Clinical Examination Allied to Ultrasonography in the Assessment of New Onset Gynaecomastia: An Observational Study

Abstract

Aim: New onset gynaecomastia is a relatively common present ation to breast surgical services. The main aim of clinical and radiological evaluation is to exclude the presence of concurrent breast cancer. There exists much variability in the clinical assessment of male patients presenting with new onset gynaecomastia. Materials and Methods:In the presented pilot study, all the male patients presenting with new onset gynaecomastia to our department over a period of two years were studied.Results: Fifty three patients presented with new onset gynaecomastia during the study period. Clinical examination allied with ultrasonography confirmed benign breast disease in 50 patients with only three patient requiring breast biopsy to exclude malignancy. We detail the efficacy of utilising clinical examination in conjunction with ultrasonography to evaluate new onset gynaecomastia. Conclusion:We show that clinical examination used in conjunction with ultrasonography is both highly sensitive and specific for detecting male breast cancer in patients presenting with new onset gynaecomastia.

Shear-wave elastography quantitative assessment of the male breast: added value to distinguish benign and malignant palpable masses

“…From January 2011 to December 2015, 65 consecutive adult male patients (average 62.1 years, range 26-87) were recruited for the study. All patients were addressed by a first-line radiological centre for specialized advice and complementary examination at our regional Comprehensive cancer centre for unilateral (8) or bilateral (57, one of the two being suspicious) palpable masses. None of the patients had a personal history of breast cancer, chemotherapy or radiation therapy for any other cancer.…”

“…Other authors have found this diagnostic management controversial as cancer and gynaecomastia can coexist (21-55% of cases) 7 and as positive predictive value of a first-line mammography remains limited. 6,8 Consequently, the added value of each imaging modality and their place in diagnosis management remains unclear.…”

Clinical and ultrasonographic features of male breast tumors: A retrospective analysis

“…The majority of male breast lesions are benign; malignancy of the male breast is rare [ 1 ], accounting for only 0.7% to 1% of all breast cancers and 0.17% of all cancers in men [ 2 , 3 ]. Gynecomastia within the subareolar regions is the most common benign condition of the male breast in newborns, adolescents, and the elderly [ 2 , 3 ]. Gynecomastia is seen histologically in 50% of all men at autopsy [ 4 ].…”

“…A non-calcified mass is the most common mammographic finding in male breast cancer [ 2 ]. However, some case reports have shown that male breast cancers were not detected by mammography [ 3 ]. There are no statistically significant differences between the sensitivity and specificity of mammography and US in diagnosing male breast lesions [ 2 , 7 ].…”

“…Ultrasonography is recommended for the evaluation of male breast lesions because it is a convenient, non-invasive, and low-cost tool that does not require exposure to ionizing radiation [ 3 ]. The BI-RADS (Breast Imaging-Reporting and Data System) US lexicon [ 10 ] is widely used to describe the characteristics of breast lesions in women.…”