40세 이상 남성의 편측 유방종괴의 정확한 평가
Accurate Evaluation of Unilateral Breast Masses in Men Aged over 40 Years
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Purpose: Breast enlargement commonly occurs in men, with advancing age. The main challenge in these individuals is to differentiate benign enlargement from carcinoma. Methods: We retrospectively analyzed the medical records of 38 patients aged over 40 years who were underwent surgery for unilateral breast masses over a 15-year period (six cases of carcinoma, 32 cases of gynecomastia). We compared clinicopathologic characteristics between the two groups, and reviewed the performance of physical examination and fine-needle aspiration biopsy (FNAB) for diagnosing male breast masses. Results: The delay before presentation was significantly longer in patients with carcinoma than in those with gynecomastia (median, 14 months vs. 3 months). A history of carcinoma and a family history of breast carcinoma were more common in patients with carcinoma than in those with gynecomastia (16.7% vs. 6.3% [p=0.412] and 33.7% vs. 9.8% [p=0.169], respectively). The proportions of patients receiving medication, and with histories of alcohol consumption and smoking were similar in the two groups. Among the 12 cases in which the results of preoperative FNAB and physical examination as diagnostic tests were not in agreement, the former proved to be more accurate than the latter (16.7% vs. 83.3%). Conclusion: Carcinoma must be excluded in individuals presenting with unilateral breast masses, particularly in those who present with painless masses. FNAB should be routinely performed, being quick and safe diagnostic procedure, in all outpatients departments, which could help avoid diagnostic operations for gynecomastia.
Abstract
Purpose: Breast enlargement commonly occurs in men, with advancing age. The main challenge in these individuals is to differentiate benign enlargement from carcinoma. Methods: We retrospectively analyzed the medical records of 38 patients aged over 40 years who were underwent surgery for unilateral breast masses over a 15-year period (six cases of carcinoma, 32 cases of gynecomastia). We compared clinicopathologic characteristics between the two groups, and reviewed the performance of physical examination and fine-needle aspiration biopsy (FNAB) for diagnosing male breast masses. Results: The delay before presentation was significantly longer in patients with carcinoma than in those with gynecomastia (median, 14 months vs. 3 months). A history of carcinoma and a family history of breast carcinoma were more common in patients with carcinoma than in those with gynecomastia (16.7% vs. 6.3% [p=0.412] and 33.7% vs. 9.8% [p=0.169], respectively). The proportions of patients receiving medication, and with histories of alcohol consumption and smoking were similar in the two groups. Among the 12 cases in which the results of preoperative FNAB and physical examination as diagnostic tests were not in agreement, the former proved to be more accurate than the latter (16.7% vs. 83.3%). Conclusion: Carcinoma must be excluded in individuals presenting with unilateral breast masses, particularly in those who present with painless masses. FNAB should be routinely performed, being quick and safe diagnostic procedure, in all outpatients departments, which could help avoid diagnostic operations for gynecomastia.
참고문헌 (16)
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