Outcomes of male patients attending the symptomatic breast unit: adherence to local and national imaging guidelines and effectiveness of clinical examination and imaging in detecting male breast cancer

• Published in: Clinical radiology 2022-01, Vol.77 (1), p.e64-e74
• Main Authors: Healy, N.A., Parag, Y., Wallis, M.G., Tanner, J., Kilburn-Toppin, F.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Breast - diagnostic imaging; Breast Neoplasms, Male - diagnostic imaging; Guideline Adherence - statistics & numerical data; Humans; Male; Middle Aged; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2021.09.018

To review outcomes of male patients attending the breast unit, evaluate effectiveness of imaging and examination in detecting breast cancer and review adherence to guidelines for male breast imaging. A retrospective review was undertaken of male patients attending Cambridge Breast Unit from 1 January 2015 to 31 December 2019. Patient electronic records and imaging were reviewed to establish demographics, clinical findings, imaging, biopsy, and pathology outcomes. Of 1,362 male patients attending the breast unit, 1,028 (75%) had imaging performed. Biopsy was performed in 41 men (3%), with 14 cancers diagnosed (1%). Clinical examination showed 42.7% sensitivity, 99.6% specificity, 54.6% positive predictive value (PPV) and 99.4% negative predictive value (NPV) for detection of cancer. Mammogram demonstrated 84.6% sensitivity, 99.4% specificity, 69.8% PPV, and 99.8% NPV for detection of malignancy. Ultrasound demonstrated 78.6% sensitivity, 98.9% specificity, 73.3% PPV and 99.2% NPV for detection of cancer. Forty-one percent of patients