Breast Health for the Other Sex

Women aren't the only sex being screened for breast cancer across the country.

Doctors are reporting that more and more men are asking for mammograms. Many of them are not suffering from cancer but from gynecomastia, a condition that causes painful swelling in the breast yet rarely leads to a tumor.

There hasn't been a dramatic spike in male breast cancer cases across the country, but more and more men are becoming aware that they have breasts and can get breast cancer. The disease is uncommon among men. Male breast cancer accounts for approximately 1 percent of all breast cancers cases. Approximately 2000 patients are diagnosed each year.

The incidence of male breast cancer increased between 1973 and 1998, however, and the reasons for this are unclear. The good news is that men seem to be becoming more aware of their risk and have been taking a more proactive approach to their breast health.

Yes, Mammograms for Males

Researchers from the Mayo Clinic in Jacksonville, Fla. performed a whopping 212 mammograms on 198 men from 2001 to 2004, according to their report from a recent breast cancer symposium in San Antonio, Texas. The scans weren't routine -- most of the 15 million mammograms ordered or provided during doctor's office visits per year are intended to screen women for breast cancer -- but these tests were specifically for males.

"Mammograms in men? Did I hear that right?" asked Elias Friedman, an 18-year-old male. "I didn't realize that men have breasts, so how can they get a mammogram?"

Men have breast tissue, too. As a fetus develops within the uterus, rudimentary breasts normally form in both sexes. Most newborn males have some breast enlargement -- meaning the infant is born with more breast tissue than a normal male would carry -- from exposure to the high levels of female hormones during pregnancy. But these breasts go away within the first few weeks of life.

Remember the "manssiere" episode of "Seinfield"? There may really be a market for it. Some males develop abnormally enlarged breasts, a condition called gynecomastia, or "woman-like" breasts. During mid-puberty, about two-thirds of boys develop breasts, which can last anywhere for a few months to a few years. About half of adult men have male breasts.

But male breasts that are as large as a woman's are uncommon. Males who do feel self-conscious about the appearance of their breasts can have plastic surgery to remove or reduce the breasts and re-contour the area afterward so it looks normal.

The Causes

So what causes breast enlargement in men?

Being overweight is probably the most common cause of breast enlargement in males. Hormones are another common cause; special proteins act like messengers in the blood to tell the breasts to grow. High levels of hormones, an abnormal mix of hormones, an extra-sensitive response to the hormones that turn on breast growth or a low response to hormones that stop breast growth could all be possible roots of the problem. Drinking too much alcohol can cause breast enlargement, so you may want to put down that second six-pack.

Some males are born with inherited genetic syndromes, which might cause breast enlargement. And there is also a list of medicines that can make a man grow breasts.

Mammography's main role for men is to closely follow individuals who are at high risk for breast cancer. These are men with a proven BRCA1 or BRCA2 gene abnormality or who have already had breast cancer. In 2006, about 213,000 new cases of breast cancer will have been diagnosed in women and about 1720 new cases in men.

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Dr. Marisa Weiss is the president and founder of and the director of breast health outreach at Lankenau Hospital in Wynnewood, Pa.