Incidental discovery of bilateral breast cancer in a 24-year-old man presenting with gynecomastia

We present a case of a 24-year-old man who was treated for gynecomastia with bilateral mastectomy and free nipple grafts with subsequent discovery of bilateral breast cancer in the submitted specimens. Surgical treatment of gynecomastia is becoming more popular with over 16,000 procedures of gynecomastia reduction performed in 2005, an increase of 17% compared with the previous year. This case underscores the rare but real possibility of detecting breast cancer in men who present with gynecomastia to plastic surgeons. We caution that male breast tissue should be regarded with the same oncologic principle as female breast tissue. In cases in which ultrasound-assisted suction lipectomy is used, the inability to analyze the breast tissue should be disclosed to the patient.