Pictorial Review–Male Breast Ultrasound

Abstract

1) To understand male breast anatomy, physiology and pathology. 2) To become familiar with the ultrasound features of benign and malignant male breast conditions, diagnostic pitfalls and optimizing techniques. 3) To present a spectrum of male breast pathologic cases. Male breast ultrasound and bilateral oblique mammographic views are routinely performed for imaging evaluation of the male breast at our institutions. High frequency linear transducers are used to obtain high resolution ultrasonography of the breast. We review the imaging and pathologic features of a spectrum of benign and malignant processes involving the male breast. The most common clinical scenario is gynaecomastia, which has different ultrasound appearances in its nodular, dendritic or diffuse forms. The rarer benign palpable lumps such as angiolipoma, schwannoma, intraductal papilloma, and lipoma have typically well-defined borders with varying echogenicities. The other non-neoplastic entities such as intramammary lymph node, sebaceous cyst, diabetic mastopathy, hematoma, fat necrosis, subareolar abscess, breast augmentation, venous malformation, secondary syphilis, and nodular fasciitis are not commonly seen in male breast ultrasound. The majority of male breast conditions are benign. Ultrasound provides useful clinical information in ascertaining the nature of a lesion, its vascular supply and the relationship with the surrounding structures. The knowledge and experience of the operator is crucial in making the accurate diagnosis by overcoming the potential diagnostic pitfalls and optimising techniques. This enables the clinician in planning and optimising the appropriate therapy.