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What is atypical epitheliosis or gynaecomastia with atypia?

Q: The context is of gynaecomastia that my father has been diagnosed with in his right breast. The first FNAC report mentions atypical epitheliosis. A review of the slides by a second pathologist mentions gynaecomastia with focal area of atypia. What do atypical epitheliosis or gynaecomastia with focal area of atypia mean in layman's language? I would also like to know what is the implication of atypia - is it malignancy? Also, is it true that breast cancer in men is rare but it may be more threatening than breast cancer in women? What are the chances of it being cured? When there is a lump in the breast and one that is somewhat painful, is it an early or a late stage of the disease?

A:If this is true unilateral gynaecomastia affecting the right breast alone in a 71 year old male it should be investigated adequately. The term Atypia itself does not mean malignancy but cannot be totally ignored either. It may mean just a small focal non-malignant change in an otherwise benign proliferative condition of gynaecomastia or may mean a more serious disease in another area. My suggestion is that the cytology already available may be reexamined by a dependable cytopathologist (for example, if the patient is in Delhi then I suggest Sir Ganga Ram Hospital Dept. of Pathology-Division of cytopatholgy) and if necessary a proper repeat FNAC done by them. The result from that would decide if surgery is to be done. At any rate, as I said earlier, if this change is confirmed to be only on one side a limited surgery may be necessary.

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