# A breast lump in a man: what to check and when to seek care

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- **Category:** Breast health
- **Published and reviewed:** 1 October 2026
- **Author:** Dr Luhard, MBChB (Pret)
- **Reading time:** 8 minutes

Most breast changes in men are not cancer. A new lump still deserves a proper examination rather than an online guess or months of watchful waiting.

## In brief

- Gynaecomastia is benign enlargement of male breast glandular tissue and is a common explanation for a lump or fullness.
- A hard or fixed lump, nipple change or discharge, skin dimpling or an underarm node needs prompt medical assessment.
- Assessment may include a medication and supplement review, examination, selected blood tests, imaging or biopsy depending on the findings.
- Do not stop prescribed hormones or other medicine without discussing it with the clinician who manages your care.

## Not every lump is the same

A male breast lump may be glandular tissue behind the nipple, chest fat, a skin cyst, inflammation, an injury-related change or a discrete mass. Appearance alone cannot reliably distinguish these.

Gynaecomastia is benign growth of glandular breast tissue. It often feels rubbery or firm beneath the nipple and may be tender. It may affect one or both sides. It is not the same as breast cancer and is not considered premalignant.

## Changes that should not be ignored

Arrange assessment for any new, unexplained or persistent breast change, especially:

- A hard, irregular or fixed lump, particularly away from the nipple
- A newly inverted or redirected nipple, bleeding or discharge
- Dimpling, ulceration, persistent scaling, redness or swelling
- A lump in the armpit or near the collarbone
- Rapid enlargement, significant pain, fever or spreading redness

These findings do not automatically mean cancer. They are reasons for clinical examination. Painful swelling with fever or acute illness may indicate infection and needs same-day care.

## Why gynaecomastia can develop

Male breast tissue responds to androgen and oestrogen balance. Gynaecomastia can occur during puberty and ageing. Medicines, supplements, anabolic steroids, hormones, alcohol, recreational substances and liver, kidney, thyroid or testicular conditions may contribute. Sometimes no single cause is found.

Breast tenderness or enlargement during testosterone treatment deserves review, but does not prove testosterone is the cause and does not itself indicate cancer. Do not alter treatment without medical advice. Read about [responsible TRT assessment and monitoring](https://malehealth.co.za/testosterone-replacement-therapy.html).

## Breast-cancer risk in men

Breast cancer can occur in men of any age, although risk increases with age. Risk may also be higher with a strong family history, BRCA2 or another inherited pathogenic variant, previous chest radiation, Klinefelter syndrome, liver disease, obesity or certain testicular conditions.

Tell your doctor about breast, ovarian, pancreatic and prostate cancers on both sides of your family and any known genetic result.

## What assessment may involve

A focused consultation and examination usually come first. Bring a complete list of medicines, injections, supplements and performance products. Selected hormone, liver, kidney or thyroid tests may be useful when gynaecomastia has no clear explanation.

Imaging is not automatic when the examination is clearly typical of gynaecomastia. An indeterminate lump or suspicious finding may require diagnostic mammography and/or ultrasound. A suspicious lesion generally needs tissue sampling rather than repeated reassurance.

## One clear care pathway

**MaleHealth** is the male-focused information and enquiry gateway. **Dr Luhard** is the author and consulting doctor. Consultations and treatment take place through [Medify](https://themedify.com/), the patient-care practice in Waterkloof. Imaging, biopsy, genetic counselling or specialist breast care is arranged by referral when indicated.

## Prepare for a consultation

- Note when the change started and whether it is growing, painful or intermittent.
- Bring your medicine, hormone, supplement and performance-product list.
- Record relevant cancers in close relatives and their age at diagnosis.
- Mention nipple discharge, skin change, weight change, testicular symptoms or other new symptoms.
- Bring previous imaging or blood-test results.

[Request a private consultation](https://malehealth.co.za/contact.html?concern=General%20%2F%20not%20sure).

## References

1. [US National Cancer Institute: Male Breast Cancer](https://www.cancer.gov/types/breast/male-breast-cancer)
2. [American College of Radiology: Evaluation of the Symptomatic Male Breast](https://acsearch.acr.org/docs/3091547/Narrative/)
3. [European Academy of Andrology guideline on gynaecomastia](https://pubmed.ncbi.nlm.nih.gov/31099174/)
4. [Cancer Association of South Africa: Men and Breast Cancer](https://cansa.org.za/men-and-breast-cancer/)

This article is general education for adults and cannot determine the cause of a lump. It does not replace examination, imaging, biopsy or specialist care when indicated. MaleHealth is not an emergency service.