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patrickf
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Reged: 10/18/02
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Loc: TX, USA
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Gynecomastia -- painful breast lumps
#42305 - 10/24/02 10:00 AM
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I've been HIV+ for about 15 years or so, on meds for 7-8yrs..... and have been doing VERY well.
However, within the last 30 days, I've developed a painful lump (about the size of a pencil eraser) under my right breast nipple. After a thorough radiologic and surgical exam, I've been diagnosed with gynecomastia.
I didn't know anything about gynecomastia.... so I searched the web and found that gynecomastia and HIV/HAART are related.
Have any of you ever experienced this problem? If so what, treatment did you get? Was it successful? Any constructive suggestions are appreciated.
Thanks....
Patrick
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These are some answers I found using the search engine on this site.
However there is a relationship between HIV and gynecomastia, probably related to antiretrovirals. The GM is usually painful (but not always), frequently symmetrical (similar in both breats- but not always), and frequently improves/resolves after discontinuation of the causative drug (but not always. And gynecomastia is not so uncommon in the non-HIV male. I do not want to second guess your docs, but I doubt a biopsy is needed given the clear association of gynecomastia and HIV. But you should double check with your docs.
\
Do you mean gynecomastia: actual growth of breast tissue? If this is confirmed it is usually related to some medication (marijuana has also been implicated as a cause) but may be due to a hormonal problem. If you mean fatty tissue in the breast area then we are in the general area or fat accumulation probably related to HIV/antiretrovirals. So for gynecomastia get your MD to evaluate for possible causes. For fat accumulation you may not have many options likely to be successful. Some people have seen improvement with growth hormone, but it is expensive and the effects don't last after you stop it. Sometimes removing one or more of the antiretrovirals can help (DON'T DO THIS AT HOME: CHECK WITH YOUR MD). And good luck AF
Gynecomastia is a form of fat accumulation and it is associated with antiretroviral therapy, and especially regimens that include a protease inhibitor. This condition does not resolve quickly when the medications are discontinued or changed so I am not surprised that it is persistent despite your regimen changes. There are some treatment options (e.g., growth hormone) but these are difficult and expensive to use and the fat generally comes back once the therapy is stopped. You should discuss potential treatment options with your doctor. You should also be evlauated to make sure that it is HIV/antiretroviral-realted fat accumulation and that there is no other problem present.
Tons of other stuff...just do a search on this site.
http://www.thebody.com/Forums/AIDS/SideEffects/Archive/Lipodystrophy/Q1838.html
http://www.thebody.com/tpan/novdec_01/breasts.html
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A recent study done by Sibtain Rahim from NYC in New York City reproted that Efavirenz appears to be strongly associated with gynecomastia.
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Patrick,
Another option which has been tried for some people successfully is the use of a medication known as tamoxifen - an anti-estrogen. There are a few case reports in the medical literature of this drug being used quite successfully in HIV positive men with gynecomastia from antiretrovirals. You can read the abstracts of these reports by searching the medical database MEDLINE which is available through the National Library of Medicine online. Hope this is helpful.
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Hi Patrick, I was diagnosed with gynocomasta in '98. similar to you, i had painful lumps checked out and got the dx. turns out it is somewhat common among males in general, but not diagnosed because in many there are no painful symptoms, combined with the high % of overweight folks. it goes unnoticed. also, unmentioned(i found it embarrassing} mine hurt and im skinny so there was no missing it! I'd been on hiv meds for a couple years, but the culprit turned out to be Welbutrin, I'd started using to quit smoking. a few months after i stopped the Welbutrin my symptoms went away. my doc told me sometimes the body will reabsorb the fatty deposits, sometimes not. in that case they can surgically remove the breast tissue. Unless the doc words it correctly(the "pain and discomfort" angle) the procedure is considered cosmetic. since becoming aware of gynocomastia, ive noticed it in the fine print of other drugs as a side effect, albeit an uncommon one. I'm still on retrovirals, in my case they apparently weren't the culprit, since my GM started and stopped in sync with the Wellbutrin. Hope your experience with this goes as easily as mine, wish you well!
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