SONOGRAPHIC FINDINGS OF RARE BREAST CANCERS IN MALE PATIENTS: A PICTORIAL CASE REVIEW
By Mohamed Farah, King’s College Hospital NHS Foundation Trust
Background:
Male breast cancer is a rare condition representing about 1% of all breast cancer cases. The lifetime risk for a man to develop breast cancer is approximately 1 in 833. The average age of diagnosis is 60-70 years. The most common type is invasive ductal carcinoma (IDC), which constitutes 80-90% of male breast cancer (MBC) cases. This rarity often leads to under diagnosis and delays in treatment due to low suspicion and inappropriate referral pathways. This pictorial case review aims to highlight the sonographic characteristics of rare breast cancer types and their presentations in male patients, emphasising the importance of ultrasound in early detection and diagnosis.
Case Summary:
This case review encompasses a variety of rare breast cancer types/presentations in male patients presenting at PRUH from 2017-2023, highlighting their unique sonographic features. The cases include intracystic papillary carcinoma, encysted papillary carcinoma in situ, low-grade micropapillary ductal carcinoma in situ (DCIS) in a young man 28 years old, mucinous carcinoma in the axilla, bilateral breast cancer which accounts for 1.5-2% of all MBC, multifocal breast cancer, and synchronous diagnoses of breast and renal cell cancer. Sonographic findings varied from cystic lesions with solid components, well demarcated lesions with increased vascularity, area mimicking gynecomastia to malignant-looking spiculated hypoechoic masses with oedema. Mammographic findings correlated to the US findings. These imaging characteristics underscore the diversity in presentation.
Conclusion:
This review underscores the pivotal role of sonography in identifying rare/atypical presentations of MBC. Considering that US scan is usually the first imaging modality requested in male patients, increased awareness, knowledge and early recognition of these sonographic patterns is essential for timely and accurate diagnosis, proper referrals and ultimately improved patient outcomes.