title: Mammography and ultrasound in the evaluation of male breast disease.
abstract: OBJECTIVE
  To assess clinical variables that may be useful in differentiating gynaecomastia from carcinoma and to analyse the contribution of mammography and ultrasound to the evaluation of male breast disease.
  
  
  METHODS
  All men who underwent mammography and/or ultrasound between 1993 and 2006 in our hospital were retrospectively evaluated. Clinical characteristics in patients with gynaecomastia and those with carcinoma were compared. Radiological findings were classified according to the BI-RADS (Breast Imaging Reporting and Data System) criteria. The diagnostic performance of physical examination, mammography and ultrasound was determined and compared.
  
  
  RESULTS
  A total of 628 patients with 518 mammograms and 423 ultrasounds were reviewed. The final diagnoses were: 19 carcinomas, 526 gynaecomastias, 84 other benign conditions and 25 normal. There were statistically significant differences in age, bilateral involvement, clinical presentation and physical examination between patients with carcinoma and those with gynaecomastia. The diagnostic performance of physical examination was lower than that of mammography and ultrasound (p < 0.05 for specificity). Mammography was the most sensitive (94.7%) and ultrasound the most specific (95.3%) for detection of malignancy (p > 0.05). We propose an algorithm for the use of mammography and ultrasound in men.
  
  
  CONCLUSIONS
  Mammography and ultrasound, with a negative predictive value close to 100%, make it possible to avoid very many unnecessary surgical procedures in men.
authors.affiliation: Radiology Department, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n, 14004, Córdoba, Spain. rafaelamunozc@hotmail.com
authors.forename: Rafaela
authors.initials: R
authors.lastname: Muñoz Carrasco
authors.forename: Marina
authors.initials: M
authors.lastname: Alvarez Benito
authors.forename: Elisa
authors.initials: E
authors.lastname: Muñoz Gomariz
authors.forename: José Luis
authors.initials: JL
authors.lastname: Raya Povedano
authors.forename: María
authors.initials: M
authors.lastname: Martínez Paredes
mesh_terms: D000328:Adult; D018567:Breast Neoplasms, Male / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003937:Diagnosis, Differential; D006177:Gynecomastia / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data*; D014962:X-Ray Film / Q000706:statistics & numerical data*