Which imaging modalities are recommended for the diagnosis of male breast cancer in primary care?

In primary care, the recommended imaging modalities for diagnosing male breast cancer begin with clinical assessment followed by targeted imaging. Ultrasound is typically the first-line imaging modality used to evaluate palpable breast masses in men, as it effectively differentiates benign from suspicious lesions and guides further management. Mammography is also recommended to assess suspicious findings or when ultrasound results are inconclusive, providing detailed imaging of breast tissue and calcifications. If initial imaging is inconclusive or if there is a high suspicion of malignancy, referral for specialist assessment including breast magnetic resonance imaging (MRI) may be considered to further characterise lesions and assess local extent. Ultrasound-guided needle biopsy is advised if abnormal lymph nodes or suspicious lesions are identified during imaging to obtain histological diagnosis. This approach aligns with the general breast cancer diagnostic pathway, adapted for male patients, as male breast cancer is rare and often presents similarly to female breast cancer but requires careful imaging evaluation to confirm diagnosis and plan treatment NICE CG164,NICE NG101Chau et al. 2016.