A study on spectrum of male breast lesions an institutional perspective

Abstract

Background: Diseases of male breast though relatively uncommon compared to diseases of female breast, do occur, but poorly studied. These range from benign lesions to malignant diseases. Benign most commonly affect young males most common is gynecomastia. Male breast carcinoma accounts for small proportion usually present at an advanced stage. Understanding various male breast diseases is critical for timely and accurate diagnosis and management. Aims & Objectives: To study the spectrum of male breast diseases in relation to1.To determine the common types of male breast diseases in the study group2.To evaluate the age distribution of different diseases.3.To study the modes of presentation and clinical features.4.To evaluate management protocols of male breast disease.5.To note the response to treatment and complications arising during follow-up.6.To correlate clinical findings with FNAC and Histopathology.Patients & Methods: A prospective interventional study was carried out to observe spectrum of male breast lesions from 2017 to 2019 in the Department of General Surgery, Kakatiya Medical College, Mahatma Gandhi Memorial Hospital, Warangal, India. The total period of study was 24 months. Cases were selected from the OPD and from inpatients in the wards who presented with disorders of the breast. Proforma with relevant history, clinical examination and investigations was prepared and patients were assessed. total of 50 Male patients with breast diseases were included in the study. Type of study is Prospective study. Patients satisfying the following inclusion and exclusion criteria were enrolled in the study. All male patients with Breast Diseases between the ages of 14-75years. Who attended the OPD and those admitted in Department of General Surgery, MGM Hospital and who were willing to undergo investigations and treatment willing for follow up. Results: 50 cases of MBD were studied. Gynecomastia was the commonest 43 cases (86%), Carcinoma 2 cases (4%) is rare. In gynecomastia Swelling of the breast was the commonest presenting complaint. 2nd, 3rd, 4th decades most commonly involved. Idiopathic gynecomastia most common. 18 cases were treated conservatively and rest 25 underwent surgery. Carcinoma presented in old age, in advanced stage. Conclusion: Benign breast diseases are more common male breast lesions, of them gynecomastia is most common. Carcinoma male breast is rare. Gynecomastia and other benign male breast diseases are common in young age 2nd, 3rd, 4th decades, Carcinoma seen in old age from 5th decade. Common mode of presentation of Gynecomastia is painless swelling of breast; Carcinoma is lump with advanced features. Gynecomastia diagnosed on basis of history, clinical features, careful systemic examination, and baseline hormonal investigations and if required cytological investigations. Managed based on aetiology. Carcinoma investigated and treated similar to female breast cancer. Subcutaneous Mastectomy most commonly performed in Gynecomastia. MRM in carcinoma. Seroma most common postoperative complication. FNAC is an important Diagnostic tool most sensitive and specific Investigation in differentiating benign diseases from malignancy.