GYNECOMASTIA - Fibroadenoma – phylloides Tumor Pipilloma Breast Disease

Enlarged Breasts in Males and Enlarged Breasts in Females
Disorders that affect the breasts are very prevalent, it may be: congenital, functional and even malignancies.
Although the increasing number of cases of breast cancer, benign changes (congenital, inflammatory and proliferative) still represent a group of disorders most frequently encountered in clinical practice. The complaint of breast pain is present in about 70% of women aged 17-45 years.
A Cause of enlarged breasts in males is an increased level of circulating estrogens. Estrogens stimulate the breast tissue and result in enlarged breasts in males.

1 - Gynecomastia:

Abnormal growth of breast tissue in male patients is called gynecomastia.(enlarged breasts in male) This event occurs at puberty physiologically and elderly.
Some drugs can also lead to gynecomastia such as Digitalis, anabolic steroids, and spironolactone etc.
This change can also be caused by some chronic diseases such as chronic renal failure, liver cirrhosis, and malnutrition. This is because in these conditions there is an excess of estrogen that induces the growth of breast tissue.
The diagnosis is clinical palpation through the tissue, and the search for the underlying cause, if necessary with additional tests. Treatment should be based on the findings of examinations and even after treating the cause if regression of the tissue doesn’t occur, surgery can be done to remove the extra breast tissue

2 - Fibroadenoma:

Fibroadenoma is another cause of enlarged breasts in males. But it is a more common cause of enlarged breasts in females instead of a man. It is a benign tumour of the breast, involving women aged 20-35 years. Its signs and symptoms are lumps of elastic consistency and size ranging from 2 to 3 cm. During pregnancy, nodules may appear that may eventually become painful. The diagnosis is made by fine needle aspiration. The treatment depends on the patient's age and the size of the lesion.

3 - phyllodes tumour:

They are very bulky tumours, which can reach 15 cm, found more often in older women (40-50 years). Hence it is a cause of enlarged breasts in females. This tumour can behave like a giant Fibroadenoma, locally aggressive and may lead to a local fibrosis. Or can behave like a malignant tumour that may have distant metastases. It is more common in women.
The diagnosis is done by radiological and pathological examination such as x-ray and biopsy..
Treatment includes resection of the tumour with safety margins to prevent recurrences.

4 - Papilloma:

It is a benign tumour of breast epithelium.
This is a tumour located within the lactiferous ducts (location where the milk passes). It may be solitary or multiple, may be detectable or not on manual examination
Regardless of the form, which is important in this type of tumour is the possibility of it becoming malignant. The diagnosis can be done through exams such as ultrasound of the breast. The treatment is surgical, removing the entire lesion.
Author:
Dr. Sarah Raquel Cavalcanti dos Santos
edited by: Dr. Adil Ramzan

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