Atypical ductal hyperplasia in men with gynecomastia: what is their breast cancer risk?

  • Suzanne B. CoopeyEmail author
  • Kinyas Kartal
  • Clara Li
  • Adam Yala
  • Regina Barzilay
  • Heather R. Faulkner
  • Tari A. King
  • Francisco Acevedo
  • Judy E. Garber
  • Anthony J. Guidi
  • Kevin S. Hughes



Atypical ductal hyperplasia (ADH) significantly increases the risk of breast cancer in women. However, little is known about the implications of ADH in men.


Review of 932 males with breast pathology was performed to identify cases of ADH. Patients were excluded if ADH was upgraded to cancer on excision, or if they had contralateral breast cancer. Cases were reviewed to determine whether any male with ADH developed breast cancer.


Nineteen males were diagnosed with ADH from June 2003 to September 2018. All had gynecomastia. Surgical procedure was mastectomy in 8 patients and excision/reduction in 11. One patient had their nipple areola complex removed, and 1 required a free nipple graft. Median patient age at ADH diagnosis was 25 years (range 18–72 years). Of the 14 patients with bilateral gynecomastia, 10 had bilateral ADH and 4 had unilateral. Five cases of ADH were described as severe, bordering on ductal carcinoma in situ. No patient reported a family history of breast cancer. No patient took tamoxifen. At a mean follow-up of 75 months (range 4–185 months), no patient developed breast cancer.


Our study is the first to provide follow-up information for males with ADH. With 6 years of mean follow-up, no male in our series has developed breast cancer. This suggests that either ADH in men does not pose the same risk as ADH in women or that surgical excision of symptomatic gynecomastia in men effectively reduces the risk of breast cancer.


Atypical ductal hyperplasia Gynecomastia Male Breast cancer Risk 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Because of the retrospective nature of this study with minimal risk to participants, the need for informed consent was waived by our institutional review board.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Suzanne B. Coopey
    • 1
    • 9
    Email author
  • Kinyas Kartal
    • 2
  • Clara Li
    • 3
  • Adam Yala
    • 3
  • Regina Barzilay
    • 3
  • Heather R. Faulkner
    • 4
  • Tari A. King
    • 5
  • Francisco Acevedo
    • 6
  • Judy E. Garber
    • 7
  • Anthony J. Guidi
    • 8
  • Kevin S. Hughes
    • 1
  1. 1.Division of Surgical OncologyMassachusetts General HospitalBostonUSA
  2. 2.Department of General SurgeryKoc University HospitalIstanbulTurkey
  3. 3.Department of Electrical Engineering and Computer ScienceCSAIL, MITCambridgeUSA
  4. 4.Division of Plastic and Reconstructive SurgeryMassachusetts General HospitalBostonUSA
  5. 5.Department of SurgeryDana-Farber/Brigham and Women’s Cancer CenterBostonUSA
  6. 6.Department of Hematology-OncologyPontificia Universidad Catolica de ChileSantiagoChile
  7. 7.Department of Medical OncologyDana-Farber Cancer InstituteBostonUSA
  8. 8.Department of PathologyNewton-Wellesley HospitalNewtonUSA
  9. 9.BostonUSA

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