Male breast cancer
Citation, DOI and article data
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.
The average age of diagnosis of male breast cancer is 60-70 years, which is later than female breast cancer.
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.
Recognized risk factors include 9:
- exposure to ionizing radiation: especially to the chest wall
- testicular injury / infectious orchitis
- 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
- certain racial groups: may have a comparatively higher incidence
- BRCA2 gene mutation 2
Please note gynecomastia is not a risk factor per se.
- can occur anywhere within the breast but favors the subareolar area or the upper outer quadrant
- favors a slightly eccentric location relative to the nipple 7
The genetic predisposition for breast cancer can be inherited from both mother and father. First line family history includes both genders.
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 in female breast cancer 1.
Treatment and prognosis
The overall prognosis tends to be worse than for female breast cancer, possibly due to the fact that men seek medical attention for the mass at later stages (i.e. when the mass has already become palpable).
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- 2. Chen L, Chantra PK, Larsen LH et-al. Imaging characteristics of malignant lesions of the male breast. Radiographics. 26 (4): 993-1006. doi:10.1148/rg.264055116 - Pubmed citation
- 3. Dershaw DD, Borgen PI, Deutch BM et-al. Mammographic findings in men with breast cancer. AJR Am J Roentgenol. 1993;160 (2): 267-70. AJR Am J Roentgenol (abstract) - Pubmed citation
- 4. Chantra PK, So GJ, Wollman JS et-al. Mammography of the male breast. AJR Am J Roentgenol. 1995;164 (4): 853-8. AJR Am J Roentgenol (abstract) - Pubmed citation
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- 8. Gao Y, Heller SL, Moy L. Male Breast Cancer in the Age of Genetic Testing: An Opportunity for Early Detection, Tailored Therapy, and Surveillance. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1289-1311. doi:10.1148/rg.2018180013 - Pubmed
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