0:00

So our first patient is a 65-year-old man

0:02

with pain and a palpable lump behind

0:05

the left nipple for a few months.

0:08

So we can see here that we ended up being

0:11

able to get a fair amount of tissue on

0:13

the MLO views bilaterally, and actually

0:16

very little tissue on the CC views.

0:19

And the other thing to notice is that

0:21

there's a fair amount of tissue centered

0:25

under the nipple in the left breast.

0:26

And maybe a little bit on the right.

0:30

Gynecomastia is often bilateral but asymmetric.

0:36

So that's an important thing to look for.

0:38

But, um, the area that the patient can feel on the

0:41

left is probably related to this breast tissue.

0:45

And this is consistent with gynecomastia.

0:48

So for this patient, we did tomosynthesis imaging.

0:54

So we can look through those images.

0:58

And his nipple was marked with a BB, but you can

1:02

see that there's, um, this tissue, uh, behind the

1:05

nipple, and it is consistent with gynecomastia.

1:10

So the opposite breast, just looking through

1:15

that one, this nipple is marked here,

1:17

there's some fatty tissue, there's really

1:20

not any significant breast tissue there,

1:25

a few little lymph nodes here and there.

1:27

So, we also looked at his,

1:29

uh, tissue with ultrasound.

1:31

This is the left breast.

1:33

You can see this hypoechoic tissue kind of

1:35

extending out into the surrounding tissue.

1:39

It's pretty vascular.

1:41

Here it is kind of going out into the tissue.

1:46

And then on the right side,

1:48

we're really just seeing fatty tissue

1:49

going all the way up to the nipple.

1:52

Here's his nipple.

1:54

There's not much there.

1:55

So, this would be unilateral left gynecomastia.

65-year-old man with pain and palpable lump behind the left nipple for a few months

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0:00

So our first patient is a 65-year-old man

0:02

with pain and a palpable lump behind

0:05

the left nipple for a few months.

0:08

So we can see here that we ended up being

0:11

able to get a fair amount of tissue on

0:13

the MLO views bilaterally, and actually

0:16

very little tissue on the CC views.

0:19

And the other thing to notice is that

0:21

there's a fair amount of tissue centered

0:25

under the nipple in the left breast.

0:26

And maybe a little bit on the right.

0:30

Gynecomastia is often bilateral but asymmetric.

0:36

So that's an important thing to look for.

0:38

But, um, the area that the patient can feel on the

0:41

left is probably related to this breast tissue.

0:45

And this is consistent with gynecomastia.

0:48

So for this patient, we did tomosynthesis imaging.

0:54

So we can look through those images.

0:58

And his nipple was marked with a BB, but you can

1:02

see that there's, um, this tissue, uh, behind the

1:05

nipple, and it is consistent with gynecomastia.

1:10

So the opposite breast, just looking through

1:15

that one, this nipple is marked here,

1:17

there's some fatty tissue, there's really

1:20

not any significant breast tissue there,

1:25

a few little lymph nodes here and there.

1:27

So, we also looked at his,

1:29

uh, tissue with ultrasound.

1:31

This is the left breast.

1:33

You can see this hypoechoic tissue kind of

1:35

extending out into the surrounding tissue.

1:39

It's pretty vascular.

1:41

Here it is kind of going out into the tissue.

1:46

And then on the right side,

1:48

we're really just seeing fatty tissue

1:49

going all the way up to the nipple.

1:52

Here's his nipple.

1:54

There's not much there.

1:55

So, this would be unilateral left gynecomastia.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Lesson

Sample Lesson

Lesson

Palpable Lumps

Lesson

Breast Pain

Lesson

Nipple Discharge

Lesson

Skin Changes/Inflammation

Lesson

Recall from Screening

Lesson

Surveillance After Breast Cancer Treatment

Lesson

Follow Up Probably Benign Findings - BI-RADS 3

Lesson

Follow up Benign Biopsy

Lesson

Pregnant and Lactating Women

Lesson

Male Patients

65-year-old man with pain and palpable lump behind the left nipple for a few months