Aims and objectives
At birth,
the breast tissue is identical between the two sexes,
however the hormonal influence during the puberty is the cause of later differentiations.
In the male,
during the prepuberal period,
there is a testosterone increase that induces involution and atrophy of the ducts (1).
Male breast is constituted of skin,
subcutaneous fat,
stroma,
glands,
neurovascular estructures and lymphatic vessels (2).
Fig. 2
Therefore,
breast alterations related to lobular proliferation are extremely rare in men.
Such alterations could be fibroadenoma,
phyllodes tumour,
invasive lobular carcinoma,...
Methods and materials
A retrospective study from our images database of a series of 74 male patients with breast symptoms is carried out.
Ultrasonography (US) and/or mammogram were performed completing the study in some cases,
with ultrasound-guided core biopsy/fine-needle aspiration. The age ranges between 11 and 87 years,
with a mean value of 45 years.
This work spans between January 2010 and September 2017.
Data are collected and reviewed.
The findings are classified as benign,
malign or normal.
Results
74 patients are considered,
of which 58 cases (78%) present benign pathology with a mean age of 43.6 years.
Fig. 3
Within this group the majority of lesions is related to gynecomastia (48 cases,
83%),
of which 26 cases (54%) are gynecomastia bilateral and 22 cases (46%) unilateral.
Within bilateral gynecomastia,
the subdivision is made between asymmetric bilateral gynecomastia (16 cases,
61%) and symmetric bilateral (10 cases,
39%).
Between the asymmetric bilateral gynecomastia there is a majority of cases of the left breast (9 cases,...
Conclusion
The causes of the consult of male patients are usually mammary pain,
mass palpation,
secretion and/or increase of the breast size.
The majority of cases present benign lesions,
mainly gynecomastia most frequently bilateral.
Lipoma is the second most common lesion,
benign too.
The rest of the benign lesions present radiological findings similar to those of the female breast (epidermal inclusion cysts,
lipomas,
abscesses,
fat necrosis,
etc.) (2). In the majority of cases a mammogram (both MLO and CC projections) is sufficient for diagnosing gynecomastia,
and...
References
1.
Brauer,
Francis-West,
Schoenwolf and Bleyl.
Larsen's Human Embryology,
5th Edition,
2014.
Development of the Skin and Its DerivativesChapter 7,
155-171.
2.
Grant E.
Lattin,
Jr,
MD et al.
From the Radiologic Pathology Archives Diseases of the Male Breast: Radiologic- Pathologic Correlation.
RadioGraphics 2013; 33:461–489
3.
Cheri Nguyen,
MD et al.
Male Breast Disease: Pictorial Review with Radiologic- Pathologic Correlation.
RadioGraphics 2013; 33:763–779
4.
Puebla C,
Sainz JM,
Pujalá M,
Villavieja JL.
Actualización Patología mamaria masculina Radiologia 1998;40:221-8
5.
Bannayan GA,
Hajdu SI.
Gynecomastia: clinicopathologic...