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    • #36176
      Lee Ju Hee

      Hello, Mr. Birdie. Thank you for the uploads.
      I have always thought an appearance of hypoechoic tree roots behind a nipple is consistent with gynaecomastia; as you said in Q&A section.

      What if you see hyperechoic glandular tissues in the retro areola regions in males, would you still consider it gynaecomastia?

    • #36200
      Stephen Bird

      Yes indeed I would also consider this to be gynaecomastia,

      It just depends on what stage / severity the process is at.

      In the early stages you get the tree root hypo echoic changes and as it becomes more severe the echogenic glandular tissue appears.

      I am recording a part 2 of the breast webinar which will deal with the male breast and other topics like implants etc.

      I hope you will enjoy it when it becomes available.

      Happy Easter,


    • #36204
      Stephen Bird

      There is a grading system called the Tanner System.

      It is a 5 step system,

      I don’t see many radiologists reporting using the system, but it does exist.

      Tanner I
      (Preadolescent) No breast tissue
      Ill-defined hyperechoic retroareolar tissue

      Tanner Il
      Areolar enlargement with palpable retroareolar bud
      Hyperechoic retroareolar nodule with a central scar-shaped or linear
      hypoechoic area

      Tanner IlI
      Enlargement and elevation of the entire breast
      Hyperechoic glandular tissue is seen extending away from the retroareolar
      area and a central spider shaped hypochoic region is noted

      Tanner IV
      Projection of the nipple and areola above the breast
      Hyperechoic, mostly periareolar, fibroglandular tissue is seen, showing a
      prominent hypoechoic nodule in the central region

      Tanner V
      Regression of the areola to form a smooth contour with
      the rest of the breast tissue
      Hyperechoic glandular tissue is found, with increased subcutaneous
      adipose tissue anteriorly and without the hypoechoic central nodule seen
      in Tanner stages II, Ill and IV


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