A Panoramic View of Morphological Spectrum of Male Breast Lesions at a Tertiary Care Hospital in South India

Abstract

Abstract Background: Though male breast lesions are infrequently studied and documented, a wide variety of lesions afflict it. Conditions and entities that affect the female breast also occur in the male breast. However, lobular lesions are seldom seen in male breasts because of absence of terminal differentiation induced by progesterone. So far, there have been very few studies on the spectrum of male breast lesions and most of them are done either on aspiration smears or on biopsies. Therefore, in the present study, we aimed to analyse the spectrum of different types of male breast lesions at our tertiary care centre both on aspiration cytology smears and histological specimens as well as biopsies. Objectives: To study the spectrum of male breast lesions encountered in histopathology and cytology lab. Study Design: Data on male breast lesions between 2010 to 2015 were retrieved from the records of Kasturba Medical College, Mangalore. The cytological and histological features were studied and the number of benign and malignant cases recorded. Cytohistologic correlation, wherever available was done. Immunohistochemistry was studied in malignancies wherever available. Results: Out of 7700 breast lumps retrieved, 120 (1.55%) male breast lesions were identified. Of these, 54 were diagnosed by FNAC and 76 lesions on surgical specimens. On FNAC, 49 were benign and 5 malignant. The 76 cases diagnosed on histology had 70 benign and 6 malignant lesions. The benign lesions were gynecomastia, inflammatory masses, fibroadenoma and intraductal papillomas. Malignant lesions included infiltrating ductal carcinoma (NOS), papillary and metastatic carcinoma with 60% showing ER positivity. Ten of these cases had both cytology and histology. Conclusion: While gynaecomastia and invasive ductal cancer were the commonest lesions encountered in the male breast, there were other rarer benign and malignant lesions.