Kathryn Malherbe helps us understand breast imaging for male breast cancer patients.
In between our daily routine of screening mammography, occasionally we come across a middle-aged man, sitting awkwardly in our women’s wellness clinic, anticipating being called for his ‘man-ogram’.
It seems very uncommon, but we find 1% of all positive diagnosed breast cancers in men. Men typically present with similar symptoms as women:
- Palpable lump
- Change or skin texture/redness of the skin surface
- Sudden bloody discharge
- Less seldom, sudden onset pain behind the nipple
It’s a difficult concept for both men and women to grasp as it seems most breast cancer awareness is targeted to and around women. But, for men diagnosed with the disease, it’s just as disheartening and nerve-wracking to hear the words, “You have breast cancer.”
What are the male risk factors for developing breast cancer?
- Aging
- Family history
- Alcohol
- Liver disease
- Oestrogen treatment used during prostate cancer treatment
- Obesity
Breast imaging for men
The first choice in breast imaging for men is ultrasound. Any palpable lump can be targeted in real time with various ultrasound techniques. One of these techniques is elastography, which can determine the tissue stiffness of the palpable lump, proven in studies to be linked to the risk of malignancy.
Male patients over the age of
50 can also be referred for a mammogram; the procedure has the same approach as a female patient. In most cases, the views performed are limited to oblique (side views) which demonstrates the maximum amount of breast tissue in men.
The question commonly asked is: but do men actually have breast tissue? The simple answer is yes. Both men and women have fibroglandular breast tissue behind the nipple, but due to men having higher levels of testosterone and lower levels of oestrogen, their breast tissue is less prominent.
Gynecomastia
In rare cases, there is abnormal cell growth of the glandular tissue in men. Either due to chronic medication, steroidal supplements or genetic reasons.
Most men that are referred to our department end up with benign results, known as gynecomastia, which is simply explained as breast development in men.
Gynecomastia is a self-limiting condition, usually presenting as tender, swollen breast buds. The causes are usually related to medication or a sudden change in medication of middle-aged men, which causes the side effect of breast development. We also see it in young men using drug enhancement products as part of sports training regimes.
It’s typically harmless, however, never ignore symptoms. Have it checked out and if there is any suspicion, you’ll be referred for further testing, such as an ultrasound, mammogram, or an excision biopsy to have some of the tissue sent away to the pathologist to be checked.[/vc_column_text][/vc_column][/vc_row]
MEET OUR EXPERT – Kathryn Malherbe
Kathryn Malherbe is a senior mammographer working at LaVita Women’s Wellness Centre in Pretoria. She has completed her master’s degree which focused on lobular carcinoma of the breast and the diagnosis thereof can be improved with ultrasound detection tools.