Causes of Male Breast Pain and Swelling

Gynecomastia, Breast Cancer, and Other Male Breast Concerns

While not discussed often enough, assigned males may experience breast pain, breast enlargement, nipple pain, and even breast cancer.

Understanding the causes and symptoms of breast concerns in assigned males may help individuals get diagnosed and treated more quickly.

Common causes of male breast pain and swelling.

Verywell / Emily Roberts

This article explains the possible causes of breast pain or swelling in assigned males. It also discusses when you may need to be concerned about breast cancer.

Assigned Male Breast Development

Before puberty starts and hormones change, breasts look the same in those who are assigned female at birth and those who are assigned male. Children's breasts are mainly made up of skin, fat, and connective tissue that supports the nipple and areola, or the darker skin that surrounds the nipple.

In the early teen years, sex-specific hormones start to transform bodies for adulthood:

  • In assigned males, testosterone promotes testicle growth and usually keeps breasts from developing.
  • In assigned females, estrogen signals milk-producing glands to develop and increases breast size.

What Causes Breast Swelling?

Over-development or swelling of breast tissue, also called gynecomastia, may occur in assigned males:

  • During their teen years, as a normal part of the hormonal changes that occur during puberty
  • Over the age of 50, as the body naturally starts to make less testosterone

Any condition that increases estrogen or decreases testosterone can cause gynecomastia.
Keep in mind that in some cases the cause may be unknown.

Conditions

Other possible causes of gynecomastia may include:

Medications

Certain drugs can also cause gynecomastia, including:

Long-term use or overuse of these medications can increase the risk of breast swelling, especially in older assigned males.


There may be more than one factor involved in gynecomastia. For example, someone may have mild gynecomastia because of their age or weight. The condition may worsen after taking certain medications.

What Causes Breast Pain?

Most causes of male breast pain are benign, or not cancerous. The pain can be caused by hormone changes, infections, injuries, or unknown causes. 

Some common causes of male breast pain include:

  • Breast injury: An injury to the breast may cause the death of fatty tissue. This can lead to a breast lump or dimple that can look like breast cancer, even on an imaging test. A biopsy, which uses a needle to draw out fluid from the lump, may be needed to rule out cancer.
  • Runner's nipple: It's common for individuals to get irritated or bloody nipples from jogging. Friction over the nipples can result in pain, discomfort, and bleeding.
  • Mastitis: An infection of breast tissue can happen in assigned males on rare occasions, though the cause is unknown.
  • Breast cyst: A breast cyst is a fluid-filled sac that's not cancerous. Extremely rare cases have been reported in assigned males. However, the cause was not known.
  • Fibroadenoma: While uncommon in assigned males, this benign breast tumor may occur. Breast swelling usually occurs alongside fibroadenoma. The causes are unclear, but may be due to a hormonal imbalance.

How Does Breast Cancer Impact Assigned Males?

Breast cancer in assigned males is much less common than in assigned females. 1 out of every 100 breast cancers are diagnosed in assigned males.

About 2,000 assigned males are diagnosed with breast cancer in the United States each year. Most cases happen to individuals over the age of 60.

Risk Factors

Common risk factors include:

  • Family history of breast cancer
  • Obesity
  • Klinefelter syndrome
  • Exposure to a form of energy called radiation

Individuals with the mutated BRCA1 or BRCA2 gene have a higher risk of breast cancer.

There are also non-BRCA gene mutations associated with breast cancer. Some of these increase the risk of breast cancer in assigned males. It's important to know your family history of cancer so you can be proactive and get screened for these mutations.

Keep in mind that a family history of other types of cancer can be just as important. For example, BRCA2 mutations increase the risk of breast, prostate, and pancreatic cancer.

Symptoms

Symptoms of breast cancer in assigned males and assigned females are similar and include:

Most assigned males with breast cancer don't experience any pain. But, don't assume a painful breast lump isn't cancer either. It's always worth seeing your healthcare provider for an evaluation.

Symptoms in other areas of the body can occur if the cancer has spread. This is called metastatic cancer.

This can include:

  • Pain or a fracture due to bone metastases
  • Stomach pain or jaundice, or when skin and whites of the eyes yellow, due to liver metastases
  • Headaches, one-sided weakness, or speech problems due to the cancer spreading to the brain
  • Cough and shortness of breath when cancer spreads to the lungs

Diagnosis

Individuals with a family history of breast cancer can do a breast self-exam. This is an easy way to be aware of any breast changes.

If you notice any changes, your healthcare provider:

  • Will do a physical exam and take down your medical history
  • May do imaging tests like a mammogram or ultrasound
  • May refer you to a genetic counselor to test for genes that increase your risk of cancer

Summary

Assigned males may experience breast pain and swelling. In many cases, the cause is not of major concern.

However, breast pain and swelling can also be due to breast injury, infection, or an underlying medical condition—including cancer.

Be sure to let your healthcare provider know if you have any breast pain and swelling, or notice any other breast changes.

Frequently Asked Questions

  • How common is breast cancer in assigned males?

    The incidence is extremely low. In 2021, there were about 2,650 new cases of breast cancer in assigned males compared to 330,840 new cases in assigned females.

  • What are the main differences between gynecomastia and breast cancer in assigned males?

    Gynecomastia typically impacts both breasts in terms of swelling. Breast skin and nipples will not appear different. Breast cancer may cause swelling in one breast, impact the feeling of the breast tissue, and cause nipple and skin changes.

  • Is breast cancer in assigned males life-threatening?

    It can be. The five-year survival rates for assigned males with breast cancer ranges from 22% to 97%, depending on the disease stage. Other factors affect someone's prognosis, including overall health and advances in treatment.

  • When should I worry about breast pain or swelling?

    If you are experiencing pain, swelling, or any other breast changes, it's always best to bring it up to your healthcare provider. These symptoms might indicate breast cancer, or another health condition.

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