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Category: Volume 08 Issue 02 February 2020
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Title: Spectrum of Male Breast Lesions – Cytological Review

Authors: Dr Anil J, Dr Bharathi M

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.151

Abstract

   

Introduction: Fine needle aspiration cytology is a quick, reliable, effective and well established method in the evaluation of breast lumps and is being widely used in assessment of breast lesions.Breast cancer in males is relatively uncommon, accounting for <1% of all breast cancers. Due to this rarity of the disease; screening, diagnosis, and further management is a big challenge. Further adding on to the challenge, breast masses in males is rarely aspirated and hence there is limited cytopathologic experience.

Aims and Objectives: To determine the efficacy of FNAC in the study of male breast lesions and to analyze the cytological spectrum of these lesions.

Materials and Methods: This study was conducted over a period of 1 year between January 2018 to January 2019. All the cases of male breast FNAC done were documented. FNAC diagnosis were categorized as benign, malignant, suspicious for malignancy and inadequate or unsatisfactory.

Results: A total of 30 male patients with breast lump were encountered, out of which 23 cases (76.66%) were Gynecomastia, 04 cases (13.33%) were Malignancy, 02 cases (6.66%) were Suspicious for malignancy and 01 case (3.33%) was unsatisfactory.

Conclusion: FNAC is accurate and reliable tool for diagnosis of male breast lesions. However, it is more sensitive and specific if the cellularity is adequate. To avoid unnecessary surgical biopsies, we conclude that FNAC should be performed as a standard procedure in the clinical evaluation of male breast masses.

Keywords: Fine needle aspiration cytology (FNAC), Gynecomastia, Male breast lesions.

References

  1. MacIntosh RF, Merrimen JL, Barnes PJ. Application of the probabilistic approach to reporting breast fine needle aspiration in males. Acta Cytol. 2008;52:530-34.
  2. Siddiqui MT, Zakowski MF, Ashfaq R, Ali SZ: Breast masses in males: multi-instituitional experience on fine needle aspiration. Diag Cytopathology.2002 Feb;26(2): 87-91. 
  3. Rudlowski C. Male breast cancer. Breast Care. 2008;3(3):183-9.
  4. Kalyani R, Das S, Singh MS, Kumar H. Cancer profile in the department of pathology of Sri Devaraj Urs medical college, Kolar: A ten years study. Indian J Cancer. 2010;47(2):160-5.
  5. Nuttal FQ. Gynecomastia as a physical finding in normal men. J Clin Endocrinol Metab 1979 Feb;48(2):338–340. doi: 10.1210/jcem-48-2-338.
  6. Das DK, Junaid TA, Mathews SB, Ajrawi TG, Ahmed MS, Madda JP. Fine needle aspiration cytology diagnosis of male breast lesions: A study of 185 cases. Acta Cytol 1995 Sep-Oct;39(5):870–876. 
  7. Lilleng R, Paksoy N, Vural G, Langmark F, Hagmar B. Assessment of fine needle aspiration cytology and histopathology for diagnosing male breast masses. Acta Cytol 1995 Sep- Oct;39(5):877–881. 
  8. Giordano SH, Cohen DS, Buzdar AU, Perkins G, Hortobagyi GN. Breast carcinoma in men: A population based study. Cancer. 2004;101(1):51-7.
  9. Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet. 2006; 367(9510): 595-604.
  10. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59(4):225-49.
  11. Martin-Bates E, Krausz T, Phillips I: Evaluation of fine needle aspiration of the male breast for the diagnosis of gynecomastia. Cytopathol. 1990;1 (2):79-85. 
  12. Pratik Mohanrao Chide, Suprita Nayak, Dinkar Kumbhalkar. Roleof fine needle aspiration cytology in male breast lesion: 4 year observational study. September 2016 | Vol 4 | Issue 9 Page 3947.
  13. Russin VL, Lachowicz C, Kline TS. Male breast lesions: Gynecomastia and its distinction from carcinoma by aspiration biopsy cytology. Diagn Cytopathol. 1989;5:243-47.
  14. Gupta RK, Naran S, Simpson J. The role of fine needle aspiration cytology in the diagnosis of breast masses in males. Eur J Surg Oncol. 1988;14:317-20.
  15. Westend PJ, Jobse C. Evaluation of fine-needle aspiration cytology of breast masses in males. Cancer (Cancer Cytopathol). 2002;96:101-04.
  16. Wauters CAP, Kooistra BW, Heijden IMK, Strobbe LJA. Is cytology useful in the diagnostic workup of male breast lesions? A retrospective study over a 16-year period and review of the recent literature. Acta Cytol. 2010;54:259-64.
  17. Kirana Pailoor, Hilda Fernandes, Jayaprakash C S , Nisha J Marla, Murali Keshava S. Fine Needle Aspiration Cytology of Male Breast Lesions – A Retrospective Study Over a Six Year Period. Journal of Clinical and Diagnostic Research. 2014 Oct, Vol-8(10): FC13-FC15
  18. Ganguly S, Sheikh SA, Phukan A, Das J, Das S.S. Spectrum of male breast lesions: an institutional Int J Med Res Rev 2016;4(3):381-386.

Corresponding Author

Dr Anil J

Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka