What causes left-sided chest pain in a 20-year-old male?

Question

Hello doctor,

I am a 20-year-old male. I have pain and tenderness on the left side of my chest, above the areola area, not directly in the nipple. When I press the area, I can feel a tight muscle, tendon, or lump-like elongated structure. It feels more like a tight muscle than a stone-hard lump, and it seems to move slightly when pressed. The left side is more painful than the right. I have examined and pressed the area repeatedly, so it may be irritated from frequent checking.

I do not have nipple discharge or bleeding, nipple inversion, skin dimpling, ulceration, visible swelling, fever, or a clearly fixed, hard lump that is noticeable without pressing.

Could this be due to a chest wall muscle or fascial strain, rib cartilage irritation, gynecomastia, or another benign soft-tissue condition? Based on these symptoms, does this sound concerning for breast cancer, or would rest, medication, a physical examination, or an ultrasound be more appropriate?

Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I have read your query and would like to provide some guidance.

Based on what you have described, this does not sound particularly suggestive of breast cancer. In a 20-year-old male, breast cancer is very uncommon, and your symptoms are more consistent with a benign condition.

Possible causes in your case include:

Chest wall muscle or fascial strain, especially if you have been repeatedly pressing or examining the area.
Rib cartilage irritation (costochondritis).
Mild gynecomastia.
Other benign soft-tissue structures, such as muscle, tendon, or fibrous tissue, may become more noticeable on repeated examination.

The absence of nipple discharge, bleeding, nipple inversion, skin dimpling, ulceration, or an obvious visible mass is reassuring and makes breast cancer less likely. You should avoid repeatedly checking or pressing the area, as this can prolong irritation and tenderness.

If needed, simple pain relievers such as Paracetamol or Ibuprofen (provided they are safe for you to take) may help relieve the discomfort.

Please arrange a routine examination with a doctor if the discomfort persists for more than two to four weeks, worsens, or if you remain concerned. An ultrasound may be recommended if there is any uncertainty after the physical examination.

Overall, based on your description, a benign chest wall condition or mild gynecomastia is much more likely than breast cancer. An in-person examination would usually be the next appropriate step rather than assuming a serious underlying condition.

Kindly follow up if you have any further related questions.

Thank you.