Males and females are both born with breast tissue and mammary glands. Development of those glands — which don’t function in males — and of breast tissue itself usually stops when boys hit puberty. However, males are still at risk for conditions affecting breast tissue.
Breast cancer is a very rare cause of breast pain in males, though the condition may be more common than you might think. Other causes can include injury or noncancerous diseases of breast tissue. And pain that may seem to originate in the breast may be related to the heart or the muscles and tendons of the chest.
Here are some common conditions that cause breast pain in males, as well as how they’re diagnosed and treated.
Breast fat necrosis
When breast tissue is badly damaged — whether it’s from a car accident, a sports injury, or other cause — the tissue can just die rather than repair itself. When this happens, a lump or multiple lumps can form in the breast. The skin around the lump may also appear red or bruised. It may start to look dimpled. Breast fat necrosis is relatively rare in males.
A physical exam of the breast may be followed by an ultrasound. This is a painless and noninvasive screening tool that uses sound waves to create images of the breast on a nearby computer screen.
Your doctor may order a fine needle aspiration or core biopsy of the lump to determine whether it’s a sign of necrosis or a cancerous growth.
It’s not always necessary to treat breast fat necrosis. The lump of dead cells may dissolve on its own over a period of weeks or months. If the pain is severe, outpatient surgery may be an option to remove the necrotic, or dead, tissue.
If you do a lot of heavy lifting, such as bench presses, or have been playing a sport that involves contact, such as rugby or football, you’re at risk for an injury to the pectoralis major or pectoralis minor. These are the two main muscles in the chest. The tendons that attach these muscles to bones are also at risk of strains or tears.
When this happens, the main symptoms are:
- chest and arm pain
- possible deformity of the affected chest and arm
While the pain may not come from the breast itself, muscle or tendon pain in that area can sometimes seem to emanate from the breast.
A physical exam may reveal damage to the muscle. You may be asked to move your arm into certain positions to help determine the location and severity of the muscle injury.
Your doctor may order an ultrasound or MRI to more accurately diagnose the problem. An MRI uses high-powered radio waves and a strong magnetic field to create images for your doctor to see the injury in more detail.
If there’s no muscle or tendon tear, then rest, heat, and eventually stretching exercises may be enough to produce effective healing.
If there’s an actual tear, surgery may be necessary to repair the muscle. Recovery can take some time. However, you could be back to lifting weights and your normal routine in about six months.
Initial symptoms of male breast cancer often include changes in the skin or a lump, but not pain. However, pain in the breast can develop. Skin puckering or dimpling is common. There may also be redness and sometimes discharge from the nipple.
Your doctor may order a mammogram to better evaluate a suspicious lump or pain in the breast. An ultrasound and MRI may also be helpful.
Your doctor may also want to get a biopsy from any growths inside the breast. A biopsy is the only way your doctor can confirm if a lump is cancerous.
There are five standard treatments for male breast cancer:
- Surgery. Surgery will remove the tumor or the breast itself, and often lymph nodes, too.
- Chemotherapy. This therapy uses chemicals to stop the cancer from spreading.
- Hormone therapy. This can interfere with the hormones that help cancer cells multiply.
- Radiation therapy. This treatment uses high-energy X-rays or other energy to destroy the cancer cells.
- Targeted therapy. Drugs or certain substances will be used to specifically kill cancer cells, while leaving healthy cells alone.
Gynecomastia is a condition that occurs when there’s an imbalance of the hormones estrogen and testosterone. It results in an overgrowth of breast tissue in young and adult males. It can make them feel self-conscious, but it can also cause breast pain, too.
Diagnosing gynecomastia starts with a physical examination of the breast tissue, genitals, and abdomen. A blood test and mammogram are also used. Your doctor may also order an MRI and a breast tissue biopsy.
Some young males outgrow gynecomastia without any treatment. Medications used to treat breast cancer, such as tamoxifen (Soltamox), are sometimes used to treat this condition.
Liposuction, a procedure to remove excess fat tissue, may help with the appearance of the chest. A mastectomy, using small incisions, may be done to help remove breast tissue as well.
While it’s relatively common in females, it’s unusual for males to develop a breast cyst. Symptoms include a lump that may or may not be felt from the outside and, sometimes, breast pain.
A physical exam, along with a mammogram and CT scan, can be used to identify the size and location of the cyst. A biopsy can reveal more about the nature of the cyst.
If the cyst is benign, or noncancerous, it may be left alone. However, it will be monitored every six months or so to see if it grows or becomes cancerous. If your doctor believes the cyst could lead to complications, you may be advised to have it surgically removed.
A noncancerous lump in the fibroglandular tissue of the breast is much more common in females, but a fibroadenoma can still develop in males. It’s rare, though, because males usually don’t have fibroglandular tissue in their breasts.
The lump may feel round and firm, like a marble in your breast.
A physical exam, followed by an ultrasound and a biopsy, can help your doctor confirm a diagnosis of fibroadenoma, or determine another cause for the lump.
A lumpectomy — a procedure to remove a suspicious lump — can be done through small incisions that can heal relatively quickly.
Another treatment option may be cryoablation. In this minimally invasive procedure, a small wand is inserted into the breast, where it releases a tiny amount of gas to freeze and destroy the fibroadenoma. A fibroadenoma may also disappear without any treatment.
Non-breast causes of chest pain
Sometimes the cause or location of chest pain can be difficult to pinpoint. You may feel pain or discomfort in your chest and not know if it’s related to breast tissue, a muscle injury, lung disease, stomach acid, or heart trouble. Below are some common causes of chest pain unrelated to breast tissue or muscle.
When stomach acid moves up into your esophagus and irritates the esophageal lining, the result is gastroesophageal reflux disease (GERD), or heartburn. It’s a burning sensation that you may feel soon after a meal or later in the evening. It can feel worse when you lie down or bend over.
For mild and infrequent bouts of heartburn, your doctor may recommend antacid medications or proton pump inhibitors (PPIs) to neutralize or reduce stomach acid. Avoiding foods that trigger heartburn, maintaining a healthy weight, and not lying down soon after a meal may help prevent future heartburn episodes.
Chest pain caused by a respiratory condition is usually accompanied by coughing or shortness of breath. Lung-related causes of chest pain include:
- pulmonary embolism, or a blood clot in the lungs
- a collapsed lung, or when air seeps into the space between the lungs and the ribs
- pulmonary hypertension, or high blood pressure in the arteries of the lungs
Treatments for lung-related problems can range from making lifestyle changes that include quitting smoking, exercising, and managing your weight to more involved treatments. These can include oxygen therapy or surgery to remove a blood clot or repair a collapsed lung.
Sudden chest pain that comes on with shortness of breath, lightheadedness, a cold sweat, nausea, and possibly pain in the arms, neck, or back could be a heart attack.
Angina, which is chest pain caused by a reduction in blood flow to the heart muscle, may come on with exertion (stable angina) or may come on even at rest (unstable angina). Angina can be a sign that you’re at risk for a heart attack.
Diagnosing heart disease includes several tests. These include an electrocardiogram and cardiac catheterization — a procedure in which a camera on a catheter is inserted into the heart to look for problems.
If the arteries supplying blood to your heart muscle are blocked, you may find relief with:
- Angioplasty. A balloon is inflated inside an artery to open it up to improve blood flow.
- A stent. A wire or tube is inserted in an artery to help keep it open.
- Bypass surgery. A doctor takes a blood vessel from elsewhere in the body and attaches it to the heart to act as a detour for blood to go around a blockage.
Chest or breast pain in males can have some very serious causes, so don’t wait to share these symptoms with your doctor. You may need a series of tests and follow-up visits.
Diagnosing certain conditions early may mean the difference between successful treatment or more complications, so it’s worth it to take your pain as seriously as possible.