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

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. W...

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Autores principales: Tari, Daniele Ugo, Morelli, Luigi, Guida, Antonella, Pinto, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700459/
https://www.ncbi.nlm.nih.gov/pubmed/34943439
http://dx.doi.org/10.3390/diagnostics11122199
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author Tari, Daniele Ugo
Morelli, Luigi
Guida, Antonella
Pinto, Fabio
author_facet Tari, Daniele Ugo
Morelli, Luigi
Guida, Antonella
Pinto, Fabio
author_sort Tari, Daniele Ugo
collection PubMed
description 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.
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spelling pubmed-87004592021-12-24 Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management Tari, Daniele Ugo Morelli, Luigi Guida, Antonella Pinto, Fabio Diagnostics (Basel) Case Report 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. MDPI 2021-11-25 /pmc/articles/PMC8700459/ /pubmed/34943439 http://dx.doi.org/10.3390/diagnostics11122199 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Tari, Daniele Ugo
Morelli, Luigi
Guida, Antonella
Pinto, Fabio
Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management
title Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management
title_full Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management
title_fullStr Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management
title_full_unstemmed Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management
title_short Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management
title_sort male breast cancer review. a rare case of pure dcis: imaging protocol, radiomics and management
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700459/
https://www.ncbi.nlm.nih.gov/pubmed/34943439
http://dx.doi.org/10.3390/diagnostics11122199
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