Imaging in gynecomastia.

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Gynecomastia (GM) is the benign proliferation of male breast glandular tissue, common in infancy, puberty, and senescence.
• Underlying pathologies like medications, obesity, or endocrinopathies are found in 45-50% of adult men with GM.
• GM evaluation aims to diagnose, differentiate from pseudogynecomastia, exclude malignancy, and identify causes.

Purpose of the Study:

• To review the role of imaging in evaluating male breast gynecomastia.
• To assess imaging's contribution to therapeutic decision-making for GM.

Main Methods:

• Literature review of PubMed, Scopus, and CENTRAL databases.
• Identification of evidence on imaging modalities for male breast GM.

Main Results:

• Clinical diagnosis is often sufficient for male breast lesions.
• Imaging (mammography, ultrasound) is helpful when physical examination is inconclusive.
• Mammography shows subareolar opacity with nodular, dendritic, or diffuse patterns; ultrasound depicts hypoechoic areas under the areola.

Conclusions:

• Mammography and ultrasound are sensitive and specific for diagnosing GM and differentiating it from breast cancer.
• Histological confirmation is recommended for suspected malignancy or inconclusive imaging findings.
• Imaging findings can be classified using BIRADS to assess malignant potential.