Male Breast Cancer Imaging

  • Published on
    09-Apr-2018

  • View
    216

  • Download
    0

Embed Size (px)

Transcript

<ul><li><p>8/8/2019 Male Breast Cancer Imaging</p><p> 1/3</p><p>Male Breast Cancer ImagingAuthor: Marilyn A Roubidoux, MD, Professor of Radiology, Department of Radiology, Division of Breast Imaging,</p><p>University of Michigan Health SystemCoauthor(s): Stephanie K Patterson, MD, Clinical Associate Professor, Department of Breast Imaging, University ofMichigan Medical CenterContributor Information and Disclosures</p><p>Male breast cancer is similar to breast cancer in females in its etiology, family history, prognosis, andtreatment. In approximately 30% of cases of breast cancer in men, the family history is positive for the disease.</p><p>A familial form of breast cancer is seen in which both genders are at increased risk for breast cancer. Male</p><p>breast neoplasms are relatively rare, in contrast to gynecomastia, which is a relatively common</p><p>condition.1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17</p><p>Preferred Examination</p><p>The clinical examination is key in the evaluation of a palpable mass in a male. If the clinical features strongly</p><p>suggest gynecomastia, further evaluation may not be necessary. If the clinical features are equivocal, fine-</p><p>needle aspiration guided by palpation and/or excisional biopsy are necessary to make the diagnosis.</p><p>Accurate diagnosis with mammography alone has been reported, with a sensitivity and specificity of at least</p><p>90%. If clinical examination and mammography both reveal benign findings, a biopsy may be unnecessary.</p><p>Given the rarity of male breast cancer, mammography screening guidelines are not available for men.18,19</p><p>Ultrasonography can demonstrate a cyst in a male, but cysts are rare. A mammogram showing only fat can be</p><p>helpful in cases of unilateral breast enlargement without a mass, but in general, this finding is not concerning</p><p>for breast cancer and does not require further evaluation of the breast.</p><p>Although some mammographic findings do suggest male breast cancer (eg, an eccentric spiculated mass),</p><p>mammography or ultrasonography has not been compared with the predictive value of a clinical breast</p><p>examination and fine-needle aspiration. Considerable overlap also exists in the ultrasonographic appearance of</p><p>these entities.6</p><p>Magnetic resonance imaging has not been studied regarding its sensitivity in making a diagnosis, but since the</p><p>lesions are always palpable and can be biopsied easily under palpation, there is no clear role for MRI.</p><p>See the image below of Male Breast Cancer.</p><p>A partially circumscribed retroareolar mass in a male with suspicious microcalcifications;</p><p>this is known breast cancer.</p></li><li><p>8/8/2019 Male Breast Cancer Imaging</p><p> 2/3</p><p>References</p><p>1. Appelbaum AH, Evans GF, Levy KR, et al. Mammographic appearances of male breastdisease. Radiographics. May-Jun 1999;19(3):559-68. [Medline].</p><p>2. Carmalt HL, Mann LJ, Kennedy CW, et al. Carcinoma of the male breast: a review andrecommendations for management.Aust N Z J Surg. Oct 1998;68(10):712-5. [Medline].</p><p>3. Donegan WL, Redlich PN. Breast cancer in men. Surg Clin North Am. Apr 1996;76(2):343-63. [Medline].</p><p>4. Newman J. Breast cancer in men and mammography of the male breast. Radiol Technol. Sep-Oct 1997;69(1):17-28; quiz 29-36. [Medline].</p><p>5. Ravandi-Kashani F, Hayes TG. Male breast cancer: a review of the literature. Eur JCancer. Aug 1998;34(9):1341-7. [Medline].</p><p>6. Stewart RA, Howlett DC, Hearn FJ. Pictorial review: the imaging features of male breast disease. ClinRadiol. Oct 1997;52(10):739-44. [Medline].</p><p>7. Winchester DJ. Male breast cancer. Semin Surg Oncol. Sep-Oct 1996;12(5):364-9. [Medline].</p><p>8. Contractor KB, Kaur K, Rodrigues GS, Kulkarni DM, Singhal H. Male breast cancer: is the scenariochanging. World J Surg Oncol. Jun 16 2008;6:58. [Medline].</p><p>9. Lanitis S, Rice AJ, Vaughan A, Cathcart P, Filippakis G, Mufti RA, et al. Diagnosis and Management ofMale Breast Cancer. World J Surg. Sep 12 2008;[Medline].</p><p>10. Schaub NP, Maloney N, Schneider H, Feliberti E, Perry R. Changes in male breast cancer over a 30-year period.Am Surg. Aug 2008;74(8):707-11; discussion 711-2. [Medline].</p><p>11. Grenader T, Goldberg A, Shavit L. Second cancers in patients with male breast cancer: a literaturereview. J Cancer Surviv. Jun 2008;2(2):73-8. [Medline].</p><p>12. La Pinta M, Fabi A, Ascarelli A, Ponzani T, Di Carlo V, Scicchitano F, et al. Male breast cancer: 6-yearexperience. Minerva Chir. Apr 2008;63(2):71-8. [Medline].</p><p>13. Pant K, Dutta U. Understanding and management of male breast cancer: a critical review. MedOncol. Dec 12 2007;[Medline].</p><p>14. Leinung S, Horn LC, Backe J. [Male breast cancer: history, epidemiology, genetic andhistopathology]. Zentralbl Chir. Oct 2007;132(5):379-85. [Medline].</p><p>15. Dimitrov NV, Colucci P, Nagpal S. Some aspects of the endocrine profile and management ofhormone-dependent male breast cancer. Oncologist. Jul 2007;12(7):798-807. [Medline].</p><p>16. Cutuli B. Strategies in treating male breast cancer. Expert Opin Pharmacother. Feb 2007;8(2):193-202. [Medline].</p><p>17. Agrawal A, Ayantunde AA, Rampaul R, Robertson JF. Male breast cancer: a review of clinicalmanagement. Breast Cancer Res Treat. May 2007;103(1):11-21. [Medline].</p><p>18. Gnhan-Bilgen I, Bozkaya H, Ustn EE, Memis A. Male breast disease: clinical, mammographic, andultrasonographic features. Eur J Radiol. Sep 2002;43(3):246-55. [Medline].</p><p>19. Evans GF, Anthony T, Turnage RH, et al. The diagnostic accuracy of mammography in the evaluationof male breast disease.Am J Surg. Feb 2001;181(2):96-100. [Medline].</p></li><li><p>8/8/2019 Male Breast Cancer Imaging</p><p> 3/3</p><p>20. Patterson SK, Helvie MA, Aziz K, Nees AV. Outcome of men presenting with clinical breast problems:the role of mammography and ultrasound. Breast J. Sep-Oct 2006;12(5):418-23. [Medline].</p><p>21. Casagrande JT, Hanisch R, Pike MC, Ross RK, Brown JB, Henderson BE. A case-control study ofmale breast cancer. Cancer Res. Mar 1 1988;48(5):1326-30. [Medline].</p><p>22. Dao TL, Morreal C, Nemoto T. Urinary estrogen excretion in men with breast cancer. N Engl J</p><p>Med. Jul 19 1973;289(3):138-40. [Medline].</p><p>23. Evans GF, Anthony T, Turnage RH, Schumpert TD, Levy KR, Amirkhan RH. The diagnostic accuracyof mammography in the evaluation of male breast disease.Am J Surg. Feb 2001;181(2):96-100. [Medline].</p><p>24. Giordano SH, Cohen DS, Buzdar AU, et al. Breast carcinoma in men: a population-basedstudy. Cancer. Jul 1 2004;101(1):51-7. [Medline].</p><p>25. McLaughlin JK, Malker HS, Blot WJ, Weiner JA, Ericsson JL, Fraumeni JF Jr. Occupational risks formale breast cancer in Sweden. Br J Ind Med. Apr 1988;45(4):275-6. [Medline].</p><p>26. Williams WL Jr, Powers M, Wagman LD. Cancer of the male breast: a review. J Natl MedAssoc. Jul 1996;88(7):439-43. [Medline].</p></li></ul>