Diseases of the Male Breast

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 4.75
Patient Care: 1.25
Patient Interactions and Management: 1.25
Image Production: 1.00
Evaluation and Selection of Representative Images: 1.00
Procedures: 2.50
Anatomy and Physiology: 1.25
Pathology: 1.25

Mammography: 4.75
Patient Care: 1.50
Patient Interactions and Management: 1.50
Procedures: 3.25
Anatomy, Physiology, and Pathology: 3.25

Magnetic Resonance Imaging: 3.50
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 2.50
Body: 2.50

Registered Radiologist Assistant: 4.75
Procedures: 4.75
Thoracic Section: 4.75

Sonography: 3.50
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 2.50
Superficial Structures and Other Sonographic Procedures: 2.50

Radiation Therapy: 4.75
Patient Care: 3.50
Patient and Medical Record Management: 3.50
Procedures: 1.25
Treatment Sites and Tumors: 1.25

Outline

1. Introduction
2. Clinical Background
3. Normal Breast Anatomy
4. Benign Conditions
   1. Gynecomastia
   2. Lipoma
   3. Pseudoangiomatous Stromal Hyperplasia
   4. Granular Cell Tumor
   5. Fibromatosis (Desmoid Tumor
   6. Myofibroblastoma
   7. Schwannoma
   8. Breast Hemangioma
5. Malignant Conditions
   1. Invasive Ductal Carcinoma
   2. Papillary Carcinoma
   3. Invasive Lobular Carcinoma
   4. Adenoid Cystic Carcinoma
   5. Liposarcoma
   6. Dermatofibrosarcoma Protuberans
   7. Pleomorphic Hyalinizing Angiectatic Tunor
   8. Basal Cell Carcinoma of the Nipple
   9. Lymphoma and Leukemia
   10. Secondary Tumors (Metastases
6. Summary

Objectives

Upon completion of this course, students will:

1. understand the reasons men are referred for possible breast disease
2. gain awareness of the most common form of male breast cancer
3. discuss treatment options for male breast cancer patients
4. describe the AJCC tumor staging system
5. know what percent of all breast cancers are male related
6. state the observable signs of a cutaneous lesion
7. discuss clinical challenges in determining the extent of male breast disease
8. understand which breast disease does not typically appear in males
9. explain male breast anatomy
10. recognize the four breast quadrants
11. state the major components of the male breast
12. communicate the causes of gynecomastia
13. identify gynecomastia in pubescent males
14. compare the 3 appearances of gynecomastia on mammography
15. discuss the differential diagnosis process for gynecomastia
16. describe glandular tissue associated with gynecomastia
17. communicate the most common benign male breast tumor
18. state the differential diagnosis for lipoma
19. understand how PASH is discovered
20. recognize PASH on mammograms
21. understand the BI-RADS code for PASH
22. communicate how PASH is demonstrated on different imaging modalities
23. report from what type of cells granular cell tumors develop
24. name the quadrant from which granular cell tumors most commonly appear
25. express the size of granular cell tumors
26. identify how fibromatosis appears on mammograms
27. explain the treatment of choice for myofibroblastoma
28. communicate the standard of care for diagnosing schwannoma
29. know the two types of hemangiomas
30. communicate adjuvant therapy options for invasive ductal carcinoma
31. state the percentage of male breast cancer associated with ductal carcinoma in situ
32. understand how papillary carcinoma affects men more than women
33. explain the term “not otherwise specified” in relationship to male breast cancer
34. understand what can cause an increase in invasive lobular carcinoma in men
35. communicate the treatment for ILC in men
36. be familiar with the treatment for adenoid cystic carcinoma
37. know the origin of liposarcoma
38. understand how to properly diagnose liposarcoma
39. communicate skin layers and their relationship to dermatofibrosarcoma protuberans
40. understand which imaging modalities demonstrate dermatofibrosarcoma protuberans the best
41. explain the surgical excision margins for dermatofibrosarcoma protuberans
42. describe how PHAT can be confused with other breast disease
43. state the number of PHAT cases that have metastastasized
44. discuss the metastatic potential of basal cell carcinoma of the nipple
45. explain the mammographic views helpful in demonstrating calcifications in basal cell carcinoma of the nipple
46. express where primary breast lymphoma begins
47. understand how primary and secondary lymphoma present upon imaging
48. know the classic mammographic finding associated with breast lymphoma
49. state the most frequent source of breast metastasis
50. list the diagnostic tools utilized in diagnosing male breast cancer