Male breast atypical ductal hyperplasia (ADH): clinicopathological insights from a rare cohort

IF 3.9 2区医学 Q2 CELL BIOLOGY

Histopathology Pub Date : 2025-01-31 DOI:10.1111/his.15419

Reham Al-Refai, Amr Ali, Sudarshana Roychoudhury, Ahmed Bendari, Sunder Sham, Diana Kantarovich, Iskender Genco, Shabnam Jaffer, Sabina Hajiyeva

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引用次数: 0

Abstract

Aims

Atypical ductal hyperplasia (ADH) in male breast tissue is a rare condition with limited understanding. We aimed to elucidate the clinicopathological characteristics of ADH in male patients, focusing on its prevalence, presentation, and associated factors.

Methods and Results

We analysed 40 cases of ADH from 1626 male breast cases encountered between 2013 and 2023. Clinicopathological data were reviewed to identify key features and trends. The mean age of the patients in our cohort was 43 years. ADH was mainly discovered incidentally during the workup for gynecomastia in 85% (34/40) of cases. Only two cases, 5% (2/40), initially presented as a palpable mass; one was pure ADH and the other one an ADH with intraductal papilloma (IDP). Nipple discharge was the initial presentation in 7.5% (3/40) of cases, all of which were associated with IDP. Additionally, 5% (2/40) of cases were identified due to calcifications on imaging. Excision was the initial diagnostic procedure in 77.5% (31/40) of cases, and core needle biopsy (CNB) in 22.5% (9/40). In most patients 70% (28/40) had unilateral disease, while 84.4% (27/32) exhibited multifocal lesions, and 90.6% (29/32) showed cribriform architectural patterns. Notably, 77.3% (17/22) of patients had a history of medications linked to gynecomastia. During follow-up (9 months to 26 years), two patients developed ductal carcinoma in situ (DCIS).

Conclusion

ADH in male patients primarily presents incidentally alongside gynecomastia. Multifocality and cribriform patterns are common histological features. The association with medication-induced gynecomastia and the potential progression to DCIS highlight the clinical significance of ADH in males.

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查看原文本刊更多论文

男性乳腺非典型导管增生（ADH）：一个罕见队列的临床病理见解。

目的：不典型乳腺导管增生（ADH）在男性乳腺组织是一种罕见的条件，了解有限。我们的目的是阐明男性ADH患者的临床病理特征，重点是其患病率，表现和相关因素。方法与结果：对2013 - 2023年间1626例男性乳腺ADH患者中的40例进行分析。临床病理资料进行审查，以确定关键特征和趋势。我们队列中患者的平均年龄为43岁。ADH主要是在85%（34/40）的男性乳房发育症检查中偶然发现的。只有2例，5%(2/40)，最初表现为可触及的肿块；一例为单纯ADH，一例为ADH合并导管内乳头状瘤（IDP）。乳头溢液是7.5%（3/40）病例的最初表现，所有这些病例都与IDP有关。此外，5%（2/40）的病例是由于影像学上的钙化而确诊的。77.5%（31/40）的病例采用手术切除作为初始诊断手段，22.5%（9/40）的病例采用核心穿刺活检（CNB）。大多数患者中70%（28/40）为单侧病变，84.4%（27/32）为多灶性病变，90.6%（29/32）为筛状结构。值得注意的是，77.3%（17/22）的患者有与男性乳房发育相关的药物史。在随访期间（9个月至26年），2例患者发生导管原位癌（DCIS）。结论：男性ADH主要伴随男性乳房发育而出现。多灶性和筛网型是常见的组织学特征。与药物诱导的男性乳房发育和DCIS的潜在进展的关系突出了ADH在男性中的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Histopathology 医学-病理学

CiteScore

10.20

自引率

4.70%

发文量

239

审稿时长

1 months

期刊介绍： Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.