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Husband has a category 4 painful lump

Hello.  About 2 months ago my 30 year old husband discovered a painful lump in his breast near his left nipple.  He had it examined by our PCP, who suggested a mammogram and u/s.  The results came back as a category 4 last Friday.  I called and got a consultation appointment scheduled with a surgeon for next Thursday.  He also appears to have grown some breast tissue (both breasts) within the past few months, and I believe the doctor, or radiologist he saw while getting these tests said it could by gynecomastia.  He's on no legal or illegal drugs, doesn't drink excessively, and is a trim guy.

My first series of questions is this:  He mistakenly wore deodorant/anti-perspirant to the u/s and mammogram.  How much could this have skewed the results?  Also, what else could this be besides cancer?  Should we get the gynecomstia evaluated sooner than the appointment to the surgeon?  I don't even know what kind of doctor we'd go to for that.  Or will the surgeon be able to advise us about that too?

Now, about 6 months ago he was complaining about intermittent sharp pains near his heart.  He had xrays of his ribs done, and u/s of his heart at a cardiology office.  Both of those came back clear (no fracture of the ribs, nothing wrong with his heart), and the doctor attributed it to skeletal pain.  He doesn't get this pain very often anymore, but now that the risk of cancer is out there, could the cancer have worked in the reverse manner from how it usually starts?  Could he have gotten it in his chest wall first and then spread to his breast?  Would the xray and u/s have picked up a tumor on the chest wall, if that wasn't what they were looking for?  I've read up on gynecomstia and read it can be caused by a tumor, so should we be investigating other tumors/cancer?

I'm trying to remain calm, as I know this could very well turn out to be benign, but I want to make sure we quickly act on any kind of risk.  Thanks so much for any advice/insight.
3 Responses
Avatar universal
Hi.  Breast cancer is an exceedingly uncommon condition among males, and probably even rarer in 30 year old males, so I wouldn't consider this as my primary diagnosis when looking for the cause of your husband's condition.  Another thing:  you mentioned that your husband has growth in both breasts, right? Male breast cancer usually happens in one breast, not in both at the same time. Again, this makes the diagnosis of breast cancer doubtful.

So what could account for the gynecomastia?  More common conditions which can happen in males are the following:

1. Liver disease, particularly liver cirrhosis.  Just because your husband doesn't drink excessively doesn't mean that he's not prone to develop liver disease. Other conditions (e.g. viral hepatitis) can lead to cirrhosis.
2. Hyperactivity of the thyroid gland, called thyrotoxicosis, can also lead to elevated estrogen levels and cause gynecomastia.
3. Other tumors, particularly testicular tumors, can cause gynecomastia not by direct invasion of the breast by cancer cells, but also by stimulating estrogen overproduction.

As for your other questions:

1. Deodorant or anti-perspirants do not have an effect on mammography or ultrasonography
2. An internal medicine specialist can probably help you more in properly evaluating your husband's condition, but a biopsy of his breast can also help at this point.
3. Your doctor probably should be investigating the other possibilities I have enumerated above.  So the investigation should not focus solely on looking for evidence of cancer.  His liver and thyroid should also be examined.
Avatar universal
Thanks so much for the response.  He does have breast tissue growth on both sides, but he also has a lump that's only on one side, by his left nipple, that is really painful.  This is the thing they said is a category 4 and suspicious for cancer.

I will call my PCP about the breast growth, and ask if they or the surgeon should deal with it.

Thanks again, I really appreciate it.
Avatar universal
I just got the procedure report.  Can anyone help me interpret this?

Interpretation was made with the benefit of CAD, ImageChecker System (Version 8.1)

Bilateral Diagnostic Mammogram: Left Breast
CC and MLO views were taken of the left breast.
Finding: Density bilaterally, greater on the left, probably represents gynecomastia.

Ultrasound: Left Breast
Sonographic evaluation was performed where the patient palpates a lump posterior and slightly superior to the nipple.  There is an area of mixed echogenicity whose margins are not well delineated.  However, it is not irregular.  It measures approximately 2.5 cm in length.  This is felt to correspond to the patient's palpable lump.  There are no similar appearing findings on the right side.  The etiology of it is uncertain.  It is different in appearance compared to the other areas of gynecomastia.  Surgical removal or biopsy is recommended.

Thanks to anyone who can provide some insight!
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