Purpose: To summarize our institutional experience in the diagnostic workup of male patients referred for breast imaging, emphasizing on the clinical, histopathological and imaging characteristics.
Materials and Methods: A computerized search in our Radiological information system (RIS) was conducted, filtering male patients who underwent breast imaging between 2011 and 2016. The electronic medical files were investigated and archived imaging studies of the final cohort were reviewed. Subgroup dividing was generated and assessed statistically.
Results: Overall, we found 178 male patients who had breast radiological examination within the time span. The average age was 61±15 years. The commonest indication for breast imaging was for evaluation of palpable mass (88/178, 49%), followed by gynecomastia (26/178, 16%) and mastalgia (20/178, 11.2%). 13 patients (7.3%) had biopsy-proven breast cancer, with invasive ductal carcinoma the most commonly encountered (12/13, 92%). The main modality used was Ultrasonography (98%) alone, or in combination with mammography. All patients with breast cancer were older than 40 years, mostly presenting with a palpable mass (9/13, 69%), while none of the cancer manifested as breast enlargement or mastalgia. Additionally, five patients (2.8%) had metastatic disease to the breast. Overall, 56 biopsies were performed; 38 (68%) of which were negative for cancer. Using BI-RADS 4 and 5 as positive examinations and BI-RADS 1-3 as negative, imaging procedures had a sensitivity of 100% and a specificity of 83.8%. The positive predictive value was 41.9%.
Conclusion: Palpable mass is the most common cause for referral to breast imaging in male patients. Most findings are benign with specifically low likelihood of cancer diagnosis among young patients and in patients presenting with gynecomastia or mastalgia.
