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8/8/2019 Male Breast Cancer Imaging

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Male Breast Cancer ImagingAuthor: Marilyn A Roubidoux, MD, Professor of Radiology, Department of Radiology, Division of Breast Imaging,

University of Michigan Health SystemCoauthor(s): Stephanie K Patterson, MD, Clinical Associate Professor, Department of Breast Imaging, University ofMichigan Medical CenterContributor Information and Disclosures

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.

A familial form of breast cancer is seen in which both genders are at increased risk for breast cancer. Male

breast neoplasms are relatively rare, in contrast to gynecomastia, which is a relatively common

condition.1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17

Preferred Examination

The clinical examination is key in the evaluation of a palpable mass in a male. If the clinical features strongly

suggest gynecomastia, further evaluation may not be necessary. If the clinical features are equivocal, fine-

needle aspiration guided by palpation and/or excisional biopsy are necessary to make the diagnosis.

Accurate diagnosis with mammography alone has been reported, with a sensitivity and specificity of at least

90%. If clinical examination and mammography both reveal benign findings, a biopsy may be unnecessary.

Given the rarity of male breast cancer, mammography screening guidelines are not available for men.18,19

Ultrasonography can demonstrate a cyst in a male, but cysts are rare. A mammogram showing only fat can be

helpful in cases of unilateral breast enlargement without a mass, but in general, this finding is not concerning

for breast cancer and does not require further evaluation of the breast.

Although some mammographic findings do suggest male breast cancer (eg, an eccentric spiculated mass),

mammography or ultrasonography has not been compared with the predictive value of a clinical breast

examination and fine-needle aspiration. Considerable overlap also exists in the ultrasonographic appearance of

these entities.6

Magnetic resonance imaging has not been studied regarding its sensitivity in making a diagnosis, but since the

lesions are always palpable and can be biopsied easily under palpation, there is no clear role for MRI.

See the image below of Male Breast Cancer.

A partially circumscribed retroareolar mass in a male with suspicious microcalcifications;

this is known breast cancer.


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