Breast Disease in Men
Breast cancer in men is very rare and accounts for about 1% of all breast cancers. According to the American Cancer Society, the lifetime risk of getting breast cancer as a man is about 1 in 1,000. Symptoms of male breast disease are a hard firm mass, thickening of the skin, and possible nipple retraction. Enlarged axillary lymph nodes occur in fifty percent of the cases.
Because of the low incidence, screening mammography is not recommended for men – even for men who have a family history. But, any man with suspicious physical findings should have a bilateral diagnostic mammogram. Ultrasound is used for questionable or suspicious mammographic findings.
Learn more about breast disease in men.
Male Breast Cancer Risk Factors
Risk factors for breast disease in men include: advanced age, prior radiation exposure to the chest, exogenous estrogen, liver disease, androgen deficiency, family history of breast cancer and Klinefelter syndrome.
Other forms of male breast abnormalities include:
- Gynecomastia is benign enlargement of the male breast. It occurs because of an imbalance of estrogen to androgen. Patients often present with a rubbery firm mass extending concentrically posterior to the nipple. It can also be unilateral, bilateral symmetric or asymmetric which is the most common cause for male breast evaluation.
- Lipomas and fat necrosis can occur in the male breast. Lipomas may be seen as thin fibrous capsules and appear lucent mammographically. Fat necrosis can vary in appearance; however the mammographic appearance is usually pathognomic.
- Epidermal inclusion cysts present as a superficial mass clinically. These cysts are composed of laminated keratin with a wall of epidermis. Mammographically, they are superficial, dense round masses. By ultrasound, these anechoic or hypoechoic round lesions are contiguous to the epidermis.
- Intramammary lymph nodes can occur in male breasts and have similar appearance to lymph nodes in the female breast. They are usually less than a centimeter in length, found in the upper outer quadrant, and are oval with a lucent center.