Radiologic evaluation of lumps in the male breast

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Gynecomastia is common in men and has a distinct mammographic appearance.
• Mammography is frequently used in men to rule out breast cancer, despite its low incidence (1%).

Purpose of the Study:

• To determine if ultrasound and fine needle aspiration cytology (FNAC) are essential for diagnosing gynecomastia when mammograms are conclusive.
• Evaluating the necessity of further investigations for male patients with mammographic evidence of gynecomastia.

Main Methods:

• Retrospective analysis of 539 male patients referred for mammography between 2011-2013.
• Review of mammograms, ultrasound images, clinical information, and pathology/cytology reports.
• Assessment of diagnostic concordance across imaging and biopsy procedures.

Main Results:

• Of 350 patients with mammographic gynecomastia, 97% had ultrasounds and 75% had FNAC.
• No diagnostic changes occurred for gynecomastia after FNAC or biopsy.
• Eight malignant tumors were identified, including six invasive ductal carcinomas.

Conclusions:

• Supplemental ultrasound, FNAC, or biopsy is unnecessary when mammography shows classical gynecomastia in men.
• These additional investigations lead to superfluous procedures and increased healthcare costs.
• Mammography alone is sufficient for diagnosing typical gynecomastia, reducing the need for further invasive testing.