If you are a man, you may want to know more about the differences between male and female breast diseases. A male breast is susceptible to the same pathological processes as a female breast. Thankfully, these conditions have imaging findings that help distinguish between clearly benign and malignant diseases. Among the most common male breast abnormalities, gynecomastia, a number of imaging features differentiate it from a malignant mass. For a clinically suspicious group, mammography is often used as the initial imaging modality. The biopsy is usually performed under US guidance.
Fibrocystic breast disease
While the condition is commonly known as lumpy breasts, several other names include mammary dysplasia, diffuse cystic mastopathy, and chronic cystic mastitis. The most common symptoms of fibrocystic breast disease are lumpy breasts that are often mobile and may feel like tiny beads. This breast disorder is usually caused by monthly hormonal changes that a woman goes through as she prepares for pregnancy. These hormones, such as estrogen and progesterone, cause the cells to multiply and grow.
A doctor may order an ultrasound to determine the cause of the lump. These tests may help distinguish a chunk from normal breast tissue, or they may request a biopsy to confirm fibrocystic breast disease. A biopsy involves removing a sample of tissue or fluid from the lump. However, most women with fibrocystic breast disease will not need further medical intervention, as the condition is usually benign and does not require surgery. Instead, home treatments for fibrocystic breast disease can relieve the pain and discomfort associated with this condition.
Sclerosing adenosis
Sclerosing adenosis of the breast is a benign abnormality that occurs most commonly in women aged 30 to 45. It accounts for 12% of breast biopsy specimens and has no direct link to breast cancer. It does not represent a precancerous lesion, although sometimes malignant lesions develop within the lesions. Despite its benign nature, sclerosing adenosis is associated with an increased risk of developing breast cancer by two to fourfold.
Sclerosing adenosis may be asymptomatic or difficult to detect during a clinical breast exam. It is often diagnosed during a mammogram or after tests for another breast problem. Some women may also notice a small lump or pain in their breasts, but these symptoms rarely occur. In some women, the pain worsens before their period. Core biopsy is another test used to diagnose sclerosing adenosis. This involves inserting a hollow needle into the breast and removing a tissue sample. Several samples may be taken to ensure that there are no abnormalities.
Fibroadenomas
While fibroadenomas are not cancerous, they may cause concern for women. Most are not painful and range in size from a marble to a golf ball. They usually come and go in their own time. Still, some can be difficult to detect during a self-breast examination. They feel like marbles and are firm or rubbery in texture. If you notice a lump in your breast, you should schedule a doctor’s appointment immediately.
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When performed in young women, most fibroadenomas are identified on incidental breast exams. However, avoiding assuming that all firm, rubbery lesions are benign without a biopsy is vital. Because they may be malignant, healthcare providers should refer the patient to a radiologist or breast surgeon to perform further testing. Even if a fibroadenoma is benign, missed diagnosis can lead to poor patient outcomes.
Fat necrosis
A superficial breast mass can be due to fat necrosis, a type of cell death. Fat cells die due to a lack of oxygenated blood. When the dead cells die, enzyme action breaks up the fat into smaller molecules, which are absorbed by the bloodstream. The calcium deposits result. This is why a breast mass with this characteristic appearance is often suspicious of cancer. If your doctor suspects fat necrosis, you should have a mammogram as soon as possible.
The first sign of fat necrosis is bleeding in the fat layer. As the fat layer continues to die, it becomes firmer and indurated. Fat necrosis may also develop into a cyst containing oily fluid. The cyst walls can also be calcified. Multinucleated giant cells and histiocytes may also be present. Eventually, the lesion will undergo fibrosis and calcification.
Cysts
Women often develop cysts in their breasts during their middle to late thirties. Still, some young women also develop this condition. Cysts tend to be round and movable under the skin and can cause pain, tenderness, and lumpiness in the breast. They may also increase during a woman’s menstrual cycle. Cysts are usually benign but may require surgery if they become more extensive or complex.
Because of their size and location, breast cysts fall into two categories: micro and macrocysts. Microcysts are too small to feel but may be visible on imaging tests. Macrocysts are more noticeable and can measure up to one to two inches in diameter. Large cysts can cause pain and discomfort as they press on the adjacent breast tissue.
