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Type:
Educational Exhibit
Keywords:
Endocrine disorders, Cancer, Diagnostic procedure, Biopsy, Ultrasound, Mammography, Breast
Authors:
R. Patel1, K. Nayagam1, M.-A. Tran-Dang1, A. Swamy1, S. Narula2, A. Malhotra1; 1London/UK, 2St. Albans/UK
DOI:
10.1594/ecr2015/C-1667
Background
Over the past decade there has been a definite rise in the number of imaging studies performed in male patients presenting to symptomatic breast clinic with pain,
lump or both.
Most male related breast disease is usually benign or a cutaneous lesion (1,2),
however approximately 1% of all new breast cancer diagnosis are accounted for by men(1).
One of the main challenges faced by the Breast Radiologist dealing with male breast disease is the overlap in clinical and imaging features of benign and malignant breast tumours and a correct diagnosis will effectively place the patient on an appropriate treatment pathway without delay.
MALE BREAST ANATOMY
The mammary glands of males and females are essentially identical at birth and are made up of mammary lobes that drain via lactiferous ducts into the nipple.
The borders of the breast:
2nd rib superiorly to the 6th rib inferiorly
strenum medially and the midaxillary line laterally.
During the peripubertal period boys have a 30-fold increase in testosterone levels which causes involution and atrophy of the male breast ducts (2).
Male Breast Anatomy
Normal adult breast are composed of :
- Skin
- Subcutaneous fat (predominant feature)
- Atrophic ducts and stromal elements (which make up the smallest percentage)
Breast lobular development is rare in men as it is a process which relies on oestrogen and progesterone,
therefore conditions relating to lobular proliferation e.g.
fibroadenoma,
phyllodes tumour,
invasive lobular carcinoma and lobular carcinoma in-situ are rare occurrences.