Does thinning and breakage near the crown of your head always mean male pattern baldness , or can it be something else?

Hard to tell: It can mean male pattern baldness but there are also other causes of hair thinning and breakage. Only a thorough history and an exam can help arrive at the correct diagnosis and treatment.

It can be: If you had recent medical exam, blood chem panel done, ..And all test came out excellent, it can be genetics. Humans lose more or less 130 hairs a day. It can also be part of aging. Alopecia is also common. See your M.D. If you think your hair loss is excessive.