Pathologies of the male breast

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• The majority of breast lesions in men are benign, with gynaecomastia being a common condition caused by hormonal changes.
• Lipomastia, characterized by adipose tissue deposits, is a key differential diagnosis for male breast enlargement.
• Male breast cancer is rare, with risk factors including hormonal imbalances, chest irradiation history, and BRCA2 gene mutations.

Purpose of the Study:

• To review the radiological patterns and diagnostic approaches for male breast lesions.
• To differentiate between benign conditions like gynaecomastia and lipomastia from rare male breast cancer.
• To establish guidelines for the appropriate use of imaging in male breast disease evaluation.

Main Methods:

• Review of radiological patterns of gynaecomastia (nodular, dendritic, diffuse glandular).
• Discussion of differential diagnosis, primarily lipomastia.
• Analysis of risk factors and imaging characteristics of male breast cancer (mammography, sonography, MRI).

Main Results:

• Gynaecomastia presents with distinct radiological patterns.
• Mammography in male breast cancer typically shows a mass without calcifications.
• Sonography aids in assessing local spread and lymph node involvement; MRI is not currently indicated.

Conclusions:

• Clinical examination is often sufficient to distinguish benign from malignant male breast lesions.
• Imaging should be reserved for clinically uncertain cases, high-risk patients, biopsy guidance, and staging.
• Appropriate utilization of imaging modalities is essential for accurate diagnosis and management of male breast conditions.