Radiology Department, Izmir Bozyaka Training and Research Hospital, Ugur Mumcu cad. no. 25, Buca, Izmir, Turkey.
Breast J. 2010 Sep-Oct;16(5):510-8. doi: 10.1111/j.1524-4741.2010.00951.x. Epub 2010 Jun 17.
The purpose of the study was to describe the imaging findings of male breast disease. One hundred and sixty-four male patients, who underwent mammography and ultrasonography (US) between January 1999 and December 2008, were retrospectively evaluated. Seventy-five patients (46%) underwent biopsy, and 89 patients (54%) were diagnosed radiologically. The radiologic and pathologic diagnoses in 164 cases of this series were 13 cancers (8%), including one ipsilateral and one contralateral breast cancers, 147 cases of gynecomastia (90%), one fibroadenoma (0.6%), two cases of fibrocystic disease of the breast (1.2%), and one epidermoid inclusion cyst (0.6%). Three mammographic patterns were adequate to describe all 147 cases of gynecomastia in our series: 53 patients (36%) had nodular gynecomastia, 46 patients (31%) had dendritic gynecomastia, and 48 patients (33%) had diffuse gynecomastia. Gynecomastia was unilateral in 65% of cases (n=95), and bilateral in 35% of cases (n=52). On physical examination, two of the malignant lesions had no clinic features of malignancy (15%). On mammography, 11 of 13 malignant masses were demonstrated (85%). A mass with microcalcifications was seen on mammograms in one case (9%). The contours of the masses were irregular in nine cases (82%), well-circumscribed in two cases (18%). The location of the masses was retroareolar in seven cases (64%) and eccentric to the nipple in four cases (36%). The size of the masses varied between 0.5 cm and 5 cm (mean 2.4 cm). Nipple retraction was evident in five cases (45%), and skin thickening in four cases (36%). All of the malignant masses were demonstrated on ultrasound; however, one of them was seen retrospectively after mammography. All of the masses were hypoechoic and solid, the contours were well-defined and smooth in two masses (15%), and irregular in 11 masses (85%), and five masses (39%) had posterior prominent shadowing. Axillary lymphadenopathia was detected in two cases (15%). One patient had a previous contralateral breast cancer, and one had an ipsilateral. On mammography, breast cancer characteristically exhibits an irregular subareolar mass, nipple retraction, and skin ulceration or thickening, but sometimes breast cancer has a well-circumscribed contour and punctuated microcalcifications. Ultrasonography is essential and useful for further characterization and helpful for demonstrating lymphadenopathies of the axillary region.
本研究旨在描述男性乳房疾病的影像学表现。回顾性分析了 1999 年 1 月至 2008 年 12 月期间 164 例接受乳房 X 线摄影和超声（US）检查的男性患者。75 例患者（46%）接受了活检，89 例患者（54%）经影像学诊断。本系列 164 例患者的放射学和病理学诊断为 13 例癌症（8%），包括同侧和对侧乳腺癌各 1 例，147 例男性乳腺发育症（90%），1 例纤维腺瘤（0.6%），2 例乳腺纤维囊性疾病（1.2%）和 1 例表皮包涵囊肿（0.6%）。三种乳腺 X 线摄影表现足以描述本系列中所有 147 例男性乳腺发育症：53 例（36%）为结节性男性乳腺发育症，46 例（31%）为树枝状男性乳腺发育症，48 例（33%）为弥漫性男性乳腺发育症。65%（n=95）的男性乳腺发育症为单侧，35%（n=52）为双侧。体格检查时，2 例恶性病变无恶性特征（15%）。乳腺 X 线摄影显示 13 个恶性肿块中的 11 个（85%）。1 例（9%）可见伴微钙化的肿块。9 例（82%）肿块边界不规则，2 例（18%）边界清楚。7 例（64%）肿块位于乳晕后，4 例（36%）位于乳头偏心。肿块大小为 0.5 至 5 厘米（平均 2.4 厘米）。5 例（45%）乳头内陷，4 例（36%）皮肤增厚。所有恶性肿块均在超声上显示，但其中 1 例在乳腺 X 线摄影后回顾性显示。所有肿块均为低回声实性，2 个肿块边界清晰光滑（15%），11 个肿块边界不规则（85%），5 个肿块（39%）后方有显著声影。2 例（15%）检测到腋窝淋巴结病。1 例患者曾有对侧乳腺癌，1 例有同侧乳腺癌。在乳腺 X 线上，乳腺癌特征性地表现为不规则的乳晕下肿块、乳头内陷、皮肤溃疡或增厚，但有时乳腺癌具有边界清楚的轮廓和点状微钙化。超声对于进一步特征化和显示腋窝淋巴结病是必不可少且有用的。
