eMedicine Specialties > Radiology > Breast

Breast Cancer, Male: Imaging

Author: Marilyn A Roubidoux, MD, Professor of Radiology, Department of Breast Imaging, University of Michigan Medical Center
Coauthor(s): Stephanie K Patterson, MD, Clinical Associate Professor, Department of Breast Imaging, University of Michigan Medical Center
Contributor Information and Disclosures

Updated: Sep 24, 2008

Radiography

Findings


A partially circumscribed retroareolar mass in a ...

A partially circumscribed retroareolar mass in a male with suspicious microcalcifications; this is known breast cancer.

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A partially circumscribed retroareolar mass in a ...

A partially circumscribed retroareolar mass in a male with suspicious microcalcifications; this is known breast cancer.


On mammography, male breast cancer is subareolar or somewhat eccentric to the nipple, with well-defined, ill-defined, or spiculated margins. Calcifications are observed less commonly than in female breast cancer and, when found, are coarser in appearance. Calcifications can also be seen in fat necrosis. Axillary adenopathy may be observed as well.1,22

Degree of Confidence

Mammography is highly sensitive and specific for breast cancer in men, but it should be used to complement the clinical examination. At present, not enough clinical data are available to determine whether the combination of imaging and clinical findings can replace biopsy for the diagnosis of palpable breast abnormalities in men. Ultimately, biopsy should be considered to diagnose male breast cancer because the findings of inflammation, gynecomastia, and fat necrosis can be similar.24

False Positives/Negatives

Inflammation, gynecomastia, and fat necrosis may appear similar on mammograms; therefore, these condition can cause false-positive findings. Cases of carcinoma have been found by ultrasonography after they were obscured on previous mammograms by gynecomastia.

Ultrasonography

Findings

A hypoechoic mass with irregular, ill-defined, or circumscribed margins may be observed on ultrasonography. With color flow imaging, vascular flow within the mass may be demonstrated.22,24

Degree of Confidence

Similar sonographic findings may be observed in gynecomastia or inflammation; therefore, ultrasonography alone is not a reliable method to distinguish male breast cancer from other etiologies.

False Positives/Negatives

Abscesses, gynecomastia, and fat necrosis may all give false positives.

More on Breast Cancer, Male

Overview: Breast Cancer, Male
Imaging: Breast Cancer, Male
Follow-up: Breast Cancer, Male
Multimedia: Breast Cancer, Male
References
Further Reading
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References

  1. Appelbaum AH, Evans GF, Levy KR, et al. Mammographic appearances of male breast disease. Radiographics. May-Jun 1999;19(3):559-68. [Medline].

  2. Carmalt HL, Mann LJ, Kennedy CW, et al. Carcinoma of the male breast: a review and recommendations for management. Aust N Z J Surg. Oct 1998;68(10):712-5. [Medline].

  3. Donegan WL, Redlich PN. Breast cancer in men. Surg Clin North Am. Apr 1996;76(2):343-63. [Medline].

  4. Newman J. Breast cancer in men and mammography of the male breast. Radiol Technol. Sep-Oct 1997;69(1):17-28; quiz 29-36. [Medline].

  5. Ravandi-Kashani F, Hayes TG. Male breast cancer: a review of the literature. Eur J Cancer. Aug 1998;34(9):1341-7. [Medline].

  6. Stewart RA, Howlett DC, Hearn FJ. Pictorial review: the imaging features of male breast disease. Clin Radiol. Oct 1997;52(10):739-44. [Medline].

  7. Winchester DJ. Male breast cancer. Semin Surg Oncol. Sep-Oct 1996;12(5):364-9. [Medline].

  8. Contractor KB, Kaur K, Rodrigues GS, Kulkarni DM, Singhal H. Male breast cancer: is the scenario changing. World J Surg Oncol. Jun 16 2008;6:58. [Medline].

  9. Lanitis S, Rice AJ, Vaughan A, Cathcart P, Filippakis G, Mufti RA, et al. Diagnosis and Management of Male Breast Cancer. World J Surg. Sep 12 2008;[Medline].

  10. Schaub NP, Maloney N, Schneider H, Feliberti E, Perry R. Changes in male breast cancer over a 30-year period. Am Surg. Aug 2008;74(8):707-11; discussion 711-2. [Medline].

  11. Grenader T, Goldberg A, Shavit L. Second cancers in patients with male breast cancer: a literature review. J Cancer Surviv. Jun 2008;2(2):73-8. [Medline].

  12. La Pinta M, Fabi A, Ascarelli A, Ponzani T, Di Carlo V, Scicchitano F, et al. Male breast cancer: 6-year experience. Minerva Chir. Apr 2008;63(2):71-8. [Medline].

  13. Pant K, Dutta U. Understanding and management of male breast cancer: a critical review. Med Oncol. Dec 12 2007;[Medline].

  14. Leinung S, Horn LC, Backe J. [Male breast cancer: history, epidemiology, genetic and histopathology]. Zentralbl Chir. Oct 2007;132(5):379-85. [Medline].

  15. Dimitrov NV, Colucci P, Nagpal S. Some aspects of the endocrine profile and management of hormone-dependent male breast cancer. Oncologist. Jul 2007;12(7):798-807. [Medline].

  16. Cutuli B. Strategies in treating male breast cancer. Expert Opin Pharmacother. Feb 2007;8(2):193-202. [Medline].

  17. Agrawal A, Ayantunde AA, Rampaul R, Robertson JF. Male breast cancer: a review of clinical management. Breast Cancer Res Treat. May 2007;103(1):11-21. [Medline].

  18. Casagrande JT, Hanisch R, Pike MC, Ross RK, Brown JB, Henderson BE. A case-control study of male breast cancer. Cancer Res. Mar 1 1988;48(5):1326-30. [Medline].

  19. Dao TL, Morreal C, Nemoto T. Urinary estrogen excretion in men with breast cancer. N Engl J Med. Jul 19 1973;289(3):138-40. [Medline].

  20. McLaughlin JK, Malker HS, Blot WJ, Weiner JA, Ericsson JL, Fraumeni JF Jr. Occupational risks for male breast cancer in Sweden. Br J Ind Med. Apr 1988;45(4):275-6. [Medline].

  21. Giordano SH, Cohen DS, Buzdar AU, et al. Breast carcinoma in men: a population-based study. Cancer. Jul 1 2004;101(1):51-7. [Medline].

  22. Günhan-Bilgen I, Bozkaya H, Ustün EE, Memis A. Male breast disease: clinical, mammographic, and ultrasonographic features. Eur J Radiol. Sep 2002;43(3):246-55. [Medline].

  23. Evans GF, Anthony T, Turnage RH, et al. The diagnostic accuracy of mammography in the evaluation of male breast disease. Am J Surg. Feb 2001;181(2):96-100. [Medline].

  24. Patterson SK, Helvie MA, Aziz K, Nees AV. Outcome of men presenting with clinical breast problems: the role of mammography and ultrasound. Breast J. Sep-Oct 2006;12(5):418-23. [Medline].

  25. Evans GF, Anthony T, Turnage RH, Schumpert TD, Levy KR, Amirkhan RH. The diagnostic accuracy of mammography in the evaluation of male breast disease. Am J Surg. Feb 2001;181(2):96-100. [Medline].

  26. Williams WL Jr, Powers M, Wagman LD. Cancer of the male breast: a review. J Natl Med Assoc. Jul 1996;88(7):439-43. [Medline].

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Further Reading

Adult preventive health care: cancer screening.
University of Michigan Health System.  2004 May.  12 pages.  NGC:003785
 
Referral guidelines for suspected cancer in adults and children.
National Collaborating Centre for Primary Care.  2005 Jun.  791 pages.  NGC:004465
 
American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer.
American Society of Clinical Oncology - Medical Specialty Society.  2005 Oct 20.  18 pages.  NGC:004562
 
American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting.
American Society of Clinical Oncology.  1997 May (revised 2006 Nov 1).  7 pages.  NGC:005304
 
Paclitaxel for the adjuvant treatment of early node-positive breast cancer.
National Institute for Health and Clinical Excellence (NICE) - National Government Agency [Non-U.S.].  2006 Sep.  18 pages.  NGC:005737

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Keywords

male breast cancer, male breast neoplasm, male breast tumor, male breast carcinoma, breast cancer in men, breast cancer men, breast diagnosis, male breast self-examination, breast mass, male breast abnormality, breast cancer awareness

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Contributor Information and Disclosures

Author

Marilyn A Roubidoux, MD, Professor of Radiology, Department of Breast Imaging, University of Michigan Medical Center
Disclosure: Nothing to disclose.

Coauthor(s)

Stephanie K Patterson, MD, Clinical Associate Professor, Department of Breast Imaging, University of Michigan Medical Center
Disclosure: Nothing to disclose.

Medical Editor

John M Lewin, MD, Section Chief, Breast Imaging, Diversified Radiology of Colorado, PC; Associate Clinical Professor, Department of Preventative Medicine and Biometrics, University of Colorado Denver
John M Lewin, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Radiological Society of North America, and Society of Breast Imaging
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Edward Azavedo, MD, PhD, Director of Clinical Breast Imaging Services, Associate Professor, Department of Radiology, Karolinska University Hospital, Sweden
Edward Azavedo, MD, PhD is a member of the following medical societies: Swedish Medical Association and Swedish Society of Medicine
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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