Benign breast diseases in men beyond gynecomastia

Introduction: Benign breast diseases in men, other than gynecomastia, are poorly understood due to their low prevalence.This study describes the clinical characteristics, mammographic and ultrasound (US) findings, and the histology of benign breast lesions in Mexican men.Material and methods: Men over 18 years of age with benign breast lesions, with or without gynecomastia, were included.The reason for consultation and associated clinical abnormalities were described.Mammography and/or US were performed and reported according to Breast Imaging Reporting and Data System (BI-RADS) categories.The histopathology diagnosis was reported.Results: Twenty-eight men with a mean age of 44.6 ± 18.2 years were included.A palpable lump was the main reason for consultation (n = 22, 78.6%).Oval or irregular masses without calcifications predominated on mammography.US findings commonly showed solid, oval, circumscribed, hypoechoic masses with absent or peripheral vascularity.BI-RADS categories 2 (n = 10, 35.7%) and 4A (n = 9, 32.1%) were the most common, followed by 4B (n = 3, 10.7%), 3 (n = 3, 10.7%), and 1 (n = 2, 7.2%), with only one case (3.6%) in category 5. Predominantly diffuse gynecomastia (71.4%) was found in 20 men.Mastitis was the most common histopathology diagnosis (n = 8, 28.6%), followed by epidermoid cyst, pseudoangiomatous stromal hyperplasia, ductal ectasia, myofibroblast, dermoid cyst, hemangioma and cyst, leiomyoma, inclusion cyst, and pilomatrixoma.Conclusion: Benign breast diseases in men, other than gynecomastia, showed imaging findings suspicious for malignancy, with more than 50% classified as BI-RADS categories 3, 4, or 5. Histopathology revealed a wide range of benign diagnoses.This case series is the largest report of Mexican men with benign breast lesions beyond gynecomastia.