Pictorial essay: A retrospective review of male breast diseases in Maiduguri and Kano, Nigeria

Abstract

Introduction: Breast diseases in men are not as common as those in women and though male breast cancer is seen rarely, thus the lack of screening guidelines worldwide, benign breast diseases such as gynecomastia present fairly commonly in both primary and tertiary care setting. There is a paucity of information about the pattern, protocols, and imaging features of male breast diseases in Nigeria. Objective: To review the variety of presentations and radiological features of male breast diseases encountered in Aminu Kano Teaching Hospital (AKTH) and University of Maiduguri Teaching Hospital (UMTH). We wish to discuss the departmental protocols and highlight the role of mammography and sonomammography in the evaluation of male breast diseases. Materials and Methods: A 5-year retrospective review was performed on the imaging findings of a total number of 27 male patients who presented with symptoms of breast disease to the radiology departments of AKTH (12) and UMTH (15) in Nigeria. All patients had mammography and sonomammography or sonomammography alone performed by a senior radiology resident and consultant radiologist. Selected cases had ultrasound guided biopsy and histology. Results: Twenty-seven male patients were reviewed from both centers with an age range of 0.06-69 years (mean of 33.11 ± 18.10 years). The majority of patients (88.9%) presented with breast enlargement only. Concerning laterality of disease, bilateral involvement was more common (59.3%). In unilateral disease, 33.3% of patients presented with left-sided lesions while only 7.4% had right-sided involvement. Gynecomastia was seen in twenty (20) patients and was the most common breast disease seen in male patients presenting for imaging in both centers. Breast abscesses were the second most common. We saw one case of bilateral male breast cancer. Overall, bilateral disease was far more common than unilateral. Conclusion: Mammography is the most important first-line imaging modality employed in the diagnosis of male breast diseases in our environment; sonomammography is an important and radiological modality of investigation used to differentiate gynecomastia from male breast cancer and breast abscess. Gynecomastia remains the most common occurring male breast disease in our study.