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Lipodystrophy and WastingLipodystrophy and Wasting
           
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Breast fat deposits/pain
Oct 3, 2003

In the past 12 months I have noticed fat deposits under my nipples and a clear fluid discharge. This is accompanied by some pain and discomfort. I haven't developed full (female) breasts, but am concerned about the trend. What can I do to reduce breast pain and size.

Thanks for your help.

Colum

Response from Dr. Moyle

I hope you have talked your doctor about this problem. He should check some of your hormone levels (such as prolactin, testosterone and sex hormone binding globulin), take a sample of the discharge for cytology and culture and consider performing some sort of biopsy or aspirate to check on the tissue. However, before you get too concerned it is not uncommon for me to see men with breast enlargement in my HIV practice. Some of this enlargement seems to be related to immune reconstitution, some and association with lipodystrophy, a small amount related to hormone disturbances and none which have been cancerous. Individuals with persistent pain and tenderness may respond to the anti oestrogen drug tamoxifen 10 mg once daily. If your doctor is unable to find a cause for the problem and it doesn't settle spontaneously it may be worthwhile trying a short course of this.

Best wishes

Graeme Moyle


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