Symptomatic differences from breast cancer
The firm disc-like mass in gynecomastia can be confused with the lump of breast cancer. It is important to distinguish gynecomastia which is a benign condition from breast cancer, which can pose a serious threat. If gynecomastia in infants persists beyond 3-4 weeks, and past puberty in teenage boys, differentials should be made by the physician. The signs that are highly suggestive of a tumor are:
- Discharge from the nipple: blood may ooze from the nipple upon irritation. A milky discharge from the nipple may suggest a prolactin-secreting tumor.
- Nipple retraction.
- A firm immobile mass, which may or may not be painful.
- Dimpling of the skin of the pectoral region.
- Swollen or tender lymph nodes, most commonly of axial region
The psychological aspect of gynecomastia
Even with the physiological gynecomastia, there comes an additional challenge to the self-image. Especially in adolescents and young adults facing gynecomastia, a comparative analysis shows increased occurrence of self-doubt, and low self-esteem. Even parents of a child having gynecomastia show a significant anxiety and embarrassment related to the appearance of their kid. [4]
Gynecomastia is also seen coupled with obesity and overweight, which manifests as a marked compromise on the general health of the subjects. Apart from health, it may have mild to serious impact on social life and personal development on a psychological level. Some of the common behavioral changes seen in such individuals are:
- Subjects view social gathering and meeting new people as a challenge.
- Subjects fear people and a feeling of being judged by them, may manifest as avoidance of engagement in social gatherings.
- Confusion as to the personal image.
- Self-hate and low self-esteem may manifest as a persistent comparison of self with social standards.
- Subjects may be embarrassed to expose body in public places, which may lead to avoidance of activities which may involve such a requirement.
Patients may also feel a constant anxiety and fear of complications of the already existing gynecomastia. There has also been reported, a fear of breast cancer in subjects having gynecomastia.