Can nipple pain and a lump in a 22-y/o male be gynecomastia?

Question

Hello doctor,

I am a 22-year-old male and have been experiencing unusual soreness around both of my nipples for about six weeks. One side is more tender than the other, and I can feel a small, rubbery lump behind my left nipple when I press on it.

I have been researching online and keep coming across information about breast cancer and lung cancer, which is making it hard for me to sleep. My family has a history of lung issues; my grandfather died of lung cancer at 68, and my dad has chronic bronchitis.

I do not smoke, but I did use some gym supplements last year, including a testosterone booster, which I stopped taking three months ago. My doctor recently checked my testosterone levels, and they came back slightly low at 2.1 ng/mL, while my estradiol levels were on the higher side.

Can a 22-year-old male with nipple pain have gynecomastia instead of breast cancer? I am really hoping it is something less serious.
I have an appointment with a general physician next week, but I wanted to get some clarity before then. Are there any specific tests, like a mammogram or ultrasound, that I should ask for?

Please guide.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concerns.

I hope you are doing well, and I wish you a speedy recovery. Initially, using hormonal supplements at the gym was not a good idea because these supplements can significantly raise progesterone levels or excessively increase testosterone.

This can lead to a rebound effect, in which the body increases levels of opposing hormones. At your age, using hormonal supplements is not recommended and can cause various issues.

Regarding your family history of lung cancer and breast cancer, these conditions are usually not directly related. However, genetic testing may be considered if there are multiple cases of breast cancer in your family. More importantly, based on your symptoms, I suggest that you undergo a bilateral breast ultrasound.

This is likely to be gynecomastia ( enlargement of male breast glandular tissue), but it may also be a benign lump or fibroadenoma (non-cancerous breast lumps), which can occur at a young age due to hormonal disturbances. Generally, these conditions are benign and do not progress to malignancy, but imaging is necessary to confirm that there is no underlying cancer.

The evaluation for gynecomastia requires a complete hormonal profile, including testosterone, estrogen, progesterone, and prolactin levels, to determine the underlying cause. If there is an organic cause, it can then be treated accordingly.

It is also very important that you stop all supplements, and it is good that you have already discontinued them for three months; I advise against returning to them.

I hope this is clear.

If you have any questions, please do not hesitate to ask.

Thank you.