Imaging features of male breast cancer in a South African population

Abstract

INTRODUCTION: Male breast cancer is a very rare entity, representing less than 1% of all cancers affecting men (1, 2). Only 0.7% of all breast carcinomas are attributed to male breast cancer (3). As a result, there is little published data worldwide and especially from South Africa about the imaging features of breast malignancy in men. This study looked at the mammographic and ultrasound features of male breast cancer in the South African context. AIM: To describe the imaging features of male breast cancer in a South African population. METHOD: The histological reports of all patients who met the inclusion criteria were extracted from the National Health Laboratory Services (NHLS) patient records database and printed. The demographic data was used to trace the relevant diagnostic imaging studies that were performed for each patient. Only the mammography and ultrasound reports were reviewed, images were not re-reviewed. RESULTS: Seventy-six patients between the ages of 31 to 89 with confirmed primary breast malignancy were found in the NHLS database for the predetermined eleven-year period. Only 20 of the 76 had imaging reports available for assessment. Thirty-five percent of malignant lesions demonstrated microcalcifications, while 20% were spiculate, 20% irregular and 25% macrolobulated. On ultrasound, only 35% of lesions were hypoechoic with 20% demonstrating posterior acoustic shadowing. Invasive ductal carcinoma represented 91% of all primary male malignant breast lesions in our study population, with 8% of lesions attributed to invasive papillary carcinoma and only 1% ductal carcinoma in-situ. CONCLUSIONS: Male breast cancer in South Africa is similar to male breast cancer elsewhere, not only on imaging but also on histology and immunohistochemistry.