A suspicious irregular density is present in the right subareolar area
An ultrasound is recommended for further evaluation of the mass. The diagnostic mammogram in a man with a palpable lump either shows benign gynecomastia (the vast majority of the time) OR a suspicious mass. The benign entities seen in women such as cysts and fibroadenomas are generally not seen in men
This mass most likely represents
Simple cyst Fibroadenoma Galactocele Cancer
Cancer
This appearance of a complex cystic mass with mural nodules is classic for intracystic papillary carcinoma. With rare exceptions, we do not typically see benign breast disease such as cysts and fibroadenomas in men.
Here is a more typical case of infiltrating ductal carcinoma in a man:
Do you need an ultrasound?
Yes No
Yes
Although this is a classic spiculated mass, and an ultrasound will not change your recommendation for image-guided needle biopsy, an ultrasound will help to plan the procedure and accurately measure the mass. Percutaneous tissue sampling will provide a diagnosis and help treatment planning. Ultrasound should be performed in a man when the mammographic findings are not classic for gynecomastia and you suspect a mass is present.
Breast cancer in men is very rare, comprising less than 0.5% of all breast cancer. They generally present as a painless hard mass. The mammographic findings are similar to invasive cancers found in women– they may be circumscribed or spiculated.
Intracystic papillary carcinoma accounts for about 5% of male breast cancers. 85% are infiltrating ductal carcinoma, not otherwise specified (NOS). Lobular cancers are exceedingly rare
