Imaging features of male breast cancer: a pictorial review

Introduction

Breast cancer in men is rare, accounting for less than 1% of all breast cancer cases. Presentation includes a lump, pain and nipple discharge, and breast malignancy must be differentiated from benign disease, particularly gynaecomastia. We have diagnosed 17 men with breast cancer between 1998 and 2007.

Methods

A retrospective review of imaging of men with histologically proven breast cancer in 10 years.

Results

The mean age at diagnosis was 63 years (range 38 to 87 years). Presentation was with a mass in 15 patients and with nipple discharge in two patients. Eleven patients had mammography and breast ultrasound (US). Mammography and US demonstrated a mass in nine patients. The US lesions were echo-poor solid lesions in eight patients and a mixed solid/cystic lesion in one patient. Calcification and skin/nipple changes were each seen in five cases. Mammogram demonstrated an asymmetric density in one patient, and in this case US was normal. Bilateral gynaecomastia was detected on mammogram and US in one patient. Histology in 14 patients demonstrated invasive ductal carcinoma with foci of ductal carcinoma in situ in six patients. Three patients had ductal carcinoma in situ only.

Conclusion

Male breast cancer most commonly manifests as a discrete mass lesion on imaging, but radiologists need to be aware of other imaging appearances.