Rong Xueyu, Zhu Qiang, Jia Wenxiu, Ma Teng, Wang Xixi, Guo Ning, Ji Hongtao
Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Breast J. 2018 Jul;24(4):599-605. doi: 10.1111/tbj.12982. Epub 2018 Jan 8.
Although rare and accounting for less than 1% of all breast cancers, the incidence of breast cancer in men has increased by 26% over the past few decades. Very little has been reported on the sonographic appearance of benign and malignant male breast conditions. The aim of this study was to describe the ultrasonographic features of male breast disease and the value of ultrasound in the evaluation of male breast disease. Between December 2006 and October 2014, ultrasound examinations were performed in 560 male patients presenting with enlargement of, pain in, and/or a lump in the breast. One hundred and thirty-six patients (24.3%) underwent surgical excision, and 424 patients (75.7%) were diagnosed by ultrasound. Their ultrasonographic features were retrospectively evaluated. The final diagnoses were gynecomastia (n = 537), primary breast cancer (n = 9), lipoma (n = 7), chronic mastitis (n = 6), and fibroadenoma (n = 1). Of the 560 lesions, 356 (63.6%) were classified as Breast Imaging Reporting and Data System (BI-RADS) category 2, 191 (34.1%) were classified as BI-RADS category 3, and 13 (2.3%) were classified as BI-RADS 4 or 5. The sensitivity, specificity, PPV, NPV, and accuracy of the detection of malignant breast masses according to ultrasound were 100%, 99.3%, 69.2%, 100%, and 97.7% respectively. The sonographic patterns of gynecomastia were nodular (n = 131, 24.4%), dendritic (n = 50, 9.3%), and diffuse glandular (n = 356, 66.3%). Color Doppler flow imaging revealed hypervascularity in five of these malignant masses, moderate vascularity in two of the masses, and mild vascularity in the remaining two masses. Other diseases included in the study are also described. Ultrasonography (US) is useful in the diagnosis of male breast diseases, especially in differentiating cancer from benign lesions.
尽管男性乳腺癌较为罕见，占所有乳腺癌的比例不到1%，但在过去几十年中，男性乳腺癌的发病率增加了26%。关于男性乳腺良性和恶性疾病的超声表现的报道很少。本研究的目的是描述男性乳腺疾病的超声特征以及超声在评估男性乳腺疾病中的价值。2006年12月至2014年10月期间，对560例出现乳腺增大、疼痛和/或肿块的男性患者进行了超声检查。136例患者（24.3%）接受了手术切除，424例患者（75.7%）通过超声诊断。对他们的超声特征进行了回顾性评估。最终诊断为男性乳房发育症（n = 537）、原发性乳腺癌（n = 9）、脂肪瘤（n = 7）、慢性乳腺炎（n = 6）和纤维腺瘤（n = 1）。在560个病灶中，356个（63.6%）被分类为乳腺影像报告和数据系统（BI-RADS）2类，191个（34.1%）被分类为BI-RADS 3类，13个（2.3%）被分类为BI-RADS 4或5类。超声检测乳腺恶性肿块的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为100%、99.3%、69.2%、100%和97.7%。男性乳房发育症的超声模式为结节状（n = 131，24.4%）、树枝状（n = 50，9.3%）和弥漫性腺体状（n = 356，66.3%）。彩色多普勒血流成像显示，这些恶性肿块中有5个为高血管性，2个为中等血管性，其余2个为轻度血管性。研究中包括的其他疾病也进行了描述。超声检查（US）在男性乳腺疾病的诊断中很有用，尤其是在区分癌症与良性病变方面。
