Could gynecomastia worsen into breast cancer? [gynecomastia]
This time, the topic is a bit heavier—
One of the questions I occasionally receive during consultations.
Can gynecomastia in men
Potentially develop into cancer?
This is a question I sometimes hear
When consulting and examining patients
Who visit the clinic for gynecomastia.
“Men can also develop breast cancer,
So if what I have is gynecomastia,
Could I also get breast cancer?”
For those who have gynecomastia,
This concern is completely understandable.
So, can gynecomastia develop into breast cancer?
To give you the answer in advance—
It can occur, but it is extremely rare.
Gynecomastia itself is a common condition
In which the glandular tissue in a man’s chest
Grows excessively.
As mentioned previously, gynecomastia in men
Can appear during three periods in life, and the prevalence rates are:
Newborns: 60–90%
Puberty: 50–60%
Middle age (50–69 years): up to 70%
On the other hand, male breast cancer occurs very rarely,
But recently, research on
“Can gynecomastia progress into cancer?”
Has been increasing.
First, let me continue from last time and explain
Why gynecomastia occurs.
The reason gynecomastia develops: ultimately, a hormonal imbalance.
A man’s chest tissue is originally very small
And does not grow much.
But when estrogen (female hormone) increases
And testosterone (male hormone) decreases,
The situation changes.
✔ Estrogen ↑ → Increase in glandular tissue
✔ Testosterone ↓ → Reduced ability to suppress estrogen
Gynecomastia is especially likely to occur in the following cases:
• Obesity
• Aging
• Use of medications that cause hormonal imbalance
• Decreased testicular function
• Certain genetic abnormalities
And this hormonal imbalance
Is also an important risk factor for male breast cancer.
Then,
What increases the possibility
Of gynecomastia leading to breast cancer?
Let me explain a few theoretical factors
That could raise the likelihood
Of gynecomastia progressing to breast cancer.
However, these are theoretical considerations,
Not typical real-world situations,
So the explanation may feel a bit technical.
1) Excessive action of female hormones (estrogen)
Estrogen stimulates several signaling pathways
That cause breast cells to continue growing.
When exposure lasts for a long time,
The risk of abnormal cellular changes increases.
Typically, after puberty,
The body finds a hormonal balance,
So this is not a problem.
But if there is an abnormality in the organs
That secrete sex hormones,
The body may be exposed to an estrogen-dominant environment—
And with that exposure, the risk can rise.
2) Increased aromatase (obesity is especially risky)
In fat tissue, an enzyme called aromatase
Converts testosterone into estrogen.
The more body fat you have,
The more aromatase your body produces.
In other words, when you are obese:
→ Gynecomastia is more likely to occur
→ And at the same time, the risk of cancer can increase
3) Genetic factors (BRCA1/2, PALB2, ATM, etc.)
Among men diagnosed with breast cancer,
Mutations in DNA repair genes such as BRCA1 and BRCA2
Are relatively common.
These mutations are also well-known
As important genetic risk factors
In female breast cancer.
Although these mutations are not definitively connected
Directly to gynecomastia,
Some studies have reported that these genes
Show expression even in gynecomastia tissue.
This suggests that
“There may be a possible association,”
But it is not a confirmed or universal link.
4) Other hormones (prolactin, IGF-1, leptin, etc.)
• Prolactin: Promotes breast cell growth
• IGF-1: Works with growth hormone to increase breast cell proliferation
• Leptin (an obesity-related hormone): Increases estrogen production
→ These additional hormonal factors
Are known to increase in both gynecomastia
And male breast cancer,
So it is reasonable to think of them as
“Factors that may indicate a possible connection
Between gynecomastia and male breast cancer,”
Rather than direct causes.
If you’ve read up to this point
You might start worrying again, thinking
‘If I have gynecomastia, doesn’t that mean I have a higher chance of getting breast cancer?’
However…
There is still not enough evidence to say
“Gynecomastia is a precancerous stage.”
Because
• Gynecomastia is extremely common, occurring in 50–70% of all men
• Male breast cancer is very rare (if it occurs, it often becomes news)
• Large-scale follow-up studies show that breast cancer almost never develops in gynecomastia patients
• Histologically, gynecomastia usually remains a benign change
Some gynecomastia patients may have a higher level of risk
But gynecomastia itself cannot be definitively considered a “precancerous stage.”
In other words, having gynecomastia does not mean you need to be afraid.
If you are worrying about typical gynecomastia,
you can set aside the fear of male breast cancer a bit.
Based on research so far,
scholars generally agree that gynecomastia cannot be considered
a precancerous stage of male breast cancer.
However!!
if it is not typical gynecomastia,
additional tests or evaluations may be necessary
regarding the possibility of developing breast cancer.
then what kind of gynecomastia is considered risky?
• if only one side enlarges firmly
• if a firm lump is felt without pain
• if the axillary lymph nodes are enlarged
• if there is bloody discharge
• if there is a BRCA1/2 gene mutation
• if there is a condition causing low male hormones, such as Klinefelter syndrome
• if there is severe obesity or old age
gynecomastia accompanied by these symptoms
requires prompt medical evaluation.
Conclusions show that there is a
Hormonal and genetic association
Between gynecomastia
And male breast cancer.
However, the evidence is still
Insufficient to say that
Gynecomastia directly progresses
To breast cancer.
If it is not a typical case
And symptoms like the ones above
Are present, you may consider that
Prompt evaluation
And regular checkups
Are necessary.
Therefore, If you are concerned
About gynecomastia And have fears
About breast cancer,
Do not delay and consider
Early evaluation And early treatment.
