Male Breast Flashcards
What does the normal male breast primarily consist of?
Fat, connective tissue, and some rudimentary subareolar ducts
The most frequent benign disorder that involves ductal and periductal connective tissues?
Gynecomastia
Most common focal mass?
lipoma
Results from proliferation of the subareolar ducts and the surrounding periductal stroma as well as an increase deposition of subcutaneous fat.
Gynecomastia
Causative factors of gynecomastia?
Hormonal imbalance, systemic disorders, drug-medication induced, estrogen producing neoplasm, idopathic
Estrogen producing neoplasms that can cause gynecomastia?
Testicular, hepatoma, bronchogenic, adrenal
Hormonal imbalances that can cause gynecomastia?
- Physiologic changes in neonate
- Hypogonadism: Klinefelter syndrome, testicular neoplasm
- Testicular failure: orchitis, irradiation, trauma
- Endocrine disorder: hyperthyroidism
Pubertal gynecomastia is most common and affect up to ___% of young males.
60%
Clinical features of gynecomastia?
- bilateral or unilateral breast enlargement
- subareolar thickening
- palpable, firm, subareolar tender lump
Mammographic features of gynecomastia?
- (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
Sonographic features of gynecomastia?
- 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
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.
Pseudogynecomastia
Male breast cancer represents less than ____% of all brest malignancies.
1%
Breast cancer usually presents at an ___ age in men than in women.
older, mean is 64yrs old
Severe and prolonged elevation of the _________ ratio in a male is a key factor increasing cancer risk.
estradiol-to-testosterone ratio
Breast cancer is likely unrelated to what?
gynecomastia, although it often coexists
There is a higher incidence of breast cancer in what group of men?
Jewish
Histologic types of male breast cancer?
- 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)
Clinical features of male breast cancer?
- 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
What percent of cancers of male breast are metastatic rather than primary?
0.5-2%
Metastasis originates commonly from where?
Prostate, melanoma, lymphoma, lung, bladder
