Male breast cancer
Male breast cancer is exceptionally rare and only accounts for less than 0.25% of male malignancies and ~0.5-1% of all breast cancer (both genders). The diagnosis is sometimes delayed due to the patient's hesitancy to seek advice. Workup from a radiological point of view is the same as for women including the use of needle biopsy to confirm the diagnosis.
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Epidemiology
The average age of diagnosis of male breast cancer is 60-70 years, which is later than female breast cancer.
Clinical presentation
Most commonly men present with a painless subareolar mass. Male breast cancer is also reported to present at a relatively advanced stage compared with female breast cancer 8.
Pathology
Histologically, the vast majority are invasive ductal carcinoma (85-90%) or ductal carcinoma in situ.
Risk factors
Recognized risk factors include:
- exposure to ionizing radiation: especially to the chest wall
- cryptorchidism
- testicular injury / infectious orchitis ref
- increased levels of estradiol
- consider this risk in transgender patients
- Klinefelter syndrome
- liver dysfunction: cirrhosis
- prostate cancer
- family history: ~30% of cases can have a positive family history
- chest trauma
- age
- certain racial groups: may have a comparatively higher incidence
- BRCA2 gene mutation 2
Please note gynecomastia is not a risk factor per se.
Location
- can occur anywhere within the breast but favors the subareolar area or the upper outer quadrant
- favors a slightly eccentric location in relative to the nipple 7
Genetics
The genetic predisposition for breast cancer can be inherited from both mother and father. First line family history includes both genders.
Radiographic features
Mammography
Typically seen as a subareolar mass (often round, oval, or lobulated) and at times can be masked by the presence of concurrent gynecomastia 3. Calcifications tend to be fewer in number and coarser than female breast cancer 1.
Treatment and prognosis
The overall prognosis tends to be worse than for female breast cancer which may due to men presenting at later stages (i.e. when the mass has grown to a palpable level).
Related Radiopaedia articles
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- breast screening
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mammography
- breast imaging and the technologist
- forbidden (check) areas in mammography
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mammography views
- craniocaudal view
- mediolateral oblique view
- additional (supplementary) views
- true lateral view
- lateromedial oblique view
- late mediolateral view
- step oblique views
- spot view
- double spot compression view
- magnification view
- exaggerated craniocaudal (axillary) view
- cleavage view
- tangential views
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- bullseye CC view
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- Eklund technique
- normal breast imaging examples
- digital breast tomosynthesis
- breast ultrasound
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- malignant lesions
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breast cancer
- breast adenocarcinoma
- ductal breast carcinoma
- ductal carcinoma in situ (DCIS)
- invasive ductal carcinoma
- lobular breast carcinoma
- ductal breast carcinoma
- adenoid cystic carcinoma of the breast
- apocrine carcinoma of the breast
- breast cancer metastases
- breast lymphoma
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- intracystic breast cancer
- male breast cancer
- malignant phyllodes tumor
- metastases to the breast
- metaplastic carcinoma the breast
- gamuts
- breast adenocarcinoma
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breast cancer
- borderline breast disease / high risk breast lesion
- benign lesions
- adenosis of the breast
- benign papillary lesions of the breast
- breast cyst
- breast hematoma
- breast hamartoma
- breast lipoma
- ductal adenoma of the breast
- epidermal inclusion cysts of the breast
- fat necrosis of the breast
- fibroadenoma
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- mammary fibromatosis
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- post-traumatic fibrosis
- pseudoangiomatous stromal hyperplasia (PASH)
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-
breast calcifications (approach)
- morphology
- distribution
- location
- lobular calcification within breast tissue
- intraductal calcification within breast tissue
- milk of calcium within a breast cyst
- vascular calcification in breast tissue
- skin (dermal) calcification in / around breast tissue
- suture calcification within breast tissue
- stromal calcification within breast tissue
- artifactual calcification from outside the breast
- suspicious breast calcifications
- infection/inflammation
- vascular lesions
- systemic disease
- gamuts
- classification systems
- malignant lesions
- breast cancer staging