male painful lump under left nipple help

[jon671]

Hi guys,

   I am a 25 year old male. I am a smoker and I am overweight, however I quit smoking a month ago and I have been dieting and exercising since trying to get healthy for my kids. No family history of breast cancer. My father died of either liver cancer or colon cancer at 54. Didn't know him so don't know the specifics.  For the last six months I have had a sore lump under my left nipple. It used to only hurt when I touch it, but lately it kind of aches alittle sometimes without touching it. It suddenly appeared and hasn't changed much in size. It worried me, but I never really did anything about it until a week ago. My doctor felt it and said it is probably some fat, but sent me to get an ultrasound. I did and the results are:

1.8 x 1.2 x 1.5cm hypoechoic mass with irregular and lobulated boarders

there are no calcifications or fluid components

there are no posterior acoustic shadowing or enhancments found

remaining breast parenchyma is normal later on in the report it calls the mass a solid

right breast checked to assess for gynecomastia minimal hypoechoic parenchyma found measuring .8 cm

When I got the ultrasound the mass was completely black and the radiologist said he couldn't tell if it was solid or fluid is this possible and if so what does it mean? How come it says something different on the report?
The doctor and the radiologist both told me it is probably an infection or some type of inflammatory thing, but because of certain suspicious characteristics they have to rule out a malignant neoplasm?  I am going to have a core needle biopsy. I have been going crazy looking all over the internet stressing out. I really feel sorry for women that they go through this. I read somewhere on the internet that if it looks suspicious on an ultrasound the chances of it not being cancer are low like 20%. He said it is a suspicious mass. What does that mean and what are my chances.

[Cleveland Clinic]

Dear jon671,  Without benefit of further evaluation and physical examination we cannot speculate on what this might be.  A suspicious lump requires further evaluation, to determine what this is.  A suspicious mass is just that something that looks abnormal and we are not quite sure what it is.  So far the testing hasn’t given a definite answer as to what this mass is.  A biopsy of the mass would help to clarify what this is.  A surgeon would be most appropriate to evaluate and determine the type of biopsy that would help best to determine what this is.  

Male breast cancer is rare, but one out of every 150 cases of breast cancer involves a man, usually in men over 60 years old.

[surgeon]

As usual, ultrasound has added no useful information to the mix when it comes to male breast lumps. What it told you us what you already knew: there's a lump. At your age, it's almost certainly gynecomastia, which is a common condition: enlargement of breast tissue in males. It's often tender, and not rarely involves only one side. Most often there's no particular explanation and it's entirely harmless. It can be due to medications, marijuana, and, rarely, endocrine problems such as testicular tumors or other hormone issues. I agree it makes sense to see a surgeon. A blood test (for hormone issues), a testicular exam, might be done. As to the lump, assuming everything else is okay, the choices are just keeping an eye on it, removing it, or doing some form of biopsy -- which would usually be a needle biopsy.

[jon671]

I am opting for either a core biopsy or just completely removing it. What are your thoughts? If it is more than likely gynecomastia how come they aren't saying anything about it to me?

[jon671]

thank you for your answers they are really helpful and comforting.

[jon671]

I got a second opinion. I saw one of the best surgeons who specializes in oncology in my area. He has alot of experience dealing with breast cancer. He looked at my ultrasound films and rescanned me. He said it is not cancer. He told me it is either an enlarged or inflamed breast bud or the beginning or gynecomastia. He told me the clinic I originally went to is known for doing things like scaring people into getting biopsies. He said it is how they make their money. I wasn't the first person they saw with the similar situation. I understand that it is better to be safe than sorry, but the radiologist at the first clinic i went to was an cold ***. I trust this doctor more he treated me like a person and really made an effort to make me understand everything. He ordered a blood test to check my hormones and another appointment in a month to view the results and rescan me with an ultrasound. He told me that he could remove it if I wanted. He said there is no need to do that for any reason other than comfort and he said that it is almost guarnteed that the pathology report would show it as benign. I am going to do the blood work ( hopefully good ) and then have him remove it for piece of mind. As of now I feel alot better I would say about 80% still catch myself thinking "what if?"

I would appreciate any feedback you have.