THE PREVALENCE OF MALE BREAST CANCER AT PRINCE SULTAN MEDICAL MILITARY CITY

Introduction: Male breast cancer may become more common, emphasizing the importance of early detection.  The diagnosing male breast cancer is more challenging due to the lack of sufficient information on screening guidelines in men, limited awareness, and education, as well as a general inclination among men to delay care. The diagnosis of male breast cancer can be made in most cases by triple assessment: clinical evaluation, radiologic assessment (mammography and ultrasound examination), and tissue biopsy (fine-needle aspiration cytology or core biopsy).

Main aim: To assess the prevalence of male breast cancer as well as the correlation between the radiological finding and BIRAD classification which was given with the pathological biopsy result.

Methodology: Retrospective cohort study of 315 male patients, who underwent mammography and ultrasound to diagnose different breast symptoms in radiology department at Prince Sultan Medical Military City- Riyadh, Saudi Arabia between January 2016, and December 2020.                Evaluated variables include age, symptoms, site of complain, radiological findings, and biopsy result.   All ultrasound and mammographic images accessed via picture archiving and communication system (PACS).  The collected data was statistically analyzed using SPSS version 20. Chi-square tests and Logistic regression models was used. Associations were considered statistically significant at P value < 0.05.

 Main Results: The result described all of sample men 275 (87%) presented with the new onset of breast Mass, 3% of them complained mainly of pain, and 4% presented with nipple discharge. Only 6% of the 315 subjects came for screening due to positive family history.

The correlation between the BIRAD classification and the final pathological diagnosis was significant (p-value < 0.001), as the biopsy results of 15 (5%) patients who were classified radiologically as BIRAD 4 or BIRAD 5 were found to be malignant.  The remaining 300 (95%) was benign, including one patient, who was classified radiologically as BIRAD 4.

Conclusion: Breast carcinoma in the male population, is a rare disease.  Despite this, there has been a surge in incidence over the past few years. The diagnosis is usually delayed until the disease has progressed and reached later stage. Public awareness should, therefore, be increased and breast cancer should be considered in the differential diagnosis of a male patient that presents with breast swelling. The majority of sampled patient found to have of benign pathology, commonly gynecomastia, while most of the malignant cases are invasive ductal carcinoma.