Male Breast Lump & Pain

[akaero]

I am a 50 year old male and and have a lump under my right nipple which is painful (bruise like) when pressed.  I have been to see my doctor who, without any testing, referred me to a surgeon who wants to do a biopsy.   Nether doctor provided any diagnoses or possible cause of the lump/pain.  The condition is asymmetrical and both doctors ruled out Gynocomostia.  I've spent less than 1 hour between both doctors and I am at a loss as to how to proceed.  I personally feel that the doctors have not done enough pre-surgical testing.  I am desperate for advice.

[turbo346cid]

A related discussion, swollen chest and under arm glands was started.

[BhumikaMD]

Hi,

You could follow the management plan as advised by your surgeon or you could take a second opinion if you are not convinced.

You could insist on getting a mammogram and/or ultrasound if money is not an issue.

Your surgeon is right about the biopsy being helpful in getting a confirmed diagnosis and to rule out cancer.

Let us know about how you are doing and if you have any other doubts.

Regards.

[akaero]

I am not taking any drugs or medications nor do I have any history of radiation therapy.  However, my mother had breast cancer about 20 years ago and has recovered.  Neither of my doctors suggested a mammogram or MRI and the surgeon didn't offer a core biopsy as an option.  A couple of months ago I had a bump right next to my nipple which resulted in a small dark scaly patch for several days, but I did not notice any discharge.  I have had not other external symptoms since.  Just the lump and the pain when touched.  The surgeon checked me for gynecomastia and ruled it out.  He checked my lymph glands and found the gland under my right arm (same side) to be slightly enlarged.  I checked myself when I got home and could not find any swelling. My surgery is scheduled for the 21st and I need to get smart way before then.

I just received a phone call from the surgeons office and we discussed some of my concerns.  The doctor does not feel that a core biopsy is practical because there is a good chance that he would have to go back in at a later date and remove the lump and that a mammogram would only add additional expense to the process because the lump should be removed.  He also said that there's about a 5% chance of it being life threatening (the big C).  

[BhumikaMD]

Hi,

Most breast lumps are not cancerous.

This could be simply physiological , or due to other causes such as gynecomastia nor due to hormonal disturbances. Are you on any drugs or medications currently?

Symptoms of male breast cancer include lumps, changes to the nipple or breast skin - redness or scaling, skin dimpling or puckering, or  nipple discharge.

What you need to do is get a clinical breast examination done by a physician. If he notices something amiss he will suggest a mammogram and USG.

It would then be possible on the basis of these reports to decide whether a core needle biopsy or a surgical excision biopsy would be the preferred option in your case.

You should go ahead with the biopsy for a confirmed diagnosis and to rule out cancer.

Do you have a family history of cancer or any history of radiation therapy - that are the risk factors for male breast cancer.

Let us know about how you are doing and if you have any other doubts.

Regards.