Breast MRI is uncommon when treating male patients, but can still provide value

Radiologists rarely turn to breast MRI when treating male patients, but according to a new study published in Current Problems in Diagnostic Radiology, it can be effective in certain scenarios.

The authors noted breast MRI is “infrequently performed” when treating male patients. “This, however, is not due to underusage of breast MRI in male patients, but rather because MRI is not necessary most cases in male patients,” wrote lead author Kyungmin Shin, MD, of the department of diagnostic radiology at the University of Texas MD Anderson Cancer Center in Houston, and colleagues. “As a result, the literature on usage of breast MRI in male patients is quite limited. Even though contrast enhanced breast MRI is not indicated in most male breast cancer patients, there are instances in which breast MRI helped our clinicians and surgeons for better management of the patients at our institution

For instance, Shin et al. noted breast MRI helps evaluate “the posterior extent of disease for possible chest wall involvement in male patients as well as female.” Ultrasound images may not be efficient enough in some cases due to acoustic shadowing or incomplete imaging.

The authors listed other examples as well.

“MRI can also be used in evaluation for possible primary breast mass in setting if clinical diagnosis of inflammatory breast cancer and evaluation for potential skin involvement in a known malignancy when clinically suspicious,” the authors wrote. “Similar to one of the indications of breast MRI for female patients, MRI can also be used in male patients for evaluation for residual disease postsurgery. It is important to note that it is essential to perform the MRI immediately after the surgery before the formation of granulation tissue, which could make interpretation difficult.”

Breast MRI may also be used for some male patients after surgery in conjunction with mammography and ultrasound. This is fairly rare, however, since “serial clinical follow-up would suffice” in most cases. On a similar note, breast MRI may be an option if evaluating a primary breast mass in a patient with a history of axillary metastasis or mass after negative mammography and ultrasound.