Keywords:
Breast, Mammography, Ultrasound, Diagnostic procedure, Education, Education and training, Cancer, Neoplasia
Authors:
B. Lannegrand Menéndez, C. Alvarez Sánchez, M. Montes Fernández, M. J. Ciudad Fernandez; Madrid/ES
DOI:
10.1594/ecr2018/C-1998
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 discarding a neoplasm.
In patients younger than 40 years,
mammogram can be avoided and only US study should be performed,
provided the frequency of malignity is very low.
However,
occasionally these benign lesions are infrequently or can raise doubts,
for instance in inflammatory lesions which can be confused with carcinomas.
In these situations a histological study is carried out (11).
Carcinoma is infrequent in the male,
much rare in patients younger than 40 years,
and it is usually unilateral.
The most common subtype of male breast cancer is the infiltrating ductal carcinoma (80% of breast cancer cases in men) followed by ductal carcinoma in situ (5%).
Infiltrating mammary carcinoma with mixed features and invasive papillary carcinoma are less common subtypes.
Metastasis to the breast from extramamammary primary malignancy is extremely rare (3).
Concluding,
the main objective of the radiologist is to identify the reduced number of cases of male breast cancer,
which present mammary symptoms.
Based on a clinic evaluation,
mammogram and/or US are carried out,
which can give additional information.
Differential diagnosis can be carried out between pathology types,
avoiding unnecessary procedures and a delay in carcinoma diagnosis (12).