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Male Breast Enlargement May Be Common

Condition Known as Gynecomastia May Occur in Nearly Half of Men

Gynecomastia in Puberty continued...

"About 95% of the time, this [condition during puberty] will disappear within three to six months," he says.

Another expert, Yong Bao, MD, assistant professor of pediatric endocrinology at the University of Miami Leonard M. Miller School of Medicine, agrees that "tincture of time" often works. The smaller the growth, the more likely it will go away, Bao says. "After the peak of puberty, it usually goes away," he says.

"Most teens do not need any therapy," Braunstein says. But if the breasts are very tender and the patient is bothered by a large degree of growth, doctors may suggest taking tamoxifen, used in breast cancer treatment, Braunstein says. It works by interfering with the activity of estrogen on the breast cells, thus stopping the growth. While tamoxifen is not officially approved for this purpose, it's used "off-label," which is legal. A course of three months of the drug is typical, he says.

About 60% of teens and adults who take tamoxifen have complete regression of the growth, Braunstein says, citing published studies, and about 80% have at least partial regression.

If tamoxifen does not work, male breast reduction or liposuction can be done.

Gynecomastia Later in Life

In older men, an imbalance of hormones is also at the root of gynecomastia, Braunstein says. "In older men, testosterone is down, estrogen is up. There is often an increase in body fat [which makes the condition more likely]."

A doctor should rule out tumors, breast cancer, and other problems, just as in preteens and teens, he says. Certain drugs used for the treatment of prostate cancer, as well as other medications, can lead to excess breast growth in men.

If possible, doctors should switch the medication associated with the breast growth, Braunstein says.

Other options are tamoxifen or surgery such as breast reduction or liposuction to remove the excess tissue.

Treatment May Not Be Needed

"Gynecomastia is a very common problem," Braunstein says. "It's been around a long time." If the teen or man isn't bothered by the problem? There's no reason to treat it, he says, if other problems have been ruled out.

Even if a teen is bothered by the condition, immediate treatment isn't warranted, Bao says. "We always recommend to wait."

Braunstein reports getting consultation fees from companies including Abbott Diagnostics, Esoterix, M&P Pharma, and Novartis -- and research funds from Procter & Gamble and BioSante.


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