Imaging findings and classification of the common and uncommon male breast diseases

Abstract

Male breast hosts various pathological conditions just like "female breast." However, histo-anatomical diversities with female breast lead to many differences regarding the frequency and presentation of diseases, the radiologic appearance of lesions, the diagnostic algorithm, and malignity features. Radiological modalities may play an important role in evaluating male breast lesions. Although some imaging findings are non-specific, having knowledge of certain imaging characteristics and radiologic patterns is the key to reduce the number of differential diagnoses or to reach an accurate diagnosis. Male breast imaging is mostly based on physical examination and is required for the complaints of palpable mass, breast enlargement, tenderness, nipple discharge, and nipple-skin changes. The majority of the male breast lumps are benign and the most common reason is gynecomastia. Although it is difficult to exclude malignancy in some cases, gynecomastia often has distinguishable imaging features. Pseudogynecomastia is another differential diagnosis that may be confused with gynecomastia. The distinction is important for the treatment plan. Apart from gynecomastia, other male breast lesions form a highly heterogeneous group and can be classified based on "Tissue origin," "Histopathological type and behavior," and "Radiologic features" for both simplification and comprehensive understanding. This article mainly focuses on emphasizing the results of basic histo-anatomical differences of male and female breasts, classifying male breast lesions, covering the spectrum of male breast diseases, and assisting radiologists in recognizing the imaging findings, in interpreting them through a holistic approach, in making a differential diagnosis, and in being a part of proper patient management.

Imaging in gynecomastia

“…In contrast, the preponderance of T secretion in men favors involution of the ducts, while TDLU maturation is absent. 26 As a result, the male breast, compared with the female, may be considered as a rudimentary structure consisting mainly of subcutaneous adipose tissue, vestigial ductal tissue devoid of mammary lobules, and a small nipple-areolar complex. In addition, in the male breast, Cooper ligaments are absent, whereas pectoral muscles are more prominent 27 (Figure 2).…”

“…On the other hand, fibrous GM expands in the surrounding tissues adapting a "spider leg" appearance and the echogenicity of the lesions increases as fibrosis develops (Figure 5C). 26,71 In color-Doppler US imaging, the florid form is commonly associated with increased vascularity, representing an inflammatory process of recent onset.…”

“…Another US technique that may assist in the characterization of a lesion is sonoelastography; however, no robust data yet exists regarding the evaluation of its findings in the male breast. 26…”

The effect of staying at home due to COVID‐19 outbreak on nursing students' life satisfaction and social competencies

“…It has been reported in many studies that the spread of COVID-19 is very fast. [16][17][18] In addition, it has been reported that a patient with COVID-19 can infect an average of 2.6 people. 7 It was determined that the students who found COVID-19 positive in one of his acquaintances had low life satisfaction (Table 2).…”

A Prospective Evaluation of Tru-Cut Biopsy and Fine-needle Aspiration Cytology in Male Breast Cancer Detection

“…In most cases, it represents the result of an unbalanced androgen to estrogen ratio (8). Apart from gynecomastia, male breast lesions can be grouped based on histopathological type and behavior, into two main categories as "benign" and "malignant" (9,10).…”