How do I know if I have glandular tissue?

[mstaman]

Hi. I've been talking to a surgeon via email, sent pics etc., and told him that there is a hard spot on the side of each nipple (right side on right breast, left side on the other) and he is saying it is most likely Lipoma.

Is there a way I can feel around myself and determine if there is actual tissue there and not just fat and Lipoma?

Thanks for any replies.

[George Pope, M.D.]

A lipoma is a benign (non-cancerous) tumor composed of fat.  Because it's fat, it is soft.  What you're describing sounds more like gland tissue, as you say it's hard, and not only that, you have it on both sides.  That would be quite a coincidence to have mirror image lipomas in the breasts.

You should be evaluated by your family doctor, IMO, or someone who can lay a hand on you and feel these areas.

Dr. Pope, MD

[DrBermant]

Hi. I've been talking to a surgeon via email, sent pics etc., and told him that there is a hard spot on the side of each nipple (right side on right breast, left side on the other) and he is saying it is most likely Lipoma.

Is there a way I can feel around myself and determine if there is actual tissue there and not just fat and Lipoma?

Thanks for any replies.

All male mammals will have gland. It is just part of being mammal.

Examination of the Male Chest is not a reliable way to determine if tissue is gland, fat, or lipoma. Fat tends to be soft and gland firm, but gland can be soft and fat firm. Lipoma (a fatty growth) can also range from firm to soft. Unlike gland, lipoma can be mobile in tissue and move during examination a short distance. Actual hard tissue is something that should not be in a male chest. Something that was not hard before and has recently changed can range from nothing, to infection, to tumor and needs investigation by clinical examination by an experienced surgeon. In the rare cases of my feeling hard tissues in the male chest, that is a major Red Flag and means I ask for a Male Mammogram and other possible evaluations. Male breast cancer is quite rare, but when you work with as many as 8 gynecomastia patients a day, the weird and unusual become something you just get to see.

The Anatomy of Gynecomastia consists of fat, gland, and skin. Fingers of gland tends to extend from the nipple between fingers of fat. Gland segments can be located well away from the central nipple, just like the female breast. This is the most common dense mass I find in my patients.

For all of the many gynecomastia patients over the years I have sent to pathology for evaluation, the diagnosis of lipoma is extremely rare. But today I just had one read by a pathologist as bilateral lipoma in addition to the other findings of multiple other prior operations that patient had done by other surgeons.

Hope this helps,

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

[mstaman]

Thanks Dr. Pope I was just going to attach a pic prior to your reply here it is. I'm 5'9" and weigh 168-170

[mstaman]

Thanks to both of you I think you convinced me to see a physician first before I commit to surgery. The cost seemed too low ($1653) but of course that's what I was going for since the $3-5k is not in my budget right now. I have insurance, is there a specific specialist to see or just a normal physician? Thanks again.

[DrBermant]

Thanks to both of you I think you convinced me to see a physician first before I commit to surgery. The cost seemed too low ($1653) but of course that's what I was going for since the $3-5k is not in my budget right now. I have insurance, is there a specific specialist to see or just a normal physician? Thanks again.

Unless dealing with infection my recommendation is to start with an experience gynecomastia surgeon who should have much greater experience in that issue. Here is where I posted how to pick a Gynecomastia Surgeon:

http://www.gynecomastia.org/smf/index.php?topic=16474.0

I have just reviewed over 600 requests over the past several years for my help by unhappy patients after other surgeons' gynecomastia surgery. Cost saving for surgery and convenience of location near them were the most common issues that patients told me that they regretted.

Hope this helps,

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