Male Breast Disease: What the Radiologist Needs to Know

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Male breast conditions often present as palpable findings, pain, or enlargement.
• Gynecomastia is the most common abnormality, requiring differentiation from malignancy.
• Male breast cancer incidence is low (<1%), with no routine screening for cisgender men.

Purpose of the Study:

• To review male breast anatomy and imaging techniques for symptomatic patients.
• To discuss benign and malignant conditions of the male breast.
• To outline imaging and screening recommendations for transgender patients.

Main Methods:

• Diagnostic mammography for patients ≥25 years.
• Targeted ultrasound for patients <25 years or when mammography is inconclusive.
• Biopsy for suspicious findings due to overlapping imaging features.

Main Results:

• Specific imaging pathways are recommended based on patient age and initial findings.
• Transgender male-to-female patients >50 on hormone therapy require breast cancer screening.
• Clinical and imaging features of benign and malignant conditions can overlap, necessitating biopsy.

Conclusions:

• Appropriate imaging is crucial for evaluating symptomatic male breast findings.
• Screening recommendations vary for specific populations, including transgender individuals.
• Distinguishing gynecomastia from malignancy requires a comprehensive diagnostic approach.