Virginia Commonwealth University Breast Imaging

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For our Male Patients

Gynecomastia is defined as breast enlargement in men and is characterized by the presence of glandular tissue on a mammogram. The tissue is typically centered on the nipple. Gynecomastia is the most common finding in men presenting with a breast lump and can be associated with tenderness. Many sources, including medications, recreational drugs, liver disease and conditions that lead to an excess of estrogen, cause this condition; however, in most men no clear etiology (cause) is identified.

Approximately 2,000 men are diagnosed with breast cancer annually in the U.S., compared with approximately 62,000 women diagnosed with breast cancer per year. Ductal carcinoma in situ and invasive ductal carcinomas are the types of breast cancer usually diagnosed in men, while invasive lobular carcinoma is exceedingly rare in men. Analogous to what is described for women, DCIS in men presents with microcalcifications and a mass is imaged in men with invasive ductal carcinoma.

Craniocaudal views in a man presenting with a  tender lump in the right breastThese are the craniocaudal views in a man presenting with a tender lump in the right breast. Glandular tissue (arrows) is present in the subareolar area on the right, corresponding to the area of concern to the patient. This is the typical appearance for gynecomastia. In comparison, fatty tissue is imaged in the left breast. As in this patient, gynecomastia is often asymmetric, involving one breast exclusively or more prominently in one breast compared with the other.

Craniocaudal views in a man presenting with a lump in the left breastThese are the craniocaudal views in a man presenting with a lump in the left breast. A mass (arrow) with spiculated margins is imaged in the left breast, corresponding to the area of concern to the patient. An invasive ductal carcinoma is diagnosed on an ultrasound-guided biopsy. The mammographic, ultrasound and MRI appearances of breast cancer in men are similar to those described for women.

“Just very attentive and cordial to me; remembered me from my last visit. Very patient.”

– Excerpt from a VCU Breast Imaging patient satisfaction survey.

Virginia Commonwealth University Medical Center VCU Breast Imaging