Medical Radiology and Radiation Safety. 2018. Vol. 63. No. 4. P. 40-49


DOI: 10.12737/article_5b83b8dbe7e4e8.68739970

Differential Radiodiagnosis of Pseudogynecomastia, Gynecomastia and Breast Cancer in Men

N.S. Vorotyntseva1, I.P. Moshurov2, M.S. Ganzya3

1. Kursk State Medical University. Kursk, Russia; 2 .Voronezh State Medical University. Voronezh. Russia; 3 .Voronezh Regional Oncology Hospital. Voronezh, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

N.S. Vorotyntseva - Dr. Sci. Med., Prof., Head of Department; I.P. Moshurov - Dr. Sci. Med., Head of Department, Chief Medical Officer; M.S. Ganzya - Radiologist


Background: With the growth in the equipment clinics with modern diagnostic equipment is increasing the detectability of male breast pathology. In this connection there is a need to determine X-ray characteristics of some forms of the male breast pathology especially breast cancer, because in Russia it stills a problem of detecting male breast cancer at early stages.

Purpose: To determine the diagnostic capabilities of chest CT to detect various pathologies of the male breast and to identify the statistically significant radiological symptoms for the differential diagnosis of pseudogynecomastia, gynecomastia and breast cancer.

Material and methods: 150 chest CT of men who were screened and treated for the various diseases in the Voronezh Regional Clinical Diagnostic Center and Kursk Regional Clinical Hospital in 2013-2015. X-ray examinations (13 chest CT, 4 PET-CT and 16 mammography) of 31 male patients with breast cancer who were surgically treated at the Voronezh Regional Oncology Hospital in 2010-2016 are presented.

Results: The obtained data on the prevalence of pseudogynecomastia and gynecomastia in men who have no presenting complaints about changes in breast. Determined the forms of gynecomastia in this group of patients. Identified radiographic signs that allow a differential diagnosis between gynecomastia and breast cancer.

Conclusions: 1. Gynecomastia is a common pathology of the male breast diagnosed by chest CT, and was diagnosed in 68.7 % of patients, who have no presenting complaints about changes in breast. In 96.1 % of cases, gynecomastia had a dendritic form. Diffuse glandular and nodular were rare forms of the disease and were respectively 2.9 % and 1 % of all cases of this disease.

  1. Statistically significant signs of malignant character of breast masses in men were: a) the connection of the tumor with skin, areola or nipple in the form of «track» to them, thickening of the skin, «pulling» of the skin or nipple to neoplasm or their immediate invasion by tumor; b) tumor invasion into the pectoralis major muscle; c) presence of microcalcifications in neoplasm; d) presence of pathologically altered axillary lymph nodes. The determination of these radiological symptoms require immediate consultation of an oncologist.
  2. Statistically significant signs of the benign character of breast masses in men were: a) bilateral lesion and the symmetry of the changes in the breasts; b) adipose tissue inclusions in breast masses. When detection gynecomastia it needs the consultation of urologist, endocrinologist, oncologist.
  3. Awareness of physicians and radiologists on the possibility of developing breast cancer in men and the knowledge of the symptoms of this disease is crucial to detect male breast cancer at early stages and, as a consequence, more successful treatment and a favorable prognosis.

Key words: gynecomastia, male breast cancer, pseudogynecomastia, differential diagnostic, chest CT, men


  1. Moshurov IP, Vorotyntseva NS, Ganzya MS. The modern views of the diagnosis of male breast cancer. Bulletin of experimental and clinical surgery. 2016;9(4):289-95. DOI: 10.18499/2070-478X-2016-9-4-289-295. Russian.
  2. Tyshchenko EV, Pak DD, Rasskazova EA. Breast cancer in men. Onkologiya. P.A. Herzen Journal of Oncology. 2014;(1):19-23. Russian.
  3. Akimova VB, Akimov DV. Comparative analysis of ultrasound and X-ray mammography in men with breast pathology. Tumors of Female Reproductive System. 2015;(3):35-42. DOI: 10.17650/1994-4098-2015-1-35-42. Russian.
  4. Letyagin VP. Breast cancer in men. Journal of N. N. Blokhin Russian Cancer Research Center RAMS. 2000;11(4):58-62. Russian.
  5. Semiglazov VF, Semiglazov VV, Dashyan GA, Paltuev RM, Migmanova NS, Shchedrin DE, et al. Breast cancer in men. Pharmateka. 2010;(6):40-5. Russian.
  6. Lapid O, Jolink F, Maijer SL. Pathological findings in gynecomastia: analysis of 5113 breasts. Annals of Plastic Surgery. 2015;74(2):163-6. DOI: 10.1097/SAP.0b013e3182920aed.
  7. Glassman LM. Pathology of the Male Breast. [Cited 2009 March 15]. Available from:
  8. Akimov DV. Ultrasound in the complex diagnosis and assessment of treatment in patients with gynecomastia. Diss. PhD. Moscow; 2014. Russian.
  9. Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab. 2014;18(2):150-8. DOI: 10.4103/2230-8210.129104.
  10. Beltsevich DG, Vanushko VE, Kuznetsov NS, Kats LE. Gynecomastia. Endocrine Surgery. 2012;(1):18-23. Russian.
  11. Korzhenkova GP. Complex X-ray and sonographic diagnosis of breast diseases: a practical guide. Moscow: STROM; Kochergina NV, editor; 2004. Russian.
  12. Yashina YuN, Rozhivanov RW, Kurbatov DG. Modern view about the epidemiology, etiology and pathogenesis of gynecomastia. Andrology and Genital Surgery. 2014;(3):8-15. Russian.
  13. Novitskaya TA, Chuprov IN, Topuzov EE, Aristov RL, Kasyanova MN. Gynecomastia: clinical, morphological and molecular-biological characteristics. Med. Almanac. 2012;4(23):39-41. Russian.
  14. Andersen JA, Gram JB. Male breast at autopsy. Acta Pathologica, Microbiologica, Et Immunologica Scandinavica. Section A. 1982;3(90):191-7.
  15. Manusharova RA, Cherkezova EI. Gynecomastia (pathophysiology, clinical examination, diagnosis, treatment). Medical Council. 2008;(7-8):48-52. Russian.
  16. Bowman JD, Kim H, Bustamante JJ. Drug-Induced Gynecomastia. Pharmacotherapy. 2012;32:1123-40. DOI: 10.1002/phar.1138.
  17. Swerdloff RS. Gynecomastia: Etiology, Diagnosis, and Treatment. [cited 2015 Aug 3]. Available from:
  18. Anderson WF, Jatoi I, Tse J, Rosenberg PS. Male breast cancer: a population-based comparison with female breast cancer. J Clin Oncol. 2010;28:232-9. DOI: 10.1200/JCO.2009.23.8162.
  19. Cutuli B, Le-Nir CC, Serin D, Kirova Y, Gaci Z, Lemanski C. Male breast cancer: Evolution of treatment and prognostic factors-Analysis of 489 cases. Crit Rev Oncol Hematol. 2010;73(3):246-54. DOI: 10.1016/j.critrevonc.
  20. Giordano SH, Cohen DS, Buzdar AU, Perkins G, Hortobagyi GN. Breast carcinoma in men: a population-based study. Cancer. 2004;101(1):51-7. DOI: 10.1002/cncr.20312.
  21. Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet. 2006;367(9510):595-604. DOI: 10.1016/S0140-6736(06)68226-3.
  22. Giordano SH, Buzdar AU, Hortobagyi GN. Breast cancer in men. Ann Intern Med. 2002;137(8):678-87.
  23. Ternovoy SК, Abduraimov АB. Radiological mammology. Moscow: GEOTAR-Media; 2007. 128 p. Russian.
  24. Yamane H, Ochi N, Honda Y, Takigawa N. Gynecomastia as a Paraneoplastic Symptom of Choriocarcinoma. Intern Med. 2016;55(18):2739-40. DOI: 10.2169/internalmedicine.55.6878.
  25. Ostrovskaya IM, Ostrovtsev LD, Efimov OYu. Breast Cancer in Men. Moscow: Medicine; 1988. 144 p. Russian.
  26. Jones J. Gynecomastia. [cited 2017 June 12]. Available from:
  27. Pailoor K, Fernandes H, Cs J, Marla NJ, Keshava SM. Fine needle aspiration cytology of male breast lesions - a retrospective study over a six year period. J Clin Diagn Res. 2014;8(10):FC13-5. DOI: 10.7860/JCDR/2014/10708.4922.

For citation: Vorotyntseva NS, Moshurov IP, Ganzya MS. Differential Radiodiagnosis of Pseudogynecomastia, Gynecomastia and Breast Cancer in Men. Medical Radiology and Radiation Safety. 2018;63(4):40-9. Russian. DOI: 10.12737/article_5b83b8dbe7e4e8.68739970

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