© Borgis - New Medicine 2/2014, s. 52-54
*Konrad Wroński1, 2
Male breast cancer – case report and review of literature
1Department of Oncology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
Head of Department: prof. Sergiusz Nawrocki, MD, PhD
2Department of Surgical Oncology, Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre, Olsztyn, Poland
Head of Department: Andrzej Lachowski, MD
Male breast cancer is rare malignant neoplasm. It accounts less than 1% of all types of cancer in male. The American Cancer Society calculate that the annual incidence rate of male breast cancer is 1.09 per 100.000 men compared with 68.73 per 100.000 women in the United States. Due to its low incidence and a limited number of men with breast cancer there have been no prospective randomized clinical trials and no clinical management target for male breast cancer.
In the following article the author described a case of a man who reported to the hospital because of male breast cancer. The patient underwent surgery and in the third day after operation left the ward. The author of this article has reviewed the literature on male breast cancer.
Male breast cancer is rare malignant neoplasm. It accounts less than 1% of all types of cancer in male (1). The American Cancer Society calculate that the annual incidence rate of male breast cancer is 1.09 per 100.000 men compared with 68.73 per 100.000 women in the United States (2). Due to its low incidence and a limited number of men with breast cancer there have been no prospective randomized clinical trials and no clinical management target for male breast cancer.
A 57-year-old man, Caucasian race, was admitted to the Department of Surgical Oncology because of diagnosed breast male cancer. The patient suffer from hypertension which was effective treatment and under GP’s control. He had no history of alcohol consumption and he was no smoker. There was no familial history of breast cancer in patient’s family.
Blood examination tests were normal. On palpable examination of the left breast there was palpable tumor located in the subareolar region which diameter was about 3 cm. In the left axilla there were felt a few hard enlarged lymph nodes. The histopathological examination of the fine-needle aspiration biopsy of the tumor and lymph nodes showed cancer cells.
The patient was qualified for surgery. Taken surgery involving amputation of the left breast with neoplasm tumor and left axillary lymph nodes dissection in one block (fig. 1-5). The material was sent for routine histopathological examination (fig. 6). The time of surgery was about 110 minutes.
Fig. 1. Breast male cancer – photo taken during surgery.
Fig. 2. Cutting lines during surgery.
Fig. 3. Photo shows mastectomy due to breast male carcinoma.
Fig. 4. Photo shows the state after mastectomy and axillary lymph nodes dissection.
Fig. 5. The scar after left mastectomy with axillary lymph node dissection due to breast male cancer.
Fig. 6. Photo of the left breast with tumor and left axillary lymph nodes after dissection in one block.
Histopatological examination of postoperative material revealed: invasive ductal breast carcinoma G2, pT3 and 25 metastases in axillary lymph nodes. The stage of breast cancer according to pTNM classification was grade III c (pT2N3M0). Estrogen receptor positivity rate was 60% and progesteron positivity rate was 5%. HER2 was 0 and Ki-67 positivity rate was 40%.
Patient after surgery felt good and did not complain of pain. The postoperative period was uncomplicated and the patient left the ward in the third day after operation. The patient underwent chemotherapy and he is in the care of outpatient surgical oncology and clinical oncology.
The incidence of male breast cancer is still increase, but the reasons of this neoplasm is still unknown. Breast male cancer is observed often than normal in African, African-American and Ashkenazi Jewish population (3). In Sub-Africa region, breast male cancer is observed from 7% to 14% of all breast cancers (3). In whole male population, breast male cancer cases are less than 1% of all breast cancers (1). In population of Ashkenazi Jewish, the increased risk is due to a high incidence of BRCA1 and BRCA2 mutations (4).
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