discharge.

After thirty years of working with men with gynecomastia in New York, we are pretty adept at picking up a possible case of MBC—it presents a bit differently than regular man boobs. In those rare instances, we refer patients on to see a specialist.

Other Kinds of Lumps and Bumps

You may have heard about lipomas—those small, fatty lumps that can develop between skin and muscle tissue. They are benign and usually don’t hurt. We most often see them elsewhere on a guy’s torso, but they can occur in the breasts.

Cysts are fairly common in women and are thought to be caused by blocked breast glands. According to Johns Hopkins, they are sacs that fill with fluid that can feel soft or hard, depending on how deeply they are located. Cysts are rare but not unheard of in men.

Benign tumors are possible in the male breast, although they are rare as well. One type is called a fibroadenoma. These seem to be associated with estrogen production, that’s why they don’t often occur in men. You can read more about these lumps in this piece by the Mayo Clinic.


Inflammation is usually easy to distinguish from other problems as it means tissues are often painful and hot as well as swollen—as in mastitis some women suffer when breastfeeding. In this case usually one of two things has occurred: either bacteria have entered the breast via a baby’s mouth, or milk has backed up and blocked a duct.

Men rarely get mastitis, though it is possible. We would not be terribly surprised to see it in a guy with nipple piercings, for instance, or in a patient with another injury that has broken the skin.

The Age-Old Fat Debate

We’ve literally heard it hundreds of times: is it fat or gynecomastia? New York patients are like every other guy in the world who seems to have a burning need to know. Some want to believe they can diet their way past moobs; some just hate the thought of having “female” tissue inside.

Indeed, some enlarged male breasts have lots of fat, some have hardly any. But rest assured, no matter whether you’re at your perfect weight or obese, your man boobs will have breast gland that needs to be banished. Bodybuilders with very low bodyfat but puffy nipples have gynecomastia. Seriously obese guys have excess fat in their breasts—fat that has produced estrogen that has produced, you got it, gynecomastia. Read more about the “double whammy” of weight gain here.

Come in and See Us

If you have a breast issue that worries you, read everything you can about it. There are lots of reputable sources of information you can find online. Schedule a visit to your primary care doctor if you think you may need a referral.

If you have a case of man boobs without much in the way of troubling symptoms, call 212-570-6080 and make an appointment to see us in New York. Gynecomastia is a sub-specialty of our practice and has been for a long time. We know about male chests!

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