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Epidemiology of male breast diseases: A 10-year institutional review

Published:November 15, 2020DOI:https://doi.org/10.1016/j.clinimag.2020.11.027

      Highlights

      • Male patients form a significantly smaller subset of patients referred to breast imaging centers.
      • The vast majority of male breast diseases are benign, the most common being gynecomastia.
      • Male patients with average risk for breast cancer do not require routine breast screening.
      • Male patients are less likely to seek medical help for breast-related symptoms due to cultural and social barriers. Understanding men's perception and providing gender-specific, targeted patient education can help breach these barriers.

      Abstract

      Objective

      To review breast imaging utilization and epidemiology of breast diseases in male patients referred to our breast center.

      Material and methods

      A retrospective analysis of all male patients who underwent breast imaging at our institution over a 10 year period (03/14/2008 to 03/13/2018) was performed. Patient history, imaging findings, biopsy reports, surgical interventions and follow-up data were reviewed.

      Results

      Over the 10 year period, 143 male patients (0.1% of referred breast center patients) underwent breast imaging (versus 139,134 female patients). Mean age was 57.4 years (SD 19.7, median 59, range 21–92 years). The most common indication for referral was a palpable breast mass (98%). The most common diagnosis was gynecomastia (72%). Of the 20 (14%) patients who underwent core biopsy; 1 (0.7%) had breast cancer and the remaining 19 had benign pathologies. Follow-up imaging was recommended for 22 (15.4%) patients, of whom 15 (68%) were lost to follow-up. Two patients under the age of 25 years inadvertently underwent initial mammography instead of ultrasound.

      Conclusion

      The epidemiology of breast diseases in our male patient population mirrors that of the general male population worldwide; with an overwhelming 99.3% cases falling into benign category. Two-thirds of our male patients for whom short interval follow up was recommended were lost to follow-up, signifying the need for a more proactive approach in ensuring their compliance. It is important to increase awareness among referring clinicians and general radiologists regarding male breast imaging recommendations so that the appropriate imaging study is performed.

      Keywords

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