differences between a malignancy and gynaecomastia:
The first step in clinical evaluation of patients consists of differentiating gynecomastia from other causes of enlarged breast tissue or mass (1).
Physical examination in male breast enlargement: (1,2)
| Malignancy |
Bilateral (usually) or unilateral | Unilateral (usually) or bilateral (rarely) |
Painless or painful (occasionally) | Painless or painful (uncommon) |
Central (subareolar) | Central (70-90%) or eccentric* |
Smooth | Irregular* |
Firm | Rubbery or hard* |
Mobile | Fixed* |
Normal nipple | Nipple deformity (17-30%) or discharge (<10%)* |
Normal skin | Thickened, red, or ulcerated skin* |
Normal axilla | Axillary adenopathy** |
*mandates surgical evaluation.
**may be associated with locally advanced malignancy
Reference:
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