Male breast carcinoma

Case contributed by Dr Garth Kruger

Presentation

A palpable right subareolar breast mass.

Patient Data

Age: 50 years
Gender: Male
mammography

The mammogram shows a subareolar spiculated breast mass under the right nipple. The MLO view shows dense prominent nodes in the right axilla.

ultrasound

The ultrasound images show a solid mass and the axilla ultrasound shows enlarged pathological nodes.

Case Discussion

This is a confirmed IDC right breast with positive metastatic disease on axilla node FNA.

This case is an illustration that not all subareolar mass lesions in men are gynecomastia. There are several red flags in this case: the mass lesion on mammogram does not have the typical conical density extending posteriorly away from the nipple; the margins are irregular and the nodes are pathological on both mammogram and ultrasound. The ultrasound images in no way resemble the typical appearance of gynecomastia. This solid mass is as tall as broad and again the triangular configuration of gynecomastia is missing. 

Compare this case with ID 30195.

Compare both the mammogram and ultrasound images with cases of gynecomastia on this website for instance ID 23358.

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