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European Radiology

, Volume 20, Issue 12, pp 2797–2805 | Cite as

Mammography and ultrasound in the evaluation of male breast disease

  • Rafaela Muñoz CarrascoEmail author
  • Marina Álvarez Benito
  • Elisa Muñoz Gomariz
  • José Luis Raya Povedano
  • María Martínez Paredes
Breast

Abstract

Objective

To assess clinical variables that may be useful in differentiating gynaecomastia from carcinoma and to analyse the contribution of mammography and ultrasound to the evaluation of male breast disease.

Methods

All men who underwent mammography and/or ultrasound between 1993 and 2006 in our hospital were retrospectively evaluated. Clinical characteristics in patients with gynaecomastia and those with carcinoma were compared. Radiological findings were classified according to the BI-RADS (Breast Imaging Reporting and Data System) criteria. The diagnostic performance of physical examination, mammography and ultrasound was determined and compared.

Results

A total of 628 patients with 518 mammograms and 423 ultrasounds were reviewed. The final diagnoses were: 19 carcinomas, 526 gynaecomastias, 84 other benign conditions and 25 normal. There were statistically significant differences in age, bilateral involvement, clinical presentation and physical examination between patients with carcinoma and those with gynaecomastia. The diagnostic performance of physical examination was lower than that of mammography and ultrasound (p < 0.05 for specificity). Mammography was the most sensitive (94.7%) and ultrasound the most specific (95.3%) for detection of malignancy (p > 0.05). We propose an algorithm for the use of mammography and ultrasound in men.

Conclusions

Mammography and ultrasound, with a negative predictive value close to 100%, make it possible to avoid very many unnecessary surgical procedures in men.

Keywords

Male breast Mammography Ultrasound Gynaecomastia Breast carcinoma 

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Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Rafaela Muñoz Carrasco
    • 1
    Email author
  • Marina Álvarez Benito
    • 1
  • Elisa Muñoz Gomariz
    • 2
  • José Luis Raya Povedano
    • 1
  • María Martínez Paredes
    • 3
  1. 1.Radiology DepartmentHospital Universitario ‘Reina Sofía’CórdobaSpain
  2. 2.Support Unit for ResearchHospital Universitario ‘Reina Sofía’CórdobaSpain
  3. 3.Radiology and Physical Medicine AreaUniversity of CórdobaCórdobaSpain

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