The role of mammography in male patients with breast symptoms

OBJECTIVE: To determine the contribution of mammography to the comprehensive clinical evaluation of men with breast symptoms. PATIENTS AND METHODS: We retrospectively reviewed the records of all men who underwent mammography between January 1,2001, and December 31, 2004, at the Mayo Clinic In Jacksonville, Fla. Medical history, mammographic findings, and breast cancer diagnoses were assessed. RESULTS: A total of 198 men had 212 mammograms. Nine mammograms (from 9 different men) (4%) showed suspicious findings. Eight men underwent biopsy, which yielded a breast cancer diagnosis in 2 (1%). Of the 212 mammograms, 203 (96%) showed benign findings, Including gynecomastia on 132 (62%). One patient with a benign-appearing mammogram later underwent breast biopsy, and malignant disease was diagnosed. All the men with breast cancer had a dominant mass on clinical examination and other findings suggestive of breast cancer. Of the 132 mammograms showing gynecomastia, 110 (83%) were from men who had taken predisposing medications or who had predisposing medical conditions. CONCLUSIONS: Mammography added little information to the initial patient evaluation. Breast cancer may be suspected by the presence of a dominant mass. Gynecomastia can be predicted on the basis of the patient's symptoms or preexisting condition. Patients with suspicious findings on examination warrant appropriate clinical management regardless of mammographic findings. Mammography in men may be of benefit only for image guidance of percutaneous biopsy of a suspicious mass.