Blue moob in Pink October

Dear Dr. G,

I am hoping you can help me with concerns I have with my mobs (male boobs). I am a middle-aged man who may have over-indulged in my younger days and am now suffering from the consequences of a good life. During my last medical check-up, I was told I am now having glucose intolerance, hypertension, high cholesterol and am clinically obese. I guess I didn’t need the obvious pointed out as my waistline has been constantly expanding.

Apart from the protruding belly, I have also developed “man boobs”. Which get me a bit concerned about the possibility of breast cancer.

I understand this is predominantly a female disease, but I read that this can also happen in men – especially those with a family history of breast cancer, which I have! I would like to come upfront and to put Dr G on spot for the causes and risks of man boobs.

What exactly are moobs, and whey do men develop it? What are the risks of breast cancer developing? I know I am not in pink of health, but I am feeling rather blues with the scary thought of getting breast cancer.

Despite the moobs, I hope Dr. G can help me to elevate my mood in Pink October!

Regards
Blue Brian

Gynecomastia, or colloquially known as “moobs”, is an excessive increase in the size of the male breast. The condition is usually benign in nature and associated with the disturbances in the endocrine system. The risk of cancer is low and the increase in breast size in men is usually just a cause of embarrassment.

However, the psychological distress and sense of dysphoria cannot be underestimated. Derogatory slang such as moobs can generate a few giggles, but gynecomastia is known to lower self-esteem in affected individuals.

The development of male breasts are physiological in newborns and during puberty. However, its pathological development can range from certain cancers, side effects of medications and hormonal disorders such as the natural decline in testosterone. The development of metabolic syndrome in unhealthy men is associated with the decline in testosterone.

Hypertension, dyslipidemia, diabetes and obesity can trigger the imbalance of estrogen and androgen. This disruption of the hormonal ratio can subsequently result in the excessive growth of breast tissue in men. However, the cause of gynecomastia is unknown in 25% of the cases.

The prevalence of gynecomastia in men has increased in recent years with no real determining factors. The increased utilisation of anabolic steroids and exposure to chemicals – such as pesticides which mimic estrogen – has been identified as potential culprits to the rising epidemiology. Although the association of gynecomastia with cancer is minimal, many affected men are still concerned about the gynecomastia leading to breast cancer.

Male breast cancer is rare in men, and generally quoted to constitute about 1% of all breast cancer cases. The incidence of such cancer is rising, perhaps attributed to the genetic testing in female family members affected by the cancer. The pathogenesis of such cancer is similar to female breast cancer, the etiology are predominantly hereditary genes of BRCA mutation, radiation exposure and alcohol abuse.

The significant differences between male and female breast cancer is a poorer prognosis – the lack of awareness in men would generally lead to delays in seeking medical attention. However, the development of male breast cancer is generally less contained as the lesion has less tissue to spread to. On that basis, the presence of excessive breast tissues in men with gynecomastia is arguably protective!

Breast Cancer Awareness Month, better known as Pink October, is an annual health campaign to increase awareness of the disease and raise fund for research in prevention, detection, diagnosis and cure of breast cancer. The campaign also aims to offer support for individuals and family affected by the disease.

Although male breast cancer is rare and generally overlooked, the male breast cancer advocacy groups, Out of the shadow of Pink and A Man’s Pink have joined forces and establishing the third week of October as “Male Breast Cancer Awareness Week”. There are even combination pink and blue ribbons to bring awareness of male breast cancer.

As the rate of sedentary lifestyle increases amongst men (and women), the risk of cancer and diseases naturally rises. The development of male boobs is generally considered risk-free and just a nuisance – and an alteration of lifestyle can adequately help to reduce the protruding chest.

With Dr G placed on the spot about man boobs, his advice is to exercise and discipline dietary intake for the sake of hormonal balance. As breast cancer can also affect men, regularly self examine for lumps and bumps, is the key for early detection and treatment.

In the spirit of Pink October his advice is: “Your smile should be an instant mood and boob lift, when knowing the excess frontal tissues may even offer some protection in the most unlikely event of cancer!”