Male Breast Cancer on Imaging

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The mammogram shows a spiculated mass with extensive edema:
    • As evidenced by skin thickening and increased trabecular markings in the breast (Images)
  • Ultrasound shows a heterogeneous, irregular, hypoechoic mass with some angular and spiculated margins (Image):
    • Internal vascularity is demonstrated on Doppler examination (Image)
  • Gynecomastia:
    • Does not cause erythema, skin thickening, and breast edema:
      • The mammogram would usually show a triangular shaped density radiating from the nipple into the breast tissue (Image)
Classic mammographic image of gynecomastia
  • The sides of the mammographic triangle in gynecomastia are:
    • Usually straight or concave (Image) as opposed to convex in breast cancer
  • The sonographic appearance of gynecomastia depends on the phase of development:
    • It can appear quite hypoechoic and have angular margin
  • Paget’s disease of the breast is rare, but it does occur in males:
    • It would present with a nipple rash and would not be expected to have secondary infection
    • There are usually no mammographic or sonographic features unless there is an underlying invasive carcinoma
  • References
    • Abeywardhana DY, Nascimento VC, Dissanayake D, Taylor D, Metcalf C, Saunders C, et al. Review of ultrasound appearance in inflammatory breast cancer: a pictorial essay. J Med Imaging Radiat Oncol. 2016;60(1):83-87.
    • Stavros AT. Evaluation of the male breast. In: Stavros AT. Breast Ultrasound. Philadelphia, PA: Lippincott Williams & Wilkins; 2004:712-741.
    • Khalkhali I, Cho J. Male breast cancer imaging. Breast J. 2015;21(3):217-218.
    • Ottini L, Palli D, Rizzo S, Ferico M, Bazan V, Russo A. Male breast cancer. Crit Rev Oncol Hematol. 2010;73(2):141-155.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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