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Male breast diseases

The rudimentary mammary (breast) glands in men rarely undergo pathological changes. Only two diseases occur in practice and are worthy of consideration. This is gynecomastia and cancer.

Gynecomastia. Normal breast of men do not have lobed structure. Nevertheless, as in women, they are organs — targets for hormonal action. The most important change in this paired organ, which occurs under the influence of the dishormonal process, is gynecomastia - an increase in the mammary glands. Gynecomastia is the result of an imbalance between estrogens, which have a stimulating effect on the tissues of the mammary glands, and androgens, which have the opposite effect. Different degrees of gynecomastia are found in various conditions, both pathological and physiological. A slight increase in the mammary glands occurs at puberty or, on the contrary, in older men. In the latter case, an increase in the mammary glands is apparently due to an increase in the level of adrenal estrogens in the conditions of the disappearance of the androgenic function of the testes. This is one of the manifestations of Klinefelter syndrome (HFKlinefelter; see chapter 8) and may be part of the symptoms of functioning testicular tumors developing from Leydig or Sertoli cells (see chapter 19). Gynecomastia is found in an adult male if there are some reasons that lead to hyperestrogenism (increased estrogen content in the tissues of the body). The most important causes of hyperestrogenism in men are cirrhosis of the liver (since the liver is involved in the metabolism of estrogen), alcoholism, drug addiction (in particular, the use of marijuana and heroin; see
Chapter 9), as well as the use of certain psychotropic drugs.

Defeat is one- or two-sided. Most often in the subareolar zone occurs hilly swelling. In a more developed pathological variant, the male breast glands become similar to the mammary glands of a teenage girl. Under the microscope, there is an excess production of dense hyalinized and collagenized pericubdural stroma. However, more attention is paid to changes in the lining of the ducts. There is marked hyperplasia, the epithelium becomes multi-layered, its surface layers are often exfoliated into the lumen of the ducts. Zone differentiation of the pavement is preserved everywhere. The shape of epithelial cells varies, but the nuclei are monomorphic.

Cancer of the male breast. This is a great rarity, it occurs 100 times less often than breast cancer in women and usually affects older men. Cancer knot quickly grows into the skin or tissue of the chest wall. Skin ulceration caused by the breakdown of malignant tissue occurs with a relatively higher frequency than in women. By its behavior, the male breast cancer is similar to the ductal carcinoma of the female mammary glands (see above). However, with “male” cancer, desmoplasia is less pronounced; therefore, the scyrrotic composition of the cancerous tissue is less common. The general order of distribution, including distant metastasis, is similar to that in ductal cancer in women.
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Male breast diseases

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