Mammographic screening in male patients at high risk for breast cancer: is it worth it?

Abstract

Purpose

To investigate the utility of mammography for breast cancer screening in a population of males at increased risk for breast cancer.

Methods

In this HIPAA-compliant institutional review board-approved single-institution study, mammography records and clinical data of 827 male patients who underwent digital mammography from September 2011–July 2018 were analyzed via the electronic medical record. 664 of these men presented with masses, pain, or nipple discharge and were excluded from this study. The remaining 163 asymptomatic men with familial and/or personal history of breast cancer, or with a known germline mutation in BRCA, underwent screening mammography and were included in this analysis.

Results

163 asymptomatic men (age: mean 63 years, range 24–87 years) underwent 806 screening mammograms. 125/163 (77%) had a personal history of breast cancer and 72/163 (44%) had a family history of breast cancer. 24/163 (15%) were known mutation carriers: 4/24 (17%) BRCA1 and 20/24 (83%) BRCA2. 792/806 (98%) of the screening mammograms were negative (BI-RADS 1 or 2); 10/806 (1.2%) were classified as BI-RADS 3, all of which were eventually downgraded to BI-RADS 2 on follow-up. 4/806 (0.4%) mammograms were abnormal (BI-RADS 4/5): all were malignant. The cancer detection rate in this cohort was 4.9 cancers/1000 examinations.

Conclusions

In our cohort, screening mammography yielded a cancer detection rate of 4.9 cancers/1000 examinations which is like the detection rate of screening mammography in a population of women at average risk, indicating that screening mammography is of value in male patients at high risk for breast cancer.

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Funding

This research was funded in part through the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748 and a Grant from the Breast Cancer Research Foundation. The sponsors were not involved in the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the article for publication.

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Correspondence to Maxine S. Jochelson.

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Conflict of interest

KP received payment for activities not related to the present article including lectures including service on speakers bureaus and for travel/accommodations/meeting expenses unrelated to activities listed from the European Society of Breast Imaging (MRI educational course, annual scientific meeting). MSJ has received an honorarium from GE for speaking, and an honorarium for speaking at the Lynn Sage Breast Cancer Symposium and at MD Anderson. EAM has received a grant from GRAIL. The rest of the authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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As this was a retrospective study, the need for informed consent was waived.

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Marino, M.A., Gucalp, A., Leithner, D. et al. Mammographic screening in male patients at high risk for breast cancer: is it worth it?. Breast Cancer Res Treat 177, 705–711 (2019). https://doi.org/10.1007/s10549-019-05338-1

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Keywords

  • Digital mammography
  • Breast cancer
  • Male
  • Screening
  • Diagnosis