Breast Cancer in Male Imaging

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.

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.

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.

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

Findings on Ultrasonography:

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.

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.