Hoda Raza S, Arpin Iii Ronald N, Gottumukkala Ravi V, Hughes Kevin S, Ly Amy, Brachtel Elena F
Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Acta Cytol. 2019;63(4):319-327. doi: 10.1159/000494486. Epub 2019 Mar 22.
Differentiation between gynecomastia, a common cause of male breast enlargement, and breast cancer is crucial for appropriate management. Fine-needle aspiration biopsy has been shown to be sensitive and specific in assessing female breast lesions, comparable to core needle biopsy. Few such studies have been conducted in men. We assessed its diagnostic value in a male patient cohort.
Men who underwent fine-needle aspiration (FNA) for palpable breast lesions at Massachusetts General Hospital from January 2007 to December 2016 were evaluated. Clinical data, radiographic findings, and cytologic diagnoses of 74 breast FNA from 71 men were reviewed. Breast aspirates were classified as nondiagnostic, benign, atypical, suspicious for malignancy, or malignant. Histology was obtained in 37 cases, and clinical and radiological data were used as follow-up in 37 patients.
Most FNA biopsies (73%) were performed by cytopathologists, and 93.2% of the breast FNA in men were adequate; 58% showed benign processes, mostly gynecomastia (n = 22), and 28.4% (n = 21) were malignant, most often ductal carcinoma. No false-positive cytologies were obtained, and there was 1 false-negative cytology. In our study, FNA of palpable male breast lesions was 95.8% sensitive and 100% specific.
FNA allows sensitive, specific, and safe evaluation and diagnosis of palpable male breast lesions.
男性乳腺增生是男性乳房增大的常见原因，区分男性乳腺增生与乳腺癌对于恰当的治疗至关重要。细针穿刺活检在评估女性乳腺病变方面已被证明具有敏感性和特异性，与粗针活检相当。针对男性的此类研究较少。我们评估了其在男性患者队列中的诊断价值。
对2007年1月至2016年12月在马萨诸塞州综合医院因可触及乳腺病变接受细针穿刺（FNA）的男性进行评估。回顾了71名男性74例乳腺FNA的临床资料、影像学检查结果和细胞学诊断。乳腺穿刺液被分类为无法诊断、良性、非典型、可疑恶性或恶性。对37例进行了组织学检查，对37例患者采用临床和放射学资料进行随访。
大多数FNA活检（73%）由细胞病理学家进行，男性乳腺FNA的93.2%足够；58%显示为良性过程，主要是男性乳腺增生（n = 22），28.4%（n = 21）为恶性，最常见的是导管癌。未获得假阳性细胞学结果，有1例假阴性细胞学结果。在我们的研究中，可触及男性乳腺病变的FNA敏感性为95.8%，特异性为100%。
FNA能够对可触及的男性乳腺病变进行敏感、特异且安全的评估和诊断。
