ARRS 2022 Abstracts

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E1364. Spotting the G-Men: Clues to Distinguish Gynecomastia From Male Breast Cancer
Authors
  1. Madiha Aslam; Mercy Fitzgerald Hospital
  2. Marion Brody; Mercy Fitzgerald Hospital
Background
Gynecomastia is the most common benign male breast abnormality, found in 85% of men who are obese and in those who present with a breast lump. It is caused by an imbalance of diminished circulating androgen and elevated estrogen levels, which results in benign proliferation of ductal and stromal tissues of the breast. Patients with gynecomastia generally present with characteristic imaging findings that assist in making the diagnosis. Male breast cancer (MBC) is rare, representing < 1% of all breast cancers. However, rarely, gynecomastia and breast cancer may be difficult to differentiate on imaging and tissue diagnosis is required. The purpose of this exhibit is to describe the discerning demographic, clinical, and imaging features of gynecomastia and male breast cancer.

Educational Goals / Teaching Points
The goals of this exhibit are to review normal anatomy and physiology of the male breast; identify the salient features of different gynecomastia patterns that usually require no further invasive workup; illustrate distinguishing imaging features of gynecomastia and MBC and demonstrate their application in cases where the diagnosis may be equivocal; and compare the demographic and clinical differences between gynecomastia and MBC, which may also provide clues to the correct diagnosis.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will briefly illustrate the normal and abnormal male breast anatomy, then discuss the discriminating clinical, demographic, and histopathological features of gynecomastia and MBC. We will provide imaging examples of classic and challenging cases.

Conclusion
Gynecomastia is a common male breast abnormality with characteristic imaging patterns. However, it can rarely mimic male breast cancer. A better understanding of the important demographic, clinical, and imaging features of both entities will help the radiologist avoid unnecessary workups and missed breast cancers.