From the Guidelines
Yes, it is appropriate to use the term "breast" when referring to the chest tissue of a male patient. Men have breast tissue just as women do, although in smaller amounts. Male breast tissue consists of fat, supportive tissue, and some glandular tissue. This terminology is medically accurate and is used in clinical settings for conditions such as gynecomastia (enlarged male breast tissue), male breast cancer, and other breast-related conditions in men, as noted in the American College of Radiology's evaluation of the symptomatic male breast 1. Using anatomically correct terminology helps ensure clear communication between healthcare providers and patients, and avoids confusion in medical documentation. While some male patients might feel uncomfortable with the term due to social associations of breasts with female anatomy, healthcare providers should normalize the correct anatomical terminology while remaining sensitive to patient preferences. The same medical terminology applies regardless of gender, as the fundamental structure of breast tissue is similar in both males and females, though with differences in development and size due to hormonal influences.
Key points to consider in the evaluation of male breast tissue include:
- Gynecomastia is the most common cause of a palpable mass, breast enlargement, or pain in men 1
- Breast cancer in men is rare, but frequently presents with associated symptoms and at an advanced stage 1
- Imaging is indicated if the differentiation between benign disease and breast cancer cannot be made on the basis of clinical findings, or if the clinical presentation is suspicious 1
- The initial recommended imaging study is ultrasound in men younger than age 25, and mammography or digital breast tomosynthesis in men age 25 and older 1
Overall, using the term "breast" in reference to male patients is a matter of medical accuracy and clarity, and healthcare providers should prioritize clear communication and anatomically correct terminology in their practice.
From the FDA Drug Label
After 6 months of treatment there was no statistically significant difference in the percentage of patients who experienced a ≥50% reduction in gynecomastia (primary efficacy analysis) Secondary efficacy analyses (absolute change in breast volume, the percentage of patients who had any reduction in the calculated volume of gynecomastia, breast pain resolution) were consistent with the primary efficacy analysis.
The term breast can be used in a male patient, as seen in the context of gynecomastia treatment in adolescent boys, where breast volume and breast pain resolution are mentioned as part of the efficacy analysis 2.
From the Research
Definition and Prevalence of Gynecomastia
- Gynecomastia is a benign proliferation of the glandular tissue of the breast in men, with a reported prevalence of 32-65% depending on age and criteria used for definition 3.
- The condition is common in infancy and puberty, typically resolving spontaneously within the first year of life or 24 months, respectively 3.
Evaluation and Management of Gynecomastia
- The purpose of gynecomastia assessment is to detect underlying pathological conditions, reversible causes, and discriminate from other breast lumps, particularly breast cancer 3.
- Evaluation should comprise a thorough medical history, physical examination of the breast and genitalia, and laboratory investigations such as testosterone, estradiol, and liver function tests 3.
- Breast imaging may be used when the clinical examination is equivocal, and core needle biopsy should be performed if the clinical picture is suspicious for a malignant lesion 3, 4.
Male Breast Cancer
- Male breast cancer is a rare disease, representing nearly 1% of total breast cancer cases worldwide, with a higher percentage of hormone receptor-positive tumors but a lower fraction of carcinomas overexpressing HER2 5.
- Treatment recommendations for male breast cancer are derived from established guidelines for breast cancer in women, with surgery being the most common treatment modality 6.
- Factors affecting survival in male breast cancer patients include age, race, insurance status, comorbidities, and tumor stage, with mastectomy associated with improved survival 6.