The Diagnostic Accuracy of Mammography and Ultrasound in the Evaluation of Male Breast Disease: A New Algorithm

Abstract

Background: The purpose of this study was to define the diagnostic accuracy of mammography and ultrasound in the evaluation of male breast disease, and to suggest a diagnostic protocol for male breast disease. Material and Methods: We retrospectively reviewed clinical, radiographic, and pathologic records of 75 patients. Breast Imaging Reporting and Data System (BI-RADS) category 4–5 mammograms and ultrasonograms were suggested as suspicious for malignancy. Results: Of the 75 patients, 23 (31%) were considered to have suspicious lesions by mammography and/or ultrasonography. 13 of the patients were shown to have breast cancer. The remaining 52 (69%) were referred for biopsy by clinicians; all of the biopsy specimens were benign (gynecomastia). The accuracy data of mammography and ultrasonography are: sensitivity, 69 and 100%; specificity, 87 and 97%; positive predictive value, 53 and 87%; negative predictive value, 93 and 100%; and accuracy, 84 and 97%, respectively. Conclusion: We suggest a new diagnostic algorithm for the evaluation of male breast disease in which ultrasonography may be used to evaluate palpable abnormalities as the first diagnostic tool of choice. To use and to trust imaging would decrease the number of falsepositive biopsies that would be generated by physical examination alone.

Socio-economic Factors Influencing Tumor Presentation and Treatment Options in Chinese Breast Cancer Patients

“…Furthermore, mammography is now an important tool for the detection of early stages of breast cancer (Smith et al, 2003;Adibelli et al, 2009) and thus has a large influence on breast cancer stage at presentation (Dalton et al, 2006;Masi et al, 2007;Pasick et al, 2008). Previous studies have found that the implementation rate of mammography is closely related to income level: people with lower incomes have lower mammography implementation rate (Ward et al, 2008;Cunningham et al, 2009), which suggests that these patients have a higher risk of presentation with a larger, more advanced stage tumor.…”

Male Breast Cancer: A Single Centre Experience and Current Evidence

“…A number of variables have been reported to affect prognosis in male breast cancer including tumor stage (1) and axillary node status (16). Borgen and colleagues retrospectively reviewed 104 male breast cancers and showed that on multivariate analysis, the most powerful predictor of outcome in men was the status of axillary lymph nodes, and the only prognostic factor that added significantly to this predictive power was the duration of symptoms (17).…”

Clinics in diagnostic imaging (147)

“…(4)(5)(6) Breast ultrasonography is also useful for evaluating male patients who present with breast masses and nipple discharge, or when the mammographic findings are not characteristic of gynaecomastia. (5,6) Mammographic or breast ultrasonographic primary findings of a unilateral and discrete mass in a male breast, at an eccentric location with respect to the nipple-areolar complex, should always raise the suspicion of a breast carcinoma. (3,7,8) This is particularly true for a solid or complex cystic breast mass that demonstrates spiculated, angulated or microlobulated margins, and increased vascularity.…”