Aims and objectives
Normal adult male breasts are composed of skin,
subcutaneous fat,
stromal elements and atrophic ducts.
Breast lobular developmentis rare in men.
Therefore,
breast conditions related to lobular proliferation,
such as fibroadenoma or lobular carcinoma are extremely uncommon in men.
Conditions related to ductal and stromal proliferation,
such as gynecomastia,
ductal carcinoma and papillary neoplasm,
may occur in men.
Male breast disease represents a spectrum ofsymptomatic benign and malignant tumors.Themost common benign lesion is gynecomastia,which has three patterns: nodular,
dendritic,
and diffuse;but there are other rarer...
Methods and materials
Imaging findings of breast lesions over a period of 4 years,
excluding gynecomastia,
were retrospectiively assessed.
The sample consisted of 13 male patients between 32 and 90 years old.
In all cases the anomaly was detected by mammography evaluation,
completing the study with ultrasound and ultrasound-guided core biopsy/FNA was performed.
Radiological findings in mammography and ultrasound were analyzed and radiopathologic correlation was performed,
comparing the results with the medical literature.
Results
Most symptomatic men werereferred for a palpable mass in our series.
Benign pathology was predominant (four abscesses,
two epidermal inclusion cysts,
one hematoma and one myofibroblastoma).
SUBAREOLAR ABSCESS
A subareolar abscess is a localized infection secondary to ductal ectasia which tends to recur unless treated by excision of both the abscess and duct.
Common clinical features include pain,
nipple swelling,
andnipple discharge.
Because of their predilection for a subareolar location,breast abscesses can simulate gynecomastia.
Four cases of subareolar abscess were seen in our series.
At...
Conclusion
Breast disease in men is uncommon,
being gynecomastia and invasive ductal carcinoma the two most important pathologies,
the first because it is the most common globally and the latter because it is the primary malignancy.
Gynecomastia will be retroareolar with a recognizablepattern.Carcinoma will often be subareolar and eccentric to the nipple without calcifications.
If a classic pattern of gynecomastia is not present,
a knowledge of the overlapping features of benign and malignant tumors will assist the radiologist in pursuing the appropriate diagnosticworkup.
References
1.
Appelbaum AH,
Evans GF,
Levy KR,
AmirkhanRH,
Schumpert TD.
Mammographic appearancesof male breast disease.
RadioGraphics 1999;19(3):559–568.
2.
Lattin,
G.,
Jesinger,
R.,
Mattu,
R.
and Glassman,
L.
(2013).
From the Radiologic Pathology Archives: Diseases of the Male Breast: Radiologic-Pathologic Correlation.
RadioGraphics,
33(2),
pp.461-489.
3.
Nguyen,
C.,
Kettler,
M.,
Swirsky,
M.,
Miller,
V.,
Scott,
C.,
Krause,
R.
and Hadro,
J.
(2013).
Male Breast Disease: Pictorial Review with Radiologic-Pathologic Correlation.
RadioGraphics,
33(3),
pp.763-779.
4.Chen L,
Chantra PK,
Larsen LH,
et al.
Imagingcharacteristics of malignant lesions of the...