Professor Kefah Mokbel, Consultant Breast Surgeon

Gynaecomastia, in simple terms means abnormally large breasts on men and derives from the Greek ‘gyne’ meaning women and ‘mastos’ meaning breasts. The condition is relatively common and affects approximately 40% of men. Also known as man boobs or ‘moobs’, gynaecomastia often resolves by itself but can be treated through change of lifestyle, drug medication, or surgery.

Breast cysts are sacs filled with fluid of variableLiable to vary or change. colour and are relatively common breast lumps reported by women or identified during a clinical examination by a doctor. Approximately 7% of all women will encounter a palpable cyst during their lifetime. Although these lumps do not spread, they can vary considerably in size and result in much anxiety. Their presence can also affect the interpretation of clinical examination findings and mammograms. Cysts can be single or multiple, affect one breast or both breasts and are frequently changing in response to hormonal fluctuations during the menstrual cycleThe monthly sequence by which a woman’s body prepares for potential fertilisation of an egg released from the ovaries, involving thickening of the uterus lining and then shedding of the lining when pregnancy does not occur..

Mastalgia literally means 'pain in the region of the breast' and is the most common symptom reported by women attending breast clinics. To make a full assessment of the cause, all patients require a full history, examination and, sometimes, investigations.True breast pain can either be cyclical (getting worse before menstruationThe shedding of the lining of the uterus (period), as part of the female reproductive cycle.) or non-cyclical (unrelated to menstruation). It is important to point out that breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. does not usually cause mastalgiaBreast pain.

Most cases of nipple discharge are due to normal, benignNot dangerous, usually applied to a tumour that is not malignant. conditions and are usually hormoneA substance produced by a gland in one part of the body and carried by the blood to the organs or tissues where it has an effect.-related. Approximately one third of all women can produce a nipple discharge by gently massaging their breasts. This 'innocent' nipple discharge usually comes from multiple ducts in both breasts in pre-menopausalRelating to the menopause, the time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle. women. Blood-stained discharge from a single duct in one breast can be sinister in nature and may represent an underlying carcinomaA malignant tumour (cancer) that is formed from the epithelium, the tissue that covers the open surfaces of organs..

Approximately one in five patients with breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. will require a mastectomy rather than a lumpectomy. As mastectomy results in the distortion of the body image, it is natural for some patients to seek reconstructive surgery. However, some women are just relieved to have had the cancer removed and are not keen on having breast reconstruction. Although an external implant is available that can be put inside the brassiere, it may be inadequate for some women.

The choice of reconstruction depends upon the woman's build, shape and size of her breasts, previous scars, and her own preferences.

Skin-sparing mastectomy (SSM) has become a valid option for women who are undergoing mastectomy and immediate breast reconstruction for early breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body.. With SSM most of the natural skin envelope is preserved during the immediate breast reconstruction leading to a much better aesthetic outcome. It also reduces the need for surgery on the other breast, which may otherwise be required to give a symmetrical appearance.