Older men

[olderguy]

Most of the participants on this board seem to be younger men, with a few older guys who have had gyne for many years.  I am in my 60's and have suddenly developed tenderness beneath both nipples.  My doctor felt some "puffiness" and sent me to a general surgeon to find out if the tissue was suspicious.  The surgeon said the tissue is benign and agreed with me that it is a mild case of gynecomastia.  He said the lumps are large enough that he wants to take them out.  My doctor says that if we are sure it is gynecomastia, then we don't want to do anything.  I asked him about tamoxifen.  He said he would rather have surgery than mess with hormonal balances.  My testosterone levels test as normal.  I have always thought my breasts were a bit too prominent.  From the pictures on these boards, I would have to say my case is and always has been quite mild.  The pain is not bad, and my inclination is to leave the situation alone for the time being.

Are there other guys out there my age who have experienced recent changes in their breast tissue?

[Time_to_fix_it]

Hi and welcome to the boards,

I was around 42 when the same thing happened to me.  No Gyne before that and then intense sensitivity began behind one nipple.  I was sent for tests (mammogram, needle biopsy, hormone profiles etc) and the diagnosis was the onset of gynecomastia.  Like you it was mild and there was no apparent reason for it starting at the age of 42.  I was put on Tamoxifen for 3 months and the tenderness stopped and the so did the growth.  As it was a mild case and only one side, I decided I could live with it.  Whether the Tamoxifen did the trick or my hormonal balance returned to normal of it’s own accord, is something no one seemed to be sure of.

All seemed well until about 6 years later (last year) when it started up again, but this time both sides started growing, again for no apparent reason.  I’m currently undergoing very rigorous tests of everything from pituitary gland down to my testes (and just about everything in between), so I’m hoping they will discover just what is causing this sporadic growth.

If you do a search on this site under Tamoxifen you will see there are studies that show this anti oestrogen can reverse some gynecomastia if caught in the early stages.  It should only be taken under an endocrinologist’s advice as there are some serious potential side effects.  In my opinion messing with your endocrine system is not something even a GP should attempt as he or she simply doesn’t have the depth of knowledge an endocrinologist has.

As men grow older our hormonal balance does shift slightly in favour of oestrogens, and it is very common indeed for males over the age of 60 to develop some gynecomastia.  How much an individual has, and how much he is prepared to put up with, is a personal thing.  Only you can decide what to do, but given that you are over 60, I think your ‘wait and see attitude is one I would take too.

Good luck.

[olderguy]

Thanks to Time_to_fix_it for the comment.  My doctor's office called yesterday to report that a recent blood test showed an elevated level of luteinizing hormone (LH).  He has scheduled an MRI to rule out the possibility of a pituitary hormone.  I think that possibility is remote, but I will go ahead with the MRI.  From what I have read about LH, it is normal for LH to increase a little bit evry year as we age.

[girlieman]

Did the General Surgeon take a biopsy of the suspicious tissue?  How did she/he rule out the possibility of cancer?

[olderguy]

The surgeon did not do or suggest a biopsy.  I gather that the tissue (more on the right than the left) looked and felt to him like gynecomastia.  He wanted to do a (long overdue) colonoscopy and "nipple extraction" of the breast tissue at the same time.  Of course, the tissue would be sent to pathology as a matter of routine.  After consulting again with my family doctor, I decided to wait six months.  I had been planning on having the colonoscopy anyway next March, when I turn 65 and go on Medicare.  Medicare will adjust the bills way down and at that time my BlueCross will become supplementary and pay 80% of what's left of the bill after Medicare pays.  So I will have 96% coverage, instead of 80%.  I am worried that Medicare and BlueCross might consider the surgery to be "cosmetic," rather than medically necessary.  Perhaps the recent onset and the pain would make it medically necessary.

[girlieman]

Do you feel confident in the MDs diagnosis?  The reason I ask is that male breast cancers are very rare.  Something like 1300 new cases diagnosed per year in the US.  A doctor can work an entire career without ever seeing a case.  I'm at risk for another form of cancer and if my doctors see a move in my blood chemistry, it's off to the Imaging Center and an abdominal CT scan for me!

Medicare is great, isn't it?  I've had very high end benefits packages from employers in the past and Medicare is by far the best.  Are you using the HMO plan or the A & B fee for service?  A personal observation:  HMOs are great if your healthy.  If you're not, fee for service is the way to go.  The great physician you want to treat you is never a provider for your HMO!

Nice to talk to an adult,

Jonathan  

[Paa_Paw]

Of the 2/3 of boys that have pubertal Gynecomastia, I was in the 10% that did not have it go away.  The condition runs in my family. The modern surgical methods now used to get rid of it did not exist back then so I still have it.

I am now 68 Years old.

Gynecomastia is usually harmless, though it can be a symptom of serious disease and should always be thoroughly checked out.

If I had surgery at this point in my life, My wife would likely be very upset.   She thinks my breasts are cute!

There are something like 200 different medications in common use that may have Gynecomastia as a side effect.

Gynecomastia is common (even normal) at birth, in puberty and in old age.  It is worth reiterating: The condition is common and usually harmless; but should always be checked out as it can sometimes (though rarely) be an important symptom of serious disease.