PapillomaMost lumps are benign, but it is very important to be sure exactly what they are and find out if they need any treatment.
Benign vs malignant :……....click & see Lumps are normally referred to as tumours, and they may be benign or malignant. In a tumour, one particular type of cell (such as a glandular, fat or muscle cell) has escaped the normal controls on growth and started to multiply.
The most important characteristic is whether these tumour cells can invade other adjacent cell types, and spread around the body (i.e. they are malignant tumours) or not (in which case they are benign).
•Cysts: lumps filled with fluid. Common types include sebaceous cysts on the skin, filled with greasy sebum, and ovarian cysts…. •Nodules: formed in inflammatory conditions such as arthritis, sarcoid and polyarteritis……. •Lipomas: lumps of fat cells…. •Fibromas and fibroademonas: lumps of fibrous or fibrous and glandular tissue….. •Haematoma: lump formed by blood escaping into the tissues – simply a large bruise….. •Haemangioma: lump formed by extra growth of blood vessels…… •Papilloma: formed from skin or internal membrane cells, for example warts….
Benign tumours do not invade or spread. They can grow quite large without causing problems, although that doesn’t mean they’re totally harmless because their growth may start to damage the other tissues or organs around them.
This is a particular problem with a type of brain tumour called a meningioma, which grows from cells in the membranes that surround the brain (the meninges). Although benign, the pressure within the skull from the growing meningioma can cause severe headaches and may be life threatening if the tumour is not removed.
Benign tumours can cause others problems, from simply looking unsightly to releasing excess hormones.
Malignant tumours:-…
Malignant tumours are also known as cancers. They invade the tissues around them and spread to other parts of the body by sending out cancer cells into the lymphatic system or through the blood stream.
These cells are deposited in other areas of the body, particularly the lungs, liver, brain and bones, to start ‘secondary’ tumours (also called metastases) at the new sites. Most malignant tumours are life threatening.
Breast tumours:- •Benign: mostly happens at younger age. Usually a round smooth lump with a border that feels separate to the rest of the breast. Changes may occur in the lump with the menstrual cycle, being more obvious just before a period. The lump may be tender. •Malignant: mostly happens at older age. Usually a craggy or irregular lump, which may be seen to tether the skin There may be other symptoms such as discharge from the nipple. There may be a family history of breast cancer especially if at a young age.
Women are advised to be on the look out for lumps in their breasts. However, among younger women at least, lumps are far more likely to be benign – in women under 40, more than nine out of ten breast lumps are benign. But these lumps still cause a lot of anxiety until they are sorted out.
The most common benign breast conditions are fibrocystic change, benign breast tumours and breast inflammation. These are common problems, in fact fibrocystic change used to be known as fibrocystic disease but, as it affects more than 50 per cent of women at some point, it was thought it could no longer be considered a disease.
Fibroadenomas (sometimes called breast mice because they can be moved around) are particularly common in women in their 20s or 30s. They are benign and not cancerous.
In most cases these lumps are quite harmless, although now and then they may cause troublesome symptoms such as tenderness (especially as many are influenced by hormone levels and tend to get more swollen and painful along with other menstrual symptoms).
Malignant breast tumours mostly occur in older women, and tend to be accompanied by other symptoms such as discharge from the nipple. The lump may feel craggy or irregular.
Women who have a family history of breast cancer, especially breast cancer at a young age, have an increased risk of malignant tumours.
Is it cancerous?
Sometimes it’s fairly clear that a lump is either benign or malignant, but further tests may be required, including x-rays, ultrasound or biopsy. Often the best way to get an answer is to remove the whole lump and send it to the laboratory for analysis.
Benign lumps may not need to be removed but this is usually the most effective way to reassure someone because, whatever the problem, it’s gone
If you find a lump •Get a doctor’s opinion – no one minds checking hundreds of harmless lumps if it means that one malignant or cancerous lump is caught early. •Don’t hide a lump or fret silently about it – if it does prove to be malignant the sooner it’s dealt with the greater the chance of cure. •Bear in mind that most lumps, especially in younger people, are benign or relatively harmless.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
Alternative Names:Jogger’s nipple is also known as runner’s nipple, surfer’s nipple, red eleven, raver’s nipple, big Q’s, red nipple, weightlifter’s nipple and gardener’s nipple, or nipple chafe. There are similar colloquial terms for almost any activity that can result in the condition.
Definition:
The nipples are formed from delicate and very sensitive tissue, and can be painful when irritated.Jogger’s nipple also known as fissure of the nipple, is a condition that can be caused by friction that can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during and/or following running or other physical exercise. This condition is also experienced by women who breastfeed and by surfers who do not wear rash guards. CLICK & SEE THE PICTURES
Jogger’s nipple is a common problem for runners, particularly long-distance ones. As you run, your clothing rubs against your nipples and can damage the surface causing soreness, dryness, inflammation and bleeding.
Cause:
Jogger’s nipple is caused by friction from the repeated rubbing of a t-shirt or other upper body clothing against the nipples during a prolonged period of exercise.
The condition is suffered mainly by runners. Long-distance runners are especially prone, because they are exposed to the friction on the nipple for the greatest period of time. However, it is not only suffered by athletes; the inside of a badge, a logo on normal items of clothing, or breastfeeding can also cause the friction which results in this condition.
Treatment ;
Wearing the right clothing will help to prevent this condition. The best material is silk because it’s soft compared with modern synthetic fibres, which can be quite coarse. Loose-fitting sportswear is also good, as it has less opportunity to rub against you. If you need to wear something that fits closely, then Lycra can be less damaging, because it holds firmly against the nipples. Women should wear a well-fitting sports bra to hold the breasts and reduce movement.
Use something to protect your nipples from the layer of clothing that rubs over them. A plaster is a straightforward idea provided you’re brave enough to remove it and some of your chest hairs, too. Surgical tape is available from the pharmacist and works in the same way but is a little less adhesive.
Barrier creams containing zinc, such as those used for a baby’s nappy area, are protective and soothing. Many people use petroleum jelly for similar benefits.
Prevention:
The condition is easily preventable and treatable. Viable methods include:
*Run shirtless whenever weather and the law permits.
*Don’t use a large, loose-fitting T-shirt during exercise.
*Wear “technical” shirts made of synthetic fabrics, not cotton.
*Stick a small bandage, waterproof bandaid, or paper surgical tape over each nipple before the commencement of exercise to act as a barrier between skin and cloth.
*If the skin is already damaged, apply a pure lanolin product (e.g. Lansinoh or Bag Balm) to the area prior to exercise to prevent chafing. If the skin is not damaged, a barrier product (e.g. Vaseline) can be used. These products do not allow air to circulate around damaged skin; this can prevent healing if used over a period of time. A “liquid bandage” can be helpful for healing or prevention, although it may sting initially.
*Use specialized products available to prevent the condition such as rash guards.
*Wear a sports bra, shimmel, compression vest, or some variety of chest binding clothing.
*Apply an antiseptic cream as soon as you suspect a fissure, with the hope that it may reduce the chances of bacterial infection that would make the condition worse.
*Use a nipple shield (of rubber, or glass and rubber) temporarily.
This condition should clear within a few days. If not, medical attention is warranted. Other skin conditions such as eczema, psoriasis, impetigo, fungal infections or an allergic reaction can cause nipple pain and changes in the appearance of the skin. In women, breastfeeding (often complicated by thrush infection), as well as hormonal changes in early pregnancy or during menstruation can also cause nipple soreness and pain.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
As a general rule milk can be stored at room temperature for 4-6 hours, in a refrigerator for up to 8 days, in a refrigerator freezer for up to 3 months and in a deep chest freezer for up to 6 mon or 12 months in a deep freezer. If you are using breast milkstorage bags, be sure to get all the air out of the bag before sealing it to prevent freezer burn. Thawed breast milk must be used within 24 hours and must be refrigerated until use. Never refreeze breast milk. CLICK & SEE
It’s very important to remember to chill your breastmilk before freezing it. Do NOT stick it directly into the freezer before it’s spent a few hours in the refrigerator.
The kind of storage you use for your milk comes down to how you plan to use it. If it’s stored for occasional use, meaning your baby is almost always getting nourishment straight from the breast, then using the plastic storage bags designed for breastmilk storage is fine. If your baby is generally being nursed from a bottle of expressed milk, as in a daycare situation, you may want to use glass bottles, as the live antibodies in breastmilk tend to stick less to the sides of glass then they do to plastic.
If you pump more in a single day you can add to your supply. If you already have milk from the same day in the freezer you can chill freshly expressed milk and add it directly to the bag that you’ve already frozen – this can only be done for same day expressions.
When warming frozen milk there is one major rule – NEVER put in on the stove or in the microwave! Microwaving destroys the antibodies in human milk and that’s one of the major reasons for breastfeeding in the first place. First thing is to remember to defrost the oldest milk first. Milk in glass bottles is best thawed in a bottle warmer. For milk stored in storage bags take it out of the second storage bag with the written information on it and either run it under warm tap water or place it in a bottle warmer.
Once your milk is warmed to the proper temperature you can pour it into the feeding bottle. Human milk is not homogenized so the fat does separate. NEVER shake human milk – always gently swirl it to mix it.
Milk thawed from the freezer can be stored in the refrigerator for up to 24 hours but remember to NEVERreuse milk that has already been in a bottle your baby has sipped off of. If you thaw 6 ounces of milk and pour 4 ounces into a bottle for baby, you can save the other 2 ounces in the refrigerator. But once the bottle has touched your baby’s lips you can only keep that milk for about an hour, due to the bacteria.
Freezing breastmilk kills some of the beneficial antibodies but is still better then formula feeding. Fresh breastmilk, either milk directly from the breast, freshly expressed or refrigerated is best, but frozen breastmmilk is still a safe and better choice for baby.
Definition:
By definition, complete ankyloglossia is the total adherence of the tongue to the floor of the mouth. Partial ankyloglossia is incomplete separation of the tongue from the bottom of the mouth due to a short frenulum, which is a fibrous membrane extending from the bottom of the tongue to an area below the bottom front teeth. Tongue-tie can be evident when the baby is crying or by careful inspection.
List of images in Gray’s Anatomy: XII. Surface anatomy and Surface Markings (Photo credit: Wikipedia)
Symptoms:
There are certain facial features that have been found to be associated with a short frenulum.
*High-arched palate: characterized by a higher than normal arch of the roof of the mouth.
*Retrognathia: very small chin.
*Micrognathia: a recessed or undefined chin.
*Prognathism: a protruding lower jaw.
*Can’t stick the tongue forward
*Difficulty feeding
*Excessive attachment of tongue to bottom of the mouth
*V-shaped notch in tip of tongue
Causes: Tongue-tie causes a significant portion of of the problems encountered with breastfeeding. It also is thought to pose other short term and long term complications, such as speech impediments, problems with swallowing, and the formation of teeth arrangement. There is some controversy over the defining characteristics of tongue-tie as well as the treatments.
When we hear the term “tongue-tied”, most of us have a mental image of someone who is struggling to speak in public, but is stammering nervously and is at a loss for words. In reality, tongue-tie is a medical condition that affects many people, and has special implications for the breastfed baby.
The medical term for the condition known as tongue-tie is “ankyloglossia”. It results when the frenulum (the band of tissue that connects the bottom of the tongue to the floor of the mouth) is too short and tight, causing the movement of the tongue to be restricted.
Tongue-tie is congenital (present at birth) and hereditary (often more that one family member has the condition). It occurs relatively often: between 0.2% and 2% of babies are born with tight frenulums.
To tell if your baby is tongue-tied, look at him and stick out your tongue. Even tiny babies will imitate you. If he is unable to extend his tongue fully, or if it has a heart shaped appearance on the tip, then you should have him evaluated by his doctor. You can also try putting your finger in his mouth (pad side up) until he starts sucking. See if his tongue extends over his gum line to cup the bottom of your finger. If not, you may want to have him checked.
In most cases, the frenulum recedes on its own during the first year, and causes no problems with feeding or speech development. A lot depends on the degree of the tongue-tie: if the points of attachment are on the very tip of the tongue and the top ridge of the bottom gum, feeding and speech are more likely to be affected than if the frenulum is attached further back.
Severe tongue-tie can cause problems with speech. Certain sounds are difficult to make if the tongue can’t move freely (especially ‘th’, ‘s’, ‘d’, ‘l’, and ‘t’). In addition to forming specific sounds, tongue-tie may also make it hard for a child to lick an ice cream cone, stick out his tongue, play a wind instrument, or French kiss. While these may not seem like important skills to you as a new mother, someday they may be very important to your child! Dental development may also be affected, with severe tongue- tie sometimes causing a gap between the two lower front teeth.
Of more immediate importance is the negative impact that a tight frenulum can have on a baby’s ability to breastfeed effectively. In order to extract milk from the breast, the baby needs to move his tongue forward to cup the nipple and areola, drawing it back in his mouth and pressing the tissue against the roof of his mouth. This compresses the lactiferous sinuses (the pockets behind the areola where the milk is stored) and allows the milk to move into the baby’s mouth. The tongue plays an important role in breastfeeding, and if the baby’s frenulum is so short that his tongue can’t extend over the lower gum, he may end up compressing the breast tissue between his gums while he nurses, which can cause severe damage to the nipples.
Tongue-tie can cause feeding difficulties such as low weight gain and constant fussiness in the baby. Nursing mothers may experience nipple trauma (the pain doesn’t go away no matter what position is used), plugged ducts, and mastitis.
Some tongue-tied babies are able to nurse effectively, depending on the way the frenulum is attached, as well as the individual variations in the mother’s breast. If the mother has small or medium nipples, the baby may be able to manage to extract the milk quite well in spite of being tongue-tied. On the other hand, if the nipples are large and/or flat, then even a slight degree of tongue-tie may cause problems for a nursing baby.
In addition to problems with nipple soreness and weight gain, some other signs that the baby may be having problems nursing effectively include breaking suction often during feedings, and making a clicking sound while nursing. Since these symptoms can also be caused by other problems, it’s a good idea to be evaluated by a knowledgeable health care provider (a lactation consultant if possible) to rule out causes other than tongue-tie. Tongue-tie should definitely be considered a possibility if breastfeeding doesn’t improve even after other measures such as adjustments in positioning have been tried.
If it is determined that tongue-tie is causing breastfeeding difficulties, there is a simple procedure called a “frenetomy” that can quickly correct the problem. In a relatively painless in-office procedure, the doctor simply clips the frenulum to loosen it and allow the tongue full range of motion. It takes less than a second, and because the frenulum contains almost no blood, there is usually only a drop or two of blood. The baby is put on the breast immediately following the procedure, and the bleeding stops almost instantly. Anesthesia and stitches are not necessary. The baby cries more because he is being restrained for a few seconds that he does because of pain. Comparing the procedure to ear piercing is a good analogy. Both involve a second or two of discomfort and a very small risk of infection, but are overall very safe and simple procedures.
Diagnosis
According to Horton et al., diagnosis of ankyloglossia may be difficult; it is not always apparent by looking at the underside of the tongue but is often dependent on the range of movement permitted by the genioglossus muscles. For infants, passively elevating the tongue tip with a tongue depressor may reveal the problem. For older children, making the tongue move to its maximum range will demonstrate the tongue tip restriction. In addition, palpation of genioglossus on the underside of the tongue will aid in confirming the diagnosis.
In most cases, the mother notices an immediate improvement in both her comfort level and the baby’s ability to nurse more efficiently. If the tongue-tie isn’t identified and the frenulum isn’t clipped until the baby is several weeks or months old, then it may take longer for him to learn to suck normally. Sometimes suck training is necessary in order for him to adapt to the new range of motion of his tongue. If tongue-tie is causing severe breastfeeding difficulties, then the sooner the frenulum is clipped, the better. Sometimes children end up having the procedure done when they are much older, because the problem isn’t identified until after they begin developing significant speech problems.
Even though clipping the frenulum is a simple, safe, and uncomplicated procedure, it may be difficult to find a doctor who is willing to perform it. The history of treating tongue-tie is somewhat controversial. Up until the nineteenth century, baby’s frenulums were clipped almost routinely. Because of the potential for feeding and speech problems, midwives were reported to keep one fingernail sharpened so that they could sweep under the tongue and snip the frenulum of just about all newborn babies. Any procedure that involves cutting tissue in the mouth can potentially involve infection or damage to the tongue, especially back in the days before sterile conditions and antibiotics. Because the procedure was overdone and in most cases, wasn’t really necessary, doctors became very reluctant to clip frenulums at all and the procedure was rarely performed.
Part of the reason frenotomies fell out of favor for many years was the fact that doctors discovered that in all but the most severe cases, speech was not affected by tongue-tie. They preferred to take a “wait and see” approach and let nature take it’s course. Most of the time, the frenulum would stretch out on its own with no intervention.
During the same time period that frenotomies were becoming less common, the rate of breastfeeding also declined dramatically. Bottle-feeding doesn’t present the same feeding difficulties for tongue-tied babies that breastfeeding does, because the mechanics are very different and extension of the tongue doesn’t play as big a role in feeding from the bottle. Since the majority of babies were bottle fed, it was easy for doctors to say that they weren’t going to perform an unnecessary procedure that didn’t interfere with feeding, and rarely caused speech problems.
Even today, with most infants in this country starting out breastfeeding, it may be difficult to find a doctor who recognizes the problem that tongue-tie can present for a nursing baby and is willing to perform a frenotomy. The procedure is seldom mentioned in the pediatric literature, and is no longer routinely taught in medical school.
If you feel that your baby’s breastfeeding difficulties may be due to tongue-tie, you may need to work at finding a health care provider who can diagnose the problem and clip the frenulum. Although any pediatrician or general family practitioner can theoretically perform a frenotomy, many prefer to make a referral to an oral surgeon, dentist, or ENT specialist.
Diagnosis of Clinically Significant Tongue-Tie
Based on a combination of anatomical appearance and functional disturbance:
Anatomical Type I: Frenulum attaches to tip of tongue in front of alveolar ridge in low lip sulcus….
Type II: Attaches 2-4mm behind tongue tip and attaches on alveolar ridge…..click for picture.
Type III: Attaches to mid-tongue and middle of floor of the mouth, usually tighter and less elastic. The tip of the tongue may appear “heart-shaped”
Type IV: Attaches against base of tongue, is shiny, and is very inelastic
Effects:-
Ankyloglossia can affect feeding, speech, and oral hygiene as well as have mechanical/social effects. Ankyloglossia can also prevent the tongue from contacting the anterior palate. This can then promote an infantile swallow and hamper the progression to an adult-like swallow which can result in an open bite deformity. It can also result in mandibular prognathism; this happens when the tongue contacts the anterior portion of the mandible with exaggerated anterior thrusts. The authors sent a survey to a total of 1598 otolaryngologists, pediatricians, speech-language pathologists and lactation consultants with questions to ascertain their beliefs on ankyloglossia; 797 of the surveys were fully completed and used in the study. It was found that 69 percent of lactation consultants but only a minority of pediatricians answered that ankyloglossia is frequently associated with feeding difficulties; 60 percent of otolaryngologists and 50 percent of speech pathologists answered that ankyloglossia is sometimes associated with speech difficulties compared to only 23 percent of pediatricians; 67 percent of otolaryngologists compared to 21 percent of pediatricians answered that ankyloglossia is sometimes associated with social and mechanical difficulties. Limitations of this study include a reduced sample size due to unreturned or incomplete surveys.
Feeding
Messner et al. studied ankyloglossia and infant feeding. Thirty-six infants with ankyloglossia were compared to a control group without ankyloglossia. The two groups were followed for six months to assess possible breastfeeding difficulties, defined as nipple pain lasting more than six weeks, or infant difficulty latching onto or staying onto the mother’s breast. Twenty-five percent of mothers of infants with ankyloglossia reported breast feeding difficulty compared with only 3 percent of the mothers in the control group. The study concluded that ankyloglossia can adversely affect breastfeeding in certain infants. Infants with ankyologlossia do not, however, have such big difficulties when feeding from a bottle. Limitations of this study include the small sample size and the fact that the quality of the mother’s breast feeding was not assessed.
Wallace and Clark also studied breastfeeding difficulties in infants with ankyloglossia.[8] They followed 10 infants with ankyloglossia who underwent surgical tongue tie division. Eight of the ten mothers experienced poor infant latching onto the breast, 6/10 experienced sore nipples and 5/10 experienced continual feeding cycles; 3/10 mothers were exclusively breastfeeding. Following a tongue tie division, 4/10 mothers noted immediate improvements in breastfeedings, 3/10 mothers did not notice any improvements and 6/10 mothers continued breastfeeding for at least four months after the surgery. The study concluded that tongue tie division may be a possible benefit for infants experiencing breastfeeding difficulties due to ankyloglossia and further investigation is warranted. The limitations of this study include that the sample size was small and that there was not a control group. In addition, the conclusions were based on subjective parent report as opposed to objective measures.
Speech
Messner and Lalakea studied speech in children with ankyloglossia. They noted that the phones likely to be affected due to ankyloglossia include sibilants and lingual sounds such as [t d z s ? ð n l]. In addition, the authors also state that it is uncertain as to which patients will have a speech disorder that can be linked to ankyloglossia and that there is no way to predict at a young age which patients will need treatment. The authors studied 30 children from one to 12 years of age with ankyloglossia, all of whom underwent frenuloplasty. Fifteen children underwent speech evaluation before and after surgery. Eleven patients were found to have abnormal articulation before surgery and nine of these patients were found to have improved articulation after surgery. Based on the findings, the authors concluded that it is possible for children with ankyloglossia to have normal speech in spite of decreased tongue mobility. However, according to their study, a large percent of children with ankyloglossia will have articulation deficits that can be linked to tongue tie and these deficits may be improved with surgery. The authors also note that ankyloglossia does not cause a delay in speech or language but, at the most, problems with enunciation. Limitations of the study include a small sample size as well as a lack of blinding of the speech-language pathologists who evaluated the subjects’ speech.
Messner and Lalakea also examined speech and ankyloglossia in another study. They studied 15 patients and speech was grossly normal in all of the subjects. However, half of the subjects reported that they thought that their speech was more effortful than other peoples’ speech.
Horton et al. discussed the relationship between ankyloglossia and speech. The authors believe that tongue tie contributes to difficulty in range and rate of articulation and that compensation is needed. Compensation at its worst, the article states, may involve a Cupid’s bow of the tongue.
While the tongue tie exists, and even years after removal, common speech abnormalities include mispronunciation of words. The most common is pronouncing Ls as Ws; for example the word “lemonade” would come out as “wemonade.”
Mechanical/Social
Ankyloglossia can result in mechanical and social effects. Lalakea and Messner studied 15 people, aged 14 to 68 years. The subjects were given questionnaires in order to assess functional complaints associated with ankyloglossia. Eight subjects noted one or more mechanical limitations which included cuts or discomfort underneath the tongue and difficulties with kissing, licking one’s lips, eating an ice cream cone, keeping one’s tongue clean and performing tongue tricks. In addition, seven subjects noted social effects such as embarrassment and teasing. The authors concluded that this study confirmed anecdotal evidence of mechanical problems associated with ankyloglossia and that it suggests that the kinds of mechanical and social problems noted may be more prevalent than previously thought. Furthermore, the authors note that some patients may be unaware of the extent of the limitations they have due to ankyloglossia since they have never experienced normal tongue range. A limitation of this study is the small sample size that also represented a large age range.
Lalakea and Messner note that mechanical and social effects may occur even without other problems related to ankyloglossia such as speech and feeding difficulties. Also, mechanical and social effects may not arise until later in childhood as younger children may be unable to recognize or report the effects. In addition, some problems may not come about until later in life, such as kissing.
Complications
The complications are rare, but recurrence of tongue tie, tongue swelling, bleeding, infection, and damage to the ducts of the salivary glands may occur.
Treatment:
Surgery is seldom necessary but if it is needed, it involves cutting the abnormally placed tissue. If the child has a mild case of tongue tie, the surgery may be done in the doctor’s office. More severe cases are done in a hospital operating room. A surgical reconstruction procedure called a z-plasty closure may be required to prevent scar tissue formation.
Prognosis:
Surgery, if performed, is usually successful.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Both men and women have breasts. In women they are well developed while in men they are rudimentary. Yet 60 per cent of men, at some point in their life, develop aesthetically unacceptable “gynaecomastia “, a term which in Greek means “breasts like a woman”.
Male babies may develop enlargement of one or both breasts. Sometimes, the affected breasts may also secrete a watery milk-like secretion. This is normal and occurs because the baby’s breast has been influenced by the mother’s hormones. It disappears if left alone. Pressing it to remove the milk can result in infection and abscess formation.
Thirty to 50 per cent boys in the age group 11 to 14 years suddenly develop breasts. It occurs because during this time the levels of the sex hormones, both estrogen (female hormone) and testosterone (male hormone), start to increase. Testosterone controls male traits such as muscle mass and body hair, while estrogen controls female traits, including the growth of breasts. A perfect ratio has to be maintained, or else it might lead to the development of breasts in boys. In 75 per cent of them, the breasts regress spontaneously within three years.
Breast enlargement in boys may persist because of hypogonadism (inadequate development of the male sex organs). This may be genetic — in people whose genetic profile is XXY instead of XY, owing to the failure of the testes to develop at all, or a result of artificial removal of the testes (castration). It may occur in adults as a result of kidney and thyroid diseases. Liver damage can also result in low testosterone levels and enlarged breasts.
Enzymes belonging to the cytochrome P450 group, found in fat tissue, convert testosterones to estrogens. As the fat tissue increases gynaecomastia can occur. Weight loss and exercises, like the bench press and push-ups, can correct this type of breast enlargement along with overall weight reduction.
These enzymes can be affected by medications for ulcers, anti psychotic drugs, sedatives, diuretics and some antibiotics. Long-term use of medications belonging to these groups can cause gynaecomastia. Several illicit drugs are available on the streets today. Some, such as the amphetamines, are touted as a “safe” adjuvant to long hours of studying as they prevent drowsiness. But long-term use of these not only damages the psyche but also promotes breast development.
“Nutritional supplements” are used by many bodybuilders. Many do not contain all the ingredients listed. Some are sold secretly “under the counter” or via the Internet. Many preparations are not legal or may have expired. They may not conform to safety standards. Moreover, they may contain steroids. Sometimes, they contain creatinine, natural ingredients found in the human body. However, they may be dangerous to health, and cause enlarged and sometimes lumpy breasts.
There is no short cut to a “Mr World” physique. At least two hours of workout is needed with a healthy high-protein, low-fat diet.
Gynaecomastia is not always harmless. It needs to be reviewed with all previous medical documents, and investigated with blood tests and scans. Very rarely, gynaecomastia confined to one side may be due to cancer.
Diagnosis and treatment of the underlying cause of gynaecomastia may lead to improvement. Changing the offending medication, avoiding alcohol and exercising regularly may be all that is required. Some medications which are anti estrogen, or testosterone derivatives can sometimes be used on a short-term basis under medical supervision. These medications are for treating other diseases and are not universally approved for the treatment of gynaecomastia.
Medical treatment or “waiting and watching” can be tried for two to three years. After that, the breast tissue tends to harden and then surgery is the only alternative. There are several options — liposuction, gland excision, skin sculpture, reduction mammoplasty or a combination of these techniques. Reduction surgery is a cosmetic procedure and is usually performed by plastic surgeons.
In 25 per cent of men with persistent gynaecomastia, there is no correctable cause, nor is the condition dangerous. If they do not wish to have surgery or try medications and just wish to live with the condition, the breasts can often be compressed. An elastic girdle worn by women around their abdomens can be used and works quite well. Or else, a loose thick shirt may be sufficient to hide the offending bulges.
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