Under normal circumstances, male breasts will not develop. When the estrogen level in the body is relatively or absolutely increased due to various reasons, and the mammary epithelial cells are stimulated by estrogen too much, a very small number of men may have unilateral or bilateral mammary hypertrophy.
Etiology and pathogenesis of gynecomastia
Male mammary hyperplasia is called male mammary dysplasia. It usually occurs around adolescence and old age, and the pathological manifestations are glandular duct hyperplasia without acinar hyperplasia, which can be generally divided into primary and secondary types. The primary patients are usually adolescent boys and elderly men, which are mainly caused by the temporary increase of endogenous estrogen or the decrease of androgen, and often subside spontaneously. Secondary patients are common in liver diseases, testicular diseases, adrenal diseases, thyroid diseases, diabetes, urogenital or nervous system tumors, prostate diseases or others. Reserpine, remifentanil, digitalis, chlorpromazine, etc. It can also cause breast development, which can generally subside after drug withdrawal. In addition, hermaphroditism and congenital testicular dysplasia can also lead to breast hypertrophy.
Chinese medicine believes that a man's breast belongs to the kidney and his nipple belongs to the liver. If his mood is not harmonious, he will be furious and hurt his liver, leading to stagnation of liver qi. However, if he is depressed for a long time, he will turn into fire, burn the body fluids of his liver and kidney, damage his liver function, and have low detoxification function, so that excessive estrogen in the human body can not be inactivated in the liver, but will act on the target organ breast, or he will be old and weak, unable to recover after a long illness, deficient kidney and liver, and unable to maintain liver wood. Or congenital deficiency, essence and blood can't support chong and ren, which leads to disorder of chong and ren, or exogenous pathogenic factors damage the liver, which leads to malnutrition of meridians and collaterals, stagnation of qi and blood, blood stasis and phlegm coagulation, and obstruction of meridians and collaterals, resulting in male breast development.
Clinical manifestations of gynecomastia
This disease can be seen at all ages. About 60-80% of the breasts are bilaterally symmetrical or asymmetrical, and some are unilaterally developed (the left side is more common than the right side). Its breast development performance varies in size, and asymmetrical or symmetrical bulges are often seen on both sides of the breast. Small ones can only touch the flat round nodules under the areola, with hard and tough texture, clear and tidy edges, good fluidity and no adhesion to the skin. The lump is located on the concentric circle with the nipple. If an eccentric circular mass is found, other lesions should be considered. Clinically, this kind of mass is called' adenoma type', and the other part of the developed breast is diffuse hyperplasia with unclear margin, which is often fused with the surrounding breast tissue, and there is no obvious nodule under the areola. Most of them can gradually expand to the size of women's breasts. Clinically, this type is called' diffuse type', and well-developed breasts often have a feeling of swelling, tingling and jumping pain, if it is obvious. A few patients have white milky secretion after nipple extrusion, and spontaneous discharge is rare.
4. How to treat gynecomastia?
If a man finds his breast hypertrophy, he should go to the hospital for diagnosis as soon as possible. If it is caused by physiology or drugs, he should not be too nervous, and he can subside on his own, or he can subside on his own after stopping taking drugs. If it is pathological, he should carefully find the cause and treat it in time. If a man has breast hypertrophy, active and effective treatment at an early stage can still return to normal. But if the time is long, breast tissue hyperplasia is irreversible and must be treated surgically.
At present, there is no feasible treatment for this disease in western medicine, mainly using hormone antagonism treatment and surgical removal, but surgical removal is easy to leave scars, which not only affects the appearance but also is easy to recur. At present, it is often not used, except that it is too large, swollen and painful, and even causes mental anxiety. At the same time, drug treatment is ineffective, and patients insist on resection, otherwise surgical treatment is generally not recommended. In addition, due to the complexity of the etiology, different causes have different treatment methods for male gynecomastia. Adolescent patients in the early stage of breast development often heal themselves and generally return to normal within 6 months.
Primary patients in adults and the elderly are not easy to heal themselves and should be treated actively. Secondary male breast development because it is often accompanied by other diseases; Therefore, treating the cause is an important measure. Over the years, our hospital has accumulated rich clinical experience in non-surgical treatment of this disease. In the treatment, according to the theory of traditional Chinese medicine and its different clinical manifestations, we should adjust the liver and kidney to adjust the function between hypothalamus-pituitary-testis axis, restore liver function, strengthen the inactivation of excess estrogen, promote metabolism, improve blood circulation, protect liver and kidney, rationally regulate endocrine and make the body healthy. From the pharmacological research, traditional Chinese medicine does not have many side effects of western medicine and hormone drugs, and its curative effect is also very remarkable. At the same time, the onset of this disease has a certain relationship with mood. Therefore, it is very important to adjust mood, keep happy, avoid anger and worry, and pay attention to the combination of work and rest. You should quit smoking and drinking at ordinary times, and you should not eat too much greasy and spicy food in your diet. During the illness, you should feel comfortable, have confidence in the treatment of the disease, adhere to the necessary physical exercise and functional exercise, pay attention to the local cleaning of the breast, prevent nipple and skin damage, and prevent infection.
Can five men also get breast cancer?
Men also get breast cancer, but it is very rare, accounting for about 1-2% of breast cancer. Compared with women, there are opposite differences in sex hormones, and androgen is dominant. Because the male breast tissue can't get the necessary estrogen stimulation, especially the breast lobe and glandular epithelium atrophy in the breast structure, the possibility of male breast cancer is very small, although the possibility of male breast cancer is very small. However, in fact, new diseases keep happening. Because of the anatomical and histological characteristics of male breast, such as small size and short lymphatic vessels in the tissue, male breast cancer is prone to metastasis, infiltration and spread in the early stage. In addition, clinically, it is found that the curative effect of testicular resection in late stage of male breast cancer is better than that of ovarian resection in late stage of female breast cancer. Therefore, when a man finds a lump in his breast, he should seek medical treatment in time to avoid delaying diagnosis and treatment and causing adverse consequences; In addition, male mammary dysplasia is not only an objective manifestation of hormone imbalance in men, but also an important cause of male breast cancer, so male mammary hypertrophy can be used as an important basis for the diagnosis of male breast cancer.
In a word, gynecomastia is not only a primary disease, but also secondary to many other serious diseases, so we should be vigilant and diagnose it in time.
When acute inflammation of the breast occurs, most of them first have nipple pain, rupture or breast lump and swelling pain, and then, chills, chills and fever. The affected breast is tender, the skin is red and swollen, the skin temperature is increased, and there is a subcutaneous lump, or the skin is not red, swollen or hot, and the lump is deep, which has nothing to do with the skin, but the pain or tenderness is heavier. In addition, there are swollen and tender lymph nodes in the ipsilateral armpit. If the treatment is not timely and appropriate, the lesion will inevitably continue to develop. The affected breast is more red and swollen, and the lump becomes soft and undulating, forming subcutaneous or superficial breast abscess. Finally, the abscess pierces outward or expands to the inner side of the breast, or the deep lump becomes bigger and softer, and the skin that was not red and swollen becomes red and swollen, the lesion scope becomes larger and larger, and the destruction of breast tissue increases. Abscess can not only pierce the skin outward, but also pierce the mammary duct inward to make the milk contain pus, and even pierce the muscles of the chest wall backwards to form a retromammary abscess. At this point, systemic symptoms are getting more and more serious.
Early treatment is the only way to prevent too much damage to the breast. The following measures are usually taken:
1. The affected breast stops breastfeeding and sucks milk on time.
2. Hold up the affected breast: Holding up the affected breast with a bra or a pocket belt can improve the blood circulation of the breast. Blood circulation is smooth, local blood is not congested, swelling is easy to subside, and inflammation is easy to control.
3. External application: cold compress can be used locally in the early stage. If suppuration is inevitable, use hot compress instead. Three or four times a day, 30 minutes each time. It would be better if we could do it continuously. Local swelling can be coated with Chinese medicine gold powder.
4. Physiotherapy: Infrared radiation (ordinary light bulb100W is also acceptable) can promote local blood circulation, which is beneficial to the absorption and dissipation of inflammation.
5. Internal treatment: intramuscular or intravenous injection of antibacterial and anti-inflammatory drugs. Chinese medicine antler powder is taken orally twice a day, 5 grams each time, which can help digestion.
6. Incision and pus discharge: If the local area has become a suppurative drug. It is necessary to cut open and drain pus as soon as possible, and pus flow can avoid the spread of inflammation. Mastitis prevention is expensive and can be completely prevented. The key is to prevent nipple rupture and milk deposition.