Which doctor is responsible?

When a mass in the female breast is rediscovered, it is usually easy to decide which doctor to consult. The gynaecologist is certainly the right person to contact when it comes to diagnosis, consultation and treatment. The situation is different for a lump in the male breast.

As explained in the previous section, lumps in the breast can have various causes. From the fake gynecomastia favored by overweight, to the real gynecomastia influenced by hormonal factors and medication, to malignant diseases of the breast tissue and the male gonads, numerous possible triggers must be considered. If a man discovers a newly formed lump in the breast, it is advisable to first consult his family doctor.

This doctor can make an initial assessment by means of a thorough palpation of the breast and, after a detailed anamnesis, which includes the question of previous illnesses, family history of breast cancer, the determination of medications taken and certain risk factors, can arrange for further examinations. These may, for example, consist of a sonographic (ultrasound) or radiographic examination of the breast by the radiologist or an examination of diseases of the male reproductive organs by the urologist/andrologist. Disorders of the hormone balance are the responsibility of the endocrinologist. When deciding on a surgical procedure, an introduction to the general surgeon or a specialist in plastic surgery is usually necessary.

What to do in case of pain?

Pain in the area of the male breast in connection with palpable lumps can indicate serious diseases and should be taken seriously and clarified accordingly. Once a diagnosis has been made, treatment can be initiated, which does not necessarily involve surgical removal of the mass in all clinical pictures. Rather, in a large number of cases a conservative, i.e. non-surgical procedure is aimed at.

Of course, this depends on the cause of the disease and should also include an adequate pain therapy in case of pain. If hormonal factors are the cause of a breast disease, hormone therapy can already alleviate the symptoms. This is also true if pathological processes in the breast are caused by taking medication.

In this case, a significant improvement is already achieved by changing the medication. If the changes mentioned above do not lead to sufficient pain relief or if the triggers of the disease lie in an area that cannot be regulated by medication, additional measures must be taken to achieve pain relief. Suitable medication comes from the group of non-steroidal anti-inflammatory drugs.

Ibuprofen in particular is a well-tolerated and effective preparation here. Paracetamol from the group of non-opioid analgesics is an equally effective pain medication and is suitable for the treatment of pain in the context of chest diseases. In gynecomastia, bras can help to prevent tension-related pain.

Particularly in the case of fake gynecomastia caused by overweight, weight reduction by restricting calorie intake and regular physical exercise is recommended. In individual cases, particularly painful findings can be eliminated by surgery. This procedure is particularly useful in the case of lipomas or fibroadenomas, as they grow to displace tissue.