Help!: 45 years old, steroids 25 years ago, gyno ever since

[leadoff1]

Hello all,
I can really use some answers!
I am 45, 150 pounds, in good health. I took steroids for about two years (about 15 months of those two years) when I was about 20. I had gyno ever since. I have semi-hard lumps under my nipples and around my nipples going toward my under arms. They have NOT gotten any bigger or plentiful, but from time to time get very sensitive, and sometimes (though rarely) painful. They are almost always slightly tender to the touch, and if I get hit in them, they will hurt. I can go weeks without thinking about them until my kids hit them by accident or lay on them. Sometimes they get tender out of nowhere. They don't look like typical gyno where the nipple gets "hangy" because over the 25 years they have hardened and seem "deeper" (not just sitting under the nipple. It looks like just mid-life fat that gathers to the side of the nipples. There are around 5 main "nodules" on each breast, the biggest about 1 inch long.
My questions are:
1. Since I know the genesis of the gyno was steroids, do I still have a risk of them becoming breast cancer? Or being the result of a disease?
2. Is my story common? Has anyone else had gyno from steroids that never went away? (25 years)
3. For those of you with long term steroid gyno, do they get tender from time to time?
4. Can you feel them under the nipple and out towards the under arm?

Thank you so much for your answers!!!!!!!!!!!!!!

[Dr. Cruise]

Steroid use is a common cause of gyencomastia.  The testosterone that was taken converts into estrogen within the body and this is the cause of the gynecomastia.  Your signs and symptoms are spot on classic.  Regarding breast cancer.  Breast cancer even in a male is legitimate.  It is a potential concern, particularly if you have a family history of breast cancer.  However, if it isn't actively growing and you don't have any significant family history of breast cancer, I would not be overly concerned.  Please see the following link of a video of a patient I treated who had a strong history of breast cancer with his mother and 2 aunts. In his case, the gynecomastia treatment was both cosmetic and prophylactic.  Julian's Story.

[DrBermant]

Hello all,
I can really use some answers!
I am 45, 150 pounds, in good health. I took steroids for about two years (about 15 months of those two years) when I was about 20. I had gyno ever since. I have semi-hard lumps under my nipples and around my nipples going toward my under arms. They have NOT gotten any bigger or plentiful, but from time to time get very sensitive, and sometimes (though rarely) painful. They are almost always slightly tender to the touch, and if I get hit in them, they will hurt. I can go weeks without thinking about them until my kids hit them by accident or lay on them. Sometimes they get tender out of nowhere. They don't look like typical gyno where the nipple gets "hangy" because over the 25 years they have hardened and seem "deeper" (not just sitting under the nipple. It looks like just mid-life fat that gathers to the side of the nipples. There are around 5 main "nodules" on each breast, the biggest about 1 inch long.
My questions are:
1. Since I know the genesis of the gyno was steroids, do I still have a risk of them becoming breast cancer? Or being the result of a disease?
2. Is my story common? Has anyone else had gyno from steroids that never went away? (25 years)
3. For those of you with long term steroid gyno, do they get tender from time to time?
4. Can you feel them under the nipple and out towards the under arm?

Thank you so much for your answers!!!!!!!!!!!!!!

Tenderness can be a Symptom of Gynecomastia that the glands are still under stimulation. I see many Bodybuilders from around the world with gynecomastia. Quite a few have been from anabolic and hormonal manipulation. For some of these patients, breast growth can continue years after stopping the steroids. Once the normal endocrine axis is broken, it sometimes can be quite difficult to fix the balance.  Sometimes breast growth / stimulation can come from several causes such as an additional Medical Problem Causing Gynecomastia. For my patients with such Red Flags, I recommend an Endocrinology evaluation.

Gynecomastia surgery is not the first step for someone with tender growing breasts. Surgery will not stop the process of further breast growth nor tenderness and I have seen too many cases of such recurrence when such factors were ignored by other doctors.

I am not aware of any studies about male breast cancer and steroid use. Such information would be hard to collect since the legal issues of the steroid world and the difficulty documenting just what was used and the variable nature of the product.

The male breast tissue, just like female tissue, does tend to extend toward the arm as you can see in this Anatomy of the Male Chest.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction