Breast Lumps (Male) and Gynaecomastia

 

Breast cancer is rare in men, and usually presents aged over 50, but if you are concerned, referral is appropriate. Refer on the suspected cancer and symptomatic breast referral form.

 

Gynaecomastia is enlargement of the male breast tissue. It can be defined as the presence of >2 cm of palpable, firm, subareolar gland and ductal breast tissue.

It may occur at any time and there are a number of causes, some physiological and others pathological. Medication accounts for up to 25% of all cases in adult men. For more information, click here

 

Men aged under 50 with sub-areolar breast lumpswill only be seen if the following blood tests are carried out and are normal:

LFT, TFT, Prolactin, Beta HCG, AFP, Test/Oest, SHBG, Gonadotrophins, Free Androgen Index

Testicular examination should also be carried out prior to referral.

Immediate referral alongside blood tests may be appropriate if significant family history, history of Klinefelters’, exposure to chest wall radiotherapy or Finasteride.

If the blood tests are abnormal then please refer to an endocrinologist.

 

If the patient proves to have gynaecomastia surgical treatment cannot be offered on the NHS, as this condition is considered a procedure of low clinical priority, and therefore not routinely funded.

The form and further information about applying for special consideration for ‘Procedures of Limited Clinical Benefit’ can be found here

 

 

Date Reviewed                              November 2021

Next Review Date                          November 2022

Author                                            Dr I Boyd, RMS GP Sifter

Reviewed By                                  Dr M Attridge, RMS GP Sifter

Contributor                                     Dr Rebecca Osborne, GPwSI Breast, RCHT

 

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