A mammogram is an X-ray imaging technique used to examine breast tissue, and yes, a man can get a mammogram. This procedure is a necessary part of the diagnostic process when a male patient presents with a suspicious symptom or known risk factors. Unlike the routine screening mammograms performed for women, the male mammogram is almost always a diagnostic tool used to investigate a specific concern. It provides detailed pictures of the internal breast structures, helping providers determine if a palpable lump or other change is benign or requires further intervention.
Understanding Male Breast Tissue and Conditions
Men possess breast tissue, which consists primarily of fat and a small amount of undeveloped ductal tissue located just behind the nipple. The presence of this ductal tissue is why men, though rarely, can develop breast cancer, as most breast cancers originate in these ducts. A condition called gynecomastia is the most common reason a man might seek breast imaging, as it involves the non-cancerous enlargement of the glandular tissue.
Gynecomastia typically presents as a soft, mobile mass situated directly beneath the nipple and is often a result of a hormone imbalance. While most breast lumps in men are benign, other non-cancerous findings can include fluid-filled cysts or lipomas, which are collections of fatty tissue. Distinguishing these harmless conditions from a potentially malignant tumor is the primary function of diagnostic imaging.
When a Mammogram is Medically Necessary
A mammogram is usually triggered by a clinical symptom or a significant risk factor, as it is not a standard screening tool for men. The most frequent warning sign is a palpable mass or lump, especially one that feels firm, fixed to the chest wall, or is not directly under the nipple. Changes to the nipple are also significant indicators, including retraction or any unusual discharge, particularly if it is bloody or clear.
Additional signs that mandate imaging include skin changes on the breast, such as dimpling, scaling, or redness, or the presence of enlarged lymph nodes in the armpit. For men without symptoms, a mammogram may be recommended if they fall into a high-risk group, such as those with a strong family history of breast cancer or a known genetic mutation like BRCA1 or BRCA2. Other risk factors include a history of radiation exposure to the chest or certain medical conditions that affect hormone levels, such as Klinefelter Syndrome.
The Male Mammography Procedure and Experience
The technical process for a male mammogram utilizes the same specialized X-ray equipment used for women. The procedure involves the compression of the breast tissue between two plates to flatten it, which is necessary to spread the tissue for a clear image and minimize the radiation dose. The technologist will typically take two standard views: the craniocaudal (CC) view, which compresses the tissue from top to bottom, and the mediolateral oblique (MLO) view, which compresses it from the side.
Because men have less tissue volume, the compression can sometimes be uncomfortable or awkward, though it is usually not described as painful. Since this is a diagnostic procedure, the radiologist is often present to review the images immediately for any abnormality. If the mammogram shows tissue that is unusually dense or if an area of concern is found, the technologist will often follow up immediately with a breast ultrasound. This supplementary imaging is useful for differentiating a solid mass from a fluid-filled cyst.
What the Radiologist is Looking For
The radiologist examines the mammogram images to differentiate benign conditions from features that are suspicious for cancer. Gynecomastia usually appears as a flame-shaped or triangular density located symmetrically behind the nipple, with margins that gradually blend into the surrounding fatty tissue. These findings are considered low risk and do not require a biopsy.
In contrast, signs suspicious for malignancy include masses with irregular or spiculated margins, meaning the edges appear jagged or star-like. The radiologist also looks closely for microcalcifications, which are tiny calcium deposits that, when clustered in an irregular or linear pattern, can be a sign of cancer. If the imaging reveals a mass with these concerning features, or if a benign-appearing mass is growing quickly, the next step is typically a recommendation for a tissue biopsy to confirm the exact nature of the finding.