A man with a lump in his breast
A 65 year old man presented to a breast clinic
A 65 year old man presented with a mass behind his right nipple. He first noticed the mass two years before, and it had been getting larger since. It was not painful so he did not seek medical help, and it was first detected during an unrelated hospital admission. He had no family history of breast cancer. At age 12 he had surgery for an undescended testicle. Examination showed a hard, irregular mass behind the right areola and palpable axillary lymph nodes.
(1) What are the differential diagnoses for a breast lump in a man?
(2) Describe the lesion in fig 1.
(3) What are the radiological findings in figs 2 and 3?
(4) How should the lump be investigated further?
(1) The differential diagnoses are breast cancer, duct ectasia, gynaecomastia, lipoma, fat necrosis, and abscess. In view of the history and examination, breast cancer is the most likely.