Case 21 Discussion
Yes. Although this is a classic spiculated mass, and an ultrasound will not change your recommendation for image-guided needle biopsy, an ultrasound will help to plan the procedure and accurately measure the mass. Percutaneous tissue sampling will provide a diagnosis and help treatment planning. Ultrasound should be performed in a man when the mammographic findings are not classic for gynecomastia and you suspect a mass is present.
Breast cancer in men is very rare, comprising less than 0.5% of all breast cancer. They generally present as a painless hard mass. The mammographic findings are similar to invasive cancers found in women-- they may be circumscribed or spiculated.
Intracystic papillary carcinoma accounts for about 5% of male breast cancers. 85% are infiltrating ductal carcinoma, not otherwise specified (NOS). Lobular cancers are exceedingly rare.
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