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c  

  
Ô 
Ô     Professor of Radiology, Department of Radiology, Division of Breast Imaging,
University of Michigan Health System
V    Clinical Associate Professor, Department of Breast Imaging, University of
Michigan Medical Center
Contributor Information and Disclosures

Male breast cancer is similar to breast cancer in females in its etiology, family history, prognosis, and
treatment. In approximately 30% of cases of breast cancer in men, the family history is positive for the disease.
A familial form of breast cancer is seen in which both genders are at increased risk for breast cancer. Male
breast neoplasms are relatively rare, in contrast to gynecomastia, which is a relatively common
condition.1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17

   

The clinical examination is key in the evaluation of a palpable mass in a male. If the clinical features strongly
suggest gynecomastia, further evaluation may not be necessary. If the clinical features are equivocal, fine-
needle aspiration guided by palpation and/or excisional biopsy are necessary to make the diagnosis.

Accurate diagnosis with mammography alone has been reported, with a sensitivity and specificity of at least
90%. If clinical examination and mammography both reveal benign findings, a biopsy may be unnecessary.
Given the rarity of male breast cancer, mammography screening guidelines are not available for men.18,19

Ultrasonography can demonstrate a cyst in a male, but cysts are rare. A mammogram showing only fat can be
helpful in cases of unilateral breast enlargement without a mass, but in general, this finding is not concerning
for breast cancer and does not require further evaluation of the breast.

Although some mammographic findings do suggest male breast cancer (eg, an eccentric spiculated mass),
mammography or ultrasonography has not been compared with the predictive value of a clinical breast
examination and fine-needle aspiration. Considerable overlap also exists in the ultrasonographic appearance of
these entities.6
Magnetic resonance imaging has not been studied regarding its sensitivity in making a diagnosis, but since the
lesions are always palpable and can be biopsied easily under palpation, there is no clear role for MRI.

See the image below of Male Breast Cancer.

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@   
1. Appelbaum AH, Evans GF, Levy KR, et al. Mammographic appearances of male breast
disease. @   . 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.
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3. Donegan WL, Redlich PN. Breast cancer in men.     


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8. Contractor KB, Kaur K, Rodrigues GS, Kulkarni DM, Singhal H. Male breast cancer: is the scenario
changing.     . 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.    . 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.
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11. Grenader T, Goldberg A, Shavit L. Second cancers in patients with male breast cancer: a literature
review.     . 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.  . Apr 2008;63(2):71-8. [Medline].

13. Pant K, Dutta U. Understanding and management of male breast cancer: a critical review. 
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14. Leinung S, Horn LC, Backe J. [Male breast cancer: history, epidemiology, genetic and
histopathology].    . 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.  . Jul 2007;12(7):798-807. [Medline].

16. Cutuli B. Strategies in treating male breast cancer.      . Feb 2007;8(2):193-
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17. Agrawal A, Ayantunde AA, Rampaul R, Robertson JF. Male breast cancer: a review of clinical
management.    @  . May 2007;103(1):11-21. [Medline].

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

19. Evans GF, Anthony T, Turnage RH, et al. The diagnostic accuracy of mammography in the evaluation
of male breast disease.
   . Feb 2001;181(2):96-100. [Medline].
20. Patterson SK, Helvie MA, Aziz K, Nees AV. Outcome of men presenting with clinical breast problems:
the role of mammography and ultrasound.  . Sep-Oct 2006;12(5):418-23. [Medline].

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

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

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

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

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

26. Williams WL Jr, Powers M, Wagman LD. Cancer of the male breast: a review.    

. Jul 1996;88(7):439-43. [Medline].

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