Mammograms More Effective in Men than Women in Detecting Breast Cancer

A recent study by the NYU School of Medicine and NYU Langone’s Perlmutter Cancer Center found that men at high risk of developing breast cancer may benefit from mammography, or a breast X-ray, screening for the disease. According to the study authors, the trial is the largest review in the United States of the medical records of men who have had a screening mammogram.

In the study, published in Radiology, data were examined from approximately 1869 men aged 18 to 96 years who had a mammogram at NYU Langone between 2005 and 2017. These 1869 men underwent 2052 examinations, which showed 2304 breast lesions. There were 149 biopsies, of which 41 were malignant and 108 were benign. There were 1781 diagnostic and 271 screening examinations. All men who underwent screening had a personal or family history of breast cancer and/or genetic mutations. Among the 271 men who had screening exams, 5 had the disease.

The study found that mammography was more effective at detecting cancer in men with high risk than is the norm for women with an average risk of breast cancer and in detecting the disease before it has spread to other parts of the body. Furthermore, men who had already had breast cancer were 84 times more likely for the disease to develop than men with no personal history of the disease. Men with an immediate relative who had breast cancer, such as a sister or mother, were 3 times more likely to develop the disease.

Current National Comprehensive Cancer Network Guidelines only recommend checking for breast cancer as part of annual physical exams, not using more sensitive imaging test such as a mammogram, for men age 35 and older with BRCA mutations.

Many men in the analysis sought testing due to concerns about a breast mass; however, the study raised concerns that a lack of targeted screening in those at high risk and the tendency to wait to feel a lump before seeking care may explain why men have a higher mortality risk than women, even though the disease is more common in women, according to the study.

The study authors explained that more research is needed to determine at what age and how often mammograms should be performed in men at high risk.

Reference

• Breast Cancer Screening Found Effective in Men at High Risk for the Disease [press release]. NYU Langone Health website. Published September 17, 2019. https://nyulangone.org/news/breast-cancer-screening-found-effective-men-high-risk-disease. Accessed September 19, 2019.
• Gao Y, Goldberg J, Young T, Babb J, et al. Breast Cancer Screening in High-Risk Men: A 12-Year Longitudinal Observational Study of Male Breast Imaging Utilization and Outcomes. RSNA. Radiology. Published September 17, 2019. Accessed September 19, 2019.