GYNECOMASTIA ULTRASOUND APPEARANCE

Gynecomastia is the abnormal swelling of breast tissue in males. While all males have breast tissue, for the majority it remains too small to see or feel. In some men hormonal changes or a reaction to medication can cause breast tissue to enlarge, resulting in gynecomastia.

In other men, swelling of the breast area is the result of the build-up of fatty tissue. Both conditions are more common in men who are overweight.

When a male patient visits a doctor regarding gynecomastia, they will examine the chest area. In many cases this will be all that is needed, as the diagnosis is often clear. However, in some cases more information may be needed.

This can be if the swelling is unusually hard, very different from one side to the other, or simply if the man is requesting treatment for the gyno. In each of these cases it is sometimes important for the doctor to have more information about the swelling. As well as possibly asking for blood tests, they may request an ultrasound of the man’s breasts.

normal breast and gynecomastia

A doctor may particularly ask for an ultrasound if breast swelling is:

  • Much bigger on one side or the other
  • Particularly painful or tender to the touch
  • Hot to the touch
  • Hard when examined
  • Accompanied by other lumps or swelling

What is an ultrasound?

Ultrasound imaging uses high frequency sound waves (too high to hear) to create pictures of tissue inside our body. It is most familiar from its use to check babies in the womb, but has numerous other uses.

An ultrasound is best for looking at soft tissue (not bone) and is easiest to use for tissue which is near the surface, meaning it is ideally suited for looking at breast tissue. Ultrasound pictures are made by passing a hand-held probe over the area, with gel on the skin to create a ‘seal’ between the skin and the probe.

Having an ultrasound doesn’t hurt – the patient feels nothing at all – and has no known significant adverse effects.

Why have a gynecomastia ultrasound?

When a doctor is investigating gynecomastia, there can be several reasons why they might request an ultrasound. No medical imaging is needed to diagnose gynecomastia, as the enlargement or swelling of the breast area can be both seen and felt. However, an ultrasound can help tell the doctor several important things about the swelling.

The useful information that an ultrasound of the male breast can give includes:

  • Whether the swelling is true breast tissue or fat
  • Whether any other problems such as infection, abscess or cancer exist
  • Giving the surgeon a ‘map’ of the chest area to plan surgery

Firstly, the ultrasound should be able to assess how much of the swelling is caused by actual breast tissue enlargement and how much is caused by the build-up of fatty tissue. Most males with gynecomastia will have a combination of both types of tissue, but when planning treatment or surgery it can be important to know how much there is of each type.

Patients with mainly fatty tissue build-up will benefit from weight loss advice or treatment. A surgeon may recommend liposuction as the best operation for these men. Male patients whose swelling is mainly caused by breast tissue will need to discuss either hormonal treatment or surgery with a mastectomy.

Before surgery it can therefore be very helpful for the surgeon to have a ‘map’ of the breast area so they can plan which type of surgery to do, or where to use each technique. Some surgeons may routinely request an ultrasound before undertaking male gynecomastia surgery.

Other important reasons for doing an ultrasound with gynecomastia can be to rule out serious causes of the swelling. Ultrasound will be able to see if there are any unusual appearance in the tissue, such as the growth of cysts, or anything in the images which might suggest cancer is developing.

Breast cancer in male patients is extremely uncommon, but it can happen. Ultrasound pictures can be used to pick up signs that suggest cancer, and may give an indication that more tests are needed.

An ultrasound will also show up if an infection or abscess within the breast tissue are the cause of the swelling. Each of these things needs different treatment, so the ultrasound can provide crucial information for the doctor.

Gynecomastia ultrasound process

The images from an ultrasound of the male breast will need to be examined by a specialist. They will be able to look at the pictures and tell the difference between fat, normal breast tissue and abnormal or diseased breast tissue.

The ultrasound scan will be done on both sides to check the appearance of each side and compare one with the other.

It is important to remember that in all ultrasounds of the male chest, the scan will be able to see breast tissue. Everyone has breast tissue, but in most men it is too small to be noticeable.

The ultrasound examination can be used to see if the breast tissue is enlarged, as well as checking how much fat is on the chest and for anything else unusual. This helps to figure out the best way to help the man get rid of his gynecomastia, and to make sure nothing is being missed.

Other medical imaging

As well as ultrasound, doctors may sometimes ask for other imaging in males with gynecomastia. Sometimes a mammogram is done, which is a special type of x-ray designed to look at breast tissue. It is especially good at looking for cancer in the breast.

Occasionally an MRI scan of the breast area is done, which can give very detailed pictures of the breast and the entire chest area, but is rarely needed.

Summary

An ultrasound of the male breast is an uncommon examination for gynecomastia. However, it can sometimes provide very useful information. An ultrasound is used to differentiate between true breast glandular tissue and fatty build-up, as well as rule out serious causes of chest swelling in the male including infection, cysts and cancer.

An ultrasound may be done before gynecomastia surgery to give the surgeon a ‘map’ of the male chest to help them plan the operation.

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