A New Imaging Workup of The Male Breast: Single-View Mammography and Ultrasonography

Abstract

Background: There is no generally accepted standard radiological approach to male breast diseases. Ultrasonography and mammography are the most preferred methods for imaging. The purpose of this study is to investigate the diagnostic performances of only single-view (mediolateral oblique) mammography and routine two-view mammography in the male breast diseases and also to evaluate the contribution of ultrasonography to the diagnosis and the management of the disease. Methods: Three hundred-twenty male patients’ breast imaging findings were evaluated retrospectively. Only mediolateral oblique and routine two-view mammograms were re-evaluated four months apart by two breast radiologists. The kappa value was calculated to measure consistency between two groups. The sensitivity, specificity, positive and negative predictive value, and detection accuracy of malignancy were calculated for both mammographic examinations and ultrasonography. Results: The accuracy of detection of malignant breast masses according to mediolateral oblique and two-view mammograms, and ultrasonography were 96.3 %, 97.5 %, and 99.5 %, respectively. Consistency between single-view and two-view mammograms was excellent (? = 0.967) and statistically significant (p=0.000). Two-view mammograms did not make any contribution to single-view mammograms. Conclusion: Only mediolateral oblique mammogram is sufficient in terms of characterization, spread and localization of the lesion, as long as mastectomy is preferred and the findings are supported by ultrasonography. Since there is no diagnostic performance difference, only mediolateral oblique view would protect from the potential adverse effects of extra radiation exposure and this is an important advantage.

Keywords

• Male breast imaging
• Mammography
• Ultrasonography