title: Radiologic evaluation of lumps in the male breast.
abstract: BACKGROUND
  Gynecomastia has a typical appearance on mammography, and occurs frequently in men. However, imaging is often performed on men with breast lumps to exclude breast cancer, which only comprises 1% of male breast masses.
  
  
  OBJECTIVE
  To assess whether ultrasound and fine needle aspiration cytology (FNAC) are necessary investigations when mammograms show classical gynecomastia.
  
  
  METHODS
  We have retrospectively collected data on male patients referred for mammography during the period 2011-2013 (a total of 539 patients). All radiological images were re-read, and descriptions of ultrasound images were reviewed. Clinical information supplied with the original referrals was assessed, along with pathology and cytology reports.
  
  
  RESULTS
  Among the 539 male patients who underwent mammography, 483 were also examined with ultrasound, and 335 were further evaluated with FNAC. Mammograms showed gynecomastia in 350 patients, and among these subjects ultrasound was performed in 340 (97%), FNAC in 261 (75%), and core biopsies in four (1%) patients. The diagnosis gynecomastia was unchanged in all patients who underwent FNAC or biopsy. Malignant tumors were found in eight patients, six of which were invasive ductal carcinomas.
  
  
  CONCLUSIONS
  In patients with a classical appearance of gynecomastia on mammography, supplemental ultrasound, FNAC, or biopsy is superfluous and contributes to unnecessary costs.
authors.affiliation: Department of Radiology, Breast Diagnostic Center, Drammen Hospital, Vestre Viken Health Trust, Drammen, Norway ase.tangerud@vestreviken.no.
authors.forename: Åse
authors.initials: Å
authors.lastname: Tangerud
authors.affiliation: Department of Radiology, Drammen Hospital, Vestre Viken Health Trust, Drammen, Norway.
authors.forename: Ivan
authors.initials: I
authors.lastname: Potapenko
authors.affiliation: Department of Breast and Endocrine Surgery, Breast Diagnostic Center, Drammen Hospital, Vestre Viken Health Trust, Drammen, Norway.
authors.forename: Helle Kristine
authors.initials: HK
authors.lastname: Skjerven
authors.affiliation: Department of Biostatistics, Institue of Basic Medical Sciences, University of Oslo, Norway.
authors.forename: Mats Julius
authors.initials: MJ
authors.lastname: Stensrud
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D062005:Biopsy, Large-Core Needle; D018567:Breast Neoplasms, Male / Q000000981:diagnostic imaging*; D006177:Gynecomastia / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary
keywords: Male breast; biopsy; breast cancer; cytology; gynecomastia; mammography; ultrasound