Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management

被引:14
作者
Tari, Daniele Ugo [1 ]
Morelli, Luigi [2 ]
Guida, Antonella [3 ]
Pinto, Fabio [4 ]
机构
[1] Caserta LHA, Dept Diagnost Senol, Dist 12,Palazzo Salute, I-81100 Caserta, Italy
[2] Caserta LHA, Dept Pathol Anat Tuoro, I-81031 Aversa, Italy
[3] Caserta LHA, Head Off, Dist 12,Palazzo Salute, I-81100 Caserta, Italy
[4] Caserta LHA, A Guerriero Hosp, Dept Radiol, I-81025 Marcianise, Italy
关键词
male breast cancer; breast neoplasms; clinical practice patterns; ductal carcinoma in situ; radiomics; digital breast tomosynthesis; proliferative disease of the breast; guidelines; CARCINOMA IN-SITU; ARCHITECTURAL DISTORTION; DIGITAL MAMMOGRAPHY; DIAGNOSTIC-ACCURACY; TOMOSYNTHESIS; DISEASE; ULTRASOUND; OUTCOMES; OCCULT; RISK;
D O I
10.3390/diagnostics11122199
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Ductal carcinoma in situ (DCIS) of male breast is a rare lesion, often associated with invasive carcinoma. When the in situ component is present in pure form, histological grade is usually low or intermediate. Imaging is difficult as gynaecomastia is often present and can mask underlying findings. We report a rare case of pure high-grade DCIS in a young male patient, with associated intraductal papilloma and atypical ductal hyperplasia. Digital breast tomosynthesis (DBT) showed an area of architectural distortion at the union of outer quadrants of the left breast without gynaecomastia. Triple assessment suggested performing a nipple-sparing mastectomy, which revealed the presence of a focal area of high-grade DCIS of 2 mm. DCIS, even of high grade, is difficult to detect with mammography and even more rare, especially when associated with other proliferative lesions. DBT with 2D synthetic reconstruction is useful as the imaging step of a triple assessment and it should be performed in both symptomatic and asymptomatic high-risk men to differentiate between malignant and benign lesions. We propose a diagnostic model to early detect breast cancer in men, optimizing resources according to efficiency, effectiveness and economy, and look forward to radiomics as a powerful tool to help radiologists.
引用
收藏
页数:16
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