title: Breast masses in males: multi-institutional experience on fine-needle aspiration.
abstract: Male breast masses are uncommon pathologic findings. They are rarely aspirated, resulting in limited cytopathologic experience. The following study describes the cytopathology of male breast lesions from data collected for a period of 10 yr from three large institutions. A total of 14,026 breast aspirations were performed of which 614 were from male patients. All cases were reviewed and correlated with the appropriate clinicopathologic follow-up. The FNA diagnoses were as follows: benign, 427 cases (gynecomastia 353, fat necrosis 21, miscellaneous 53); malignant, 32 cases (ductal carcinoma nos 15, metastatic tumors 17); and atypical/suspicious, 61 cases. Ninety-four cases were nondiagnostic due to scant cellularity. Male breast aspirates accounted for 4.3% of the total breast FNAs performed. The clinicopathologic follow-up in both the benign and malignant categories showed 100% correlation. The overall sensitivity was 95.3%, specificity was 100%, and diagnostic accuracy was 98%. A relatively high specimen unsatisfactory rate was seen (>15%). The commonest cytopathologic diagnosis was gynecomastia, followed by ductal carcinoma. Florid duct atypia in gynecomastia may mimic adenocarcinoma, necessitating a higher threshold for cytopathologic interpretation for malignancy in males.
authors.affiliation: Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD 21287-6940, USA.
authors.forename: Momin T
authors.initials: MT
authors.lastname: Siddiqui
authors.forename: Maureen F
authors.initials: MF
authors.lastname: Zakowski
authors.forename: Raheela
authors.initials: R
authors.lastname: Ashfaq
authors.forename: Syed Z
authors.initials: SZ
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D018567:Breast Neoplasms, Male / Q000473:pathology* / Q000556:secondary; D002278:Carcinoma in Situ / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000473:pathology; D006177:Gynecomastia / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity