Ultrasonographic characteristics of BI-RADS category 4 breast lesions in males.

Abstract

Aim: To evaluate the ultrasonographic features of male breast nodules classified as Breast Imaging Reporting and Data System category 4.

Material and methods: A retrospective analysis of 79 breast nodules from 77 male patients, classified as Breast Imaging Reporting and Data System category 4 after ultrasonography, was conducted. The ultrasonographic features of benign and malignant nodules were evaluated and compared. Independent risk factors for malignancy were identified by logistic regression analysis. In addition, we conducted a subgroup analysis comparing the ultrasonographic features of gynecomastia and malignant nodules in male breasts.

Results: Differences were found in age of onset, calcifications, aspect ratio greater than 1/2, Adler grading of blood flow, and axillary lymph nodes. The presence of calcifications was an independent risk factor for malignancy in males. The results of the comparison between gynecomastia and breast cancer were essentially consistent with the former. However, the differences in calcifications were not as significant as those observed in the former.

Conclusions: We identified differences in age of onset, calcification, aspect ratio greater than 1/2, blood flow, and axillary lymph nodes between benign and malignant male breast nodules classified as Breast Imaging Reporting and Data System category 4, with calcification being an independent risk factor for malignancy. These features can help determine the nature of the nodules and guide biopsy decisions.