Male Breast

Question 1

What does the normal male breast primarily consist of?

Answer 1

Fat, connective tissue, and some rudimentary subareolar ducts

Question 2

The most frequent benign disorder that involves ductal and periductal connective tissues?

Answer 2

Gynecomastia

Question 3

Most common focal mass?

Answer 3

lipoma

Question 4

Results from proliferation of the subareolar ducts and the surrounding periductal stroma as well as an increase deposition of subcutaneous fat.

Answer 4

Gynecomastia

Question 5

Causative factors of gynecomastia?

Answer 5

Hormonal imbalance, systemic disorders, drug-medication induced, estrogen producing neoplasm, idopathic

Question 6

Estrogen producing neoplasms that can cause gynecomastia?

Answer 6

Testicular, hepatoma, bronchogenic, adrenal

Question 7

Hormonal imbalances that can cause gynecomastia?

Answer 7

• Physiologic changes in neonate
• Hypogonadism: Klinefelter syndrome, testicular neoplasm
• Testicular failure: orchitis, irradiation, trauma
• Endocrine disorder: hyperthyroidism

Question 8

Pubertal gynecomastia is most common and affect up to ___% of young males.

Answer 8

60%

Question 9

Clinical features of gynecomastia?

Answer 9

• bilateral or unilateral breast enlargement
• subareolar thickening
• palpable, firm, subareolar tender lump

Question 10

Mammographic features of gynecomastia?

Answer 10

• (Early) subareolar nodular area of increased density
• (Late) fan-shaped radio dense tissue radiating out from nipple
• Diffuse glandular pattern like female breast
• Increase in subcutaneous fat
• No associated calcs

Question 11

Sonographic features of gynecomastia?

Answer 11

• Hypoechoic, subareolar nodular pattern
• Hypoechoic-tohyperechoic triangular-shaped region extending from nipple into breast core
• Prominent hypo echoic subareolar ducts surrounded by hyperechoic periductal fibrous tissue
• Possible fluid within duct lumen
• Increase in subcutaneous fat

Question 12

Breast enlargement that results from an increased amount of subcutaneous fat and is bilateral. This is common in obese males and does not involve proliferation of the ductal structures.

Answer 12

Pseudogynecomastia

Question 13

Male breast cancer represents less than ____% of all brest malignancies.

Answer 13

1%

Question 14

Breast cancer usually presents at an ___ age in men than in women.

Answer 14

older, mean is 64yrs old

Question 15

Severe and prolonged elevation of the _________ ratio in a male is a key factor increasing cancer risk.

Answer 15

estradiol-to-testosterone ratio

Question 16

Breast cancer is likely unrelated to what?

Answer 16

gynecomastia, although it often coexists

Question 17

There is a higher incidence of breast cancer in what group of men?

Answer 17

Jewish

Question 18

Histologic types of male breast cancer?

Answer 18

• Invasive ductal carcinoma, NOS (>85%)
• DCIS; Paget’s disease; Papillary (intraductal/intracystic)
• Sarcoma (4%) including lymphoma
• Other types (lobular carcinoma is rare since lobule formation is uncommon)

Question 19

Clinical features of male breast cancer?

Answer 19

• palpable, hard lump; usually painless
• Subareolar location most common, just eccentric to nipple
• Nipple and skin retraction; possible ulceration
• possible nipple discharge; often bloody or serosanguinous

Question 20

What percent of cancers of male breast are metastatic rather than primary?

Answer 20

0.5-2%

Question 21

Metastasis originates commonly from where?

Answer 21

Prostate, melanoma, lymphoma, lung, bladder