Boys with breast tissue

Carolyn H posted, “I have a 16 yr son who has been complaining of a lump/knot under his nipple. He says is it tender and I am concerned. I have heard about gynecomastia in teen boys, but what I have read indicated that is a condition where they actually grow breasts. He does not have enlarged breasts. His nipple has become inverted and the whole area is hard. Is this something to be concerned about ?”

Gynecomastia refers to excessive development of breast tissue in males, though it doesn’t necessarily mean that full breasts grow. More usually, it’s a knot of firm tissue underneath one or both nipples in a teenaged boy. There are a few medications that can cause gynecomastia, though they’re rarely used in children. Still, if your son is on any regular medications you ought to check with the doctor who prescribed them if they’re a possible trigger.

Far more commonly, gynecomastia develops as a result of the effects of hormones released during the rapid growth of puberty. There can be tenderness, and if the tissue is touched or manipulated it will grow bigger and more tender—possibly even from rubbing on a tight shirt.

If the swelling increases rapidly, has marked tenderness, feels warm, or is accompanied by any nipple discharge, you ought to take him to his doctor right away. Rarely, infections can develop in this area; or even more rarely pituitary problems can lead to these more worrisome signs.

Every teenage boy who has this worries that it is breast cancer. Please tell him that’s a zillion-to-one chance, unheard of in a teenage boy. But sometimes a visit to the doctor for some personal reassurance is the best medicine, especially if there has been a close family member who has struggled though cancer. It will be on his mind, and that needs to be addressed.

The Pediatric Insider