Spectrum of male breast lesions diagnosed by fine needle aspiration cytology: a 5-year experience at a tertiary care rural hospital in central India

Abstract

This study examines the spectrum of lesions in the male breast at a tertiary care rural hospital in central India and explores the role of Fine Needle Aspiration Cytology (FNAC) in the diagnosis of these lesions. Male breast lesions formed 5.89% (119 cases) of the 2017 breast lesions which were sent for FNA in the cytology section over a period of 5 years (January 2005-December 2009). Of these, biopsy had been performed only on 37 (31.1%) patients. Benign lesions comprised 102 (85.7%) cases, malignant lesions comprised 14 (11.8%) cases and inflammation/abscess was found in 3 (2.5%) cases. Gynecomastia was the commonest benign lesion in 86 (84.3%) cases. The cytologic features of gynecomastia included mild to moderate cellularity, cohesive sheets of bland cells, bipolar bare nuclei. Mild nuclear atypia was found in 19 cases. The cytologic features of malignancy comprised of dyshesive groups of ductular cells with moderate to severe degree of nuclear atypia and absence of bare nuclei. Histology was done in 37 cases and diagnostic accuracy of FNAC for gynecomastia was 100% and for malignancy 85.7%. This study showed that FNAC is a reliable tool for diagnosing male breast lesions. We conclude that FNAC should be performed as a standard procedure in the clinical evaluation of male breast masses. Many unnecessary surgical biopsies for histopathologic diagnosis can thus be avoided.