Male Breast Cancer Imaging

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<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. 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