Unilateral nipple discharge in a man without a palpable mass diagnosed as breast cancer

2020 ◽  
Vol 13 (11) ◽  
pp. e236223
Author(s):  
Karan N Ramakrishna ◽  
Justin Durland ◽  
Christopher Ramos ◽  
Amit Singh Dhamoon
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Early Recognition ◽  
Nipple Discharge ◽  
Care Physician ◽  
Male Breast ◽  
Laboratory Findings ◽  
Palpable Mass ◽  
History Of

A 69-year-old man without a family history of breast cancer presented to his primary care physician with a 1-year history of clear, unilateral nipple discharge (ND) without an associated palpable breast mass. His laboratory findings were significant for hyperprolactinaemia at 28 ng/mL. Diagnostic work up including mammography, ultrasound and core needle biopsy ultimately revealed a ductal carcinoma in situ and a rare papillary variant of invasive ductal carcinoma. The patient was referred to a multidisciplinary oncology team and underwent a right total mastectomy followed by adjuvant hormonal therapy. The patient made a good postoperative recovery and remains without evidence of recurrence 6 months from surgery. Male breast cancer is rare, but its incidence is increasing. Male breast cancer presenting as ND without a palpable mass is uncommon. Early recognition of breast symptoms in men can lead to earlier diagnoses and improved outcomes.

Retrospective analysis on patients with male breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19681-19681
Author(s):  
A. M. Alvarez ◽  
M. N. Gandur Quiroga ◽  
G. Cinat ◽  
J. Iturbe ◽  
T. Said Nissi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Radical Mastectomy ◽  
Male Breast ◽  
History Of ◽  
The Media ◽  
Histological Characteristics ◽  
Breast Lumps

19681 Background: Male breast cancer is uncommon, 1%(0.7 %)of all breast cancer. Nevertheless, the incidence has climbed 26% over the past 25 years. Objetive: Analyze the form of presentation and clinical evolution of patients with male breast cancer studied from 1977 to 2005. Methods: From 1977 to 2005 53 charts were analyzed: age, clinical presentation, stage (st), histological characteristics and nodal involvement. Results: Age: 33 years to 83 years (median= 59 years). Mean durations of symptoms before presentations: 11 months (m) (range 1 - 84 m.) . Forty-six (86.7%) patients (pts) had history of breast lumps, 9 (17%) were painful. Skin involvement and ulceration were present in 5 (9.43%) and 4 (7.54 %) respectively. One case of bilateralism was found. Seven (13.2%) st. I; 18 (33.96%) st. II; 20 (37.73%) st. III and 7 (13.2%) st. IV. Radical mastectomy was done in 41 pts (77.35%). Invasive ductal carcinoma was the most common histological type in 45 (84.9%). One case of lobular carcinoma was found. 60.4% of tumours expressed hormonal receptor. Adyuvant treatment: Adriamycin-based chemotherapy in 20 pts and CMF in 8 pts. Hormonotherapy was offered in 10 (19%) pts of the previous group, radiotherapy to 12 pts. twenthy pts (37.73%) presented recurrence; most common was bone in 10. The st. I and II estimated 5-year survival rate was 68% IC 95% (44–84%), st. III was 44% IC 95% (23 - 67%), st. IV (median = 24 m) with range (16 - 56 m). The 72% IC 95% (48–88%) patients st. I and II was free of disease at the 5-years, st. III was free 24% IC 95% (9–49%), st. IV (median = 7,5 m) with range (7–14 m). Conclusions: The media age at diagnosis was 59 years (10 years less than the international bibliography). (IB). Our group had longer time to presentation: 11 vs. 6 m., (IB) and most of them where in st. III. Hormonal receptore were positive in 60%. No significant financial relationships to disclose.

Male breast cancer: An institution’s 25-year experience.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 247-247
Author(s):  
J. S. Scow ◽  
A. C. Degnim ◽  
J. W. Jakub ◽  
S. Shah ◽  
R. E. Jimenez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Male Breast ◽  
Axillary Staging ◽  
Lymph Node Status ◽  
Adjuvant Radiation ◽  
Cancer Specific Survival ◽  
Palpable Mass ◽  
Tnm System

247 Background: There are no prospective and few large retrospective studies of male breast cancer (MBC). This study’s aim was to describe our institutional experience with MBC and evaluate the ability of the AJCC staging system to stratify survival. Methods: All MBC cases were identified from our institution’s cancer registry from 1984-2008. Data collected included tumor characteristics, lymph node status, treatment, age, and survival. Results: During the study period 166 MBC cases were identified. Median age at diagnosis was 62 years (range 27-87). Most common presentation was a palpable breast mass (77%). Stage at diagnosis was stage 0 (6%), stage 1 (27%), stage 2 (36%), stage 3 (17%), stage 4 (5%), and unknown (9%). Procedure performed was mastectomy in 148 patients (89%), lumpectomy in 10 patients (6%) and unknown in 8 patients (5%). Median tumor size was 2.0 cm (range 0.2-11.0 cm). Most common histology was invasive ductal carcinoma (91%). Estrogen and progesterone receptor status assessed at diagnosis was positive in 93% and 86% of cases tested respectively. HER2/neu status was positive in 6 of 47 cases tested (13%). Nodal staging was performed by axillary dissection (AD) (70%), sentinel node biopsy (SN) alone (11%), SN and AD (11%) and no axillary staging (8%); 43% were node positive, 47% node negative and 10% unknown. Adjuvant chemotherapy was given to 40 patients (24%), adjuvant hormonal therapy to 42 patients (25%) and adjuvant radiation therapy was used in 33 cases (20%). With a median follow-up of 5.5 years, 86 patients (52%) have died: 44 due to breast cancer, 23 due to causes unrelated to breast cancer, and in 19 the cause of death is unknown. Median overall survival was 9.3 years. Median cancer-specific survival was 16.0 years. For patients initially diagnosed at stage 2, 3, and 4 median cancer-specific survival was 12.9, 7.2, and 0.8 years respectively. Median cancer-specific survival was significantly different for stages 2 vs. 3 (p = 0.03) and 3 vs. 4 (p = 0.0006). Conclusions: MBC most commonly presents as a palpable mass, is hormone responsive, and is most commonly treated with mastectomy. The TNM system appropriately stratifies men with MBC by duration of survival.

scholarly journals A spontaneous unveiling of bilateral DCIS in an elderly male

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Tessa Meyer ◽  
Patrick Borgen ◽  
Kristen Rojas
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Incidence Rates ◽  
Male Breast ◽  
Elderly Male ◽  
Brca Mutations ◽  
Cancer Risk Factors ◽  
Bloody Nipple Discharge

Abstract The rarity of male breast cancer continues to limit its study despite increasing incidence rates, particularly within the past decade [Speirs V, Shaaban AM. The rising incidence of male breast cancer. Breast Cancer Res Treat 2009;115:429–30]. Although this trend appears to be substantially documented, male patients with breast cancer have been and continue to be excluded from landmark breast cancer trials. Currently, there are no standardized breast cancer screening protocols in place for men, including those with pathogenic BRCA mutations. As a result, men with breast cancer typically present at a later stage, and on average, 8–10 years later than females [Ruddy KJ, Winer EP. Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship. Ann Oncol 2013;24:1434–43]. As the incidence of disease continues to rise, the need for algorithmic standardization with regards to screening, diagnosing, treating and managing male breast cancer has become imperative. We report the case of a 71-year-old male who presented with spontaneous bloody nipple discharge and was found to have bilateral ductal carcinoma in situ.

Male breast cancer retrospective institution review of a 17-year period

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11638-e11638
Author(s):  
C. Rodriguez Franco ◽  
D. Aguiar Bujanda ◽  
S. Saura Grau ◽  
U. Bohn Sarmiento ◽  
J. Aguiar Morales
Keyword(s):  
Breast Cancer ◽  
Cancer Progression ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Bilateral Breast Cancer ◽  
Radical Mastectomy ◽  
Male Breast ◽  
Good Survival ◽  
Histologic Subtype ◽  
History Of

e11638 Background: Male breast cancer (MBC) is a very uncommon illness relative to female breast cancer (FBC) The are some differences between both that could influence the management, like gene expression, hormonal enviroment and anatomy of the gland. Methods: Retrospective review of patients diagnosed in a seventeen year period (1990–2007). Results: There were 22 male patients diagnosed in our institution with a median age of 62.4 years (range 34 to 83 years) during the period. One had bilateral breast cancer. Stage of disease was I-II in 13 patients (59%), III in 8 patients (36%), and IV in 1 patient (5%). Five patients (22.7%) had familiar history of breast cancer and 3 patients (13%) had familiar history of other kind of neoplasias. Hormonal receptor were positive in thirteen patiens (59%) and 5 were unknown (23%). Ductal carcinoma was the predominant histologic subtype with 17 patients (77%). Other types were pleomorfic, mucoid and papilar carcinoma (one each type) and 3 patients with intrapapilar carcinoma with microinfiltration. Eleven of 20 patologic available axilla had node positive (55%). Grade were I in 3 patients (13%), II in 4 patients (18%), III in 8 (37%) and undefined in in 7 (32%). Surgery was the initial treatment in 18 patients (81%), just 2 of them performing tumorectomy and the other 16 radical mastectomy. 3 patients receive neoadyuvant chemotherapy with 1 complete response and one partial response. 13 patients (59%) received adjuvant radiotherapy (RT) and 17 (77%) adjuvant hormonal therapy (HT) mostly of them with tamoxifen (14/17) and the others 3 patients with aromatase inhibitors. Adjuvant chemotherapy was used in 9 (41%) patients with an antracycline regimen. With a median follow-up of 78 months (range 7–125), overall survival was 77 % with 3 patients died with progression disease and two patients died because of intercurrent illness without evidence of cancer progression. Regarding to our population area we had an incidence of 0.96/100.000 inhabitants during this 17 year period. Conclusions: MBC in our area are in the upper limit of occidental countries incidence. Most cases can be treated with radical intention with surgery (mostly radical) and adjuvant treatment with a good survival percentage. We manage MBC like we do FBC because of absence of clinical randomized trial specific for MBC. No significant financial relationships to disclose.

scholarly journals Male Breast Cancer Presenting as Nipple Discharge

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
A. Farooq ◽  
K. Horgan
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Early Diagnosis ◽  
Male Breast Cancer ◽  
Nipple Discharge ◽  
Male Breast ◽  
Palpable Mass ◽  
Delay In Diagnosis ◽  
Underlying Malignancy ◽  
Rare Symptom

Male breast cancer (MBC) is a rare disease and constitutes less than 1% of all breast carcinoma cases. Although MBC most often presents with a palpable mass, failure to recognise the significance of other symptoms may lead to a delay in diagnosis. Nipple discharge (ND) is a rare symptom in men, but it may herald an underlying malignancy. We present two cases of (MBC) presenting with ND and emphasise the importance of this clinical sign in suspecting underlying malignancy and an opportunity for early diagnosis. We also discuss the clinical significance of ND in men in relation to current literature.

scholarly journals Male Breast Cancer: Surgical and Genetic Features and a Multidisciplinary Management Strategy

Breast Care ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Francesca Pellini ◽  
Eleonora Granuzzo ◽  
Silvia Urbani ◽  
Sara Mirandola ◽  
Marina Caldana ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
High Risk ◽  
Male Breast Cancer ◽  
Brca2 Mutation ◽  
Positive Family History ◽  
Male Breast ◽  
Mutation Carriers ◽  
History Of ◽  
Clinical Records

Background: Male breast cancer (MBC) is a rare disease with a rising incidence trend. The major risk factors related to MBC are a positive family history of breast cancer (BC) and BRCA1/2 mutations, which indicate a relevant genetic role. Methods: In this retrospective series, we enrolled 69 male patients presenting with male breast cancer (MBC) between 01/01/1992 and 31/12/2018, and 26 high-risk not-affected men presenting between 01/01/2016 and 31/12/2018. Participants’ electronic clinical records were reviewed. Patients’ data reported age at diagnosis, tumor characteristics, therapeutic management, and BRCA1/2 status as well as a family history of breast, ovarian, or prostate cancer (PCa) in first-degree relatives. Results: We analyzed 69 MBC patients. Median age was 64 years. The majority of tumors diagnosed were of an early TNM stage. The most frequent histological subtype was invasive ductal carcinoma (76.7%). Hormone receptors were positive in >90% of MBC cases. Nearly all patients underwent modified radical mastectomy or total mastectomy. Adjuvant endocrine therapy was delivered in 59.4%. Among MBC-affected patients, we recorded a high percentage of a positive family history of BC. Mutational analysis for the BRCA1/2 genes was performed in 17 MBC patients; 11.8% were carriers of BRCA2 pathogenic mutations. Among 26 healthy high-risk subjects included in this case series, 4 were BRCA1 mutation carriers and 9 were BRCA2 mutation carriers. Discussion: We evaluated the distribution of clinicopathological characteristics in MBC subjects and assessed the frequency of mutations in the BRCA genes in affected patients and healthy high-risk subjects, with the aim of proposing a surveillance program for BC and PCa.

Management of Male Breast Cancer: ASCO Guideline

2020 ◽  
Vol 38 (16) ◽  
pp. 1849-1863 ◽  
Author(s):  
Michael J. Hassett ◽  
Mark R. Somerfield ◽  
Elisha R. Baker ◽  
Fatima Cardoso ◽  
Kari J. Kansal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Male Breast Cancer ◽  
Early Stage ◽  
Metastatic Cancer ◽  
Male Breast ◽  
Eligibility Criteria ◽  
Early Stage Disease ◽  
First Line Therapy ◽  
History Of

PURPOSE To develop recommendations concerning the management of male breast cancer. METHODS ASCO convened an Expert Panel to develop recommendations based on a systematic review and a formal consensus process. RESULTS Twenty-six descriptive reports or observational studies met eligibility criteria and formed the evidentiary basis for the recommendations. RECOMMENDATIONS Many of the management approaches used for men with breast cancer are like those used for women. Men with hormone receptor–positive breast cancer who are candidates for adjuvant endocrine therapy should be offered tamoxifen for an initial duration of five years; those with a contraindication to tamoxifen may be offered a gonadotropin-releasing hormone agonist/antagonist plus aromatase inhibitor. Men who have completed five years of tamoxifen, have tolerated therapy, and still have a high risk of recurrence may be offered an additional five years of therapy. Men with early-stage disease should not be treated with bone-modifying agents to prevent recurrence, but could still receive these agents to prevent or treat osteoporosis. Men with advanced or metastatic disease should be offered endocrine therapy as first-line therapy, except in cases of visceral crisis or rapidly progressive disease. Targeted systemic therapy may be used to treat advanced or metastatic cancer using the same indications and combinations offered to women. Ipsilateral annual mammogram should be offered to men with a history of breast cancer treated with lumpectomy regardless of genetic predisposition; contralateral annual mammogram may be offered to men with a history of breast cancer and a genetic predisposing mutation. Breast magnetic resonance imaging is not recommended routinely. Genetic counseling and germline genetic testing of cancer predisposition genes should be offered to all men with breast cancer.

scholarly journals A Synchronous Diagnosis of Metastatic Male Breast Cancer and Prostate Cancer

2019 ◽  
Vol 7 ◽  
pp. 232470961984723
Author(s):  
Leila Moosavi ◽  
Phyllis Kim ◽  
An Uche ◽  
Everardo Cobos
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Male Breast Cancer ◽  
Breast Cancer Diagnosis ◽  
Male Breast ◽  
Breast Mass ◽  
Medical Attention ◽  
Cancer History ◽  
History Of ◽  
The Right

In this article, we present a patient diagnosed synchronously with metastatic male breast cancer and prostate cancer. This is a 63-year-old male and recent immigrant from Nigeria, who sought medical attention for progressively worsening of shortness of breath and acute progression of a chronic right breast mass. An invasive breast carcinoma was diagnosed by the core biopsy of the right breast mass. Within 2 months of his breast cancer diagnosis, the patient also was diagnosed with prostate adenocarcinoma after being worked up for urinary retention. By presenting this patient with a synchronous diagnosis with metastatic male breast cancer and prostate cancer, history of chronic right breast mass, and gynecomastia, we speculate on possible cancer etiologies and risk factors.

Male Breast Cancer: 13-Year Single Institution Experience

2020 ◽  
Vol 86 (10) ◽  
pp. 1345-1350
Author(s):  
Marissa K. Srour ◽  
Farin Amersi ◽  
James Mirocha ◽  
Armando E. Giuliano ◽  
Alice Chung
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Disease Free Survival ◽  
Recurrence Score ◽  
Breast Conserving Surgery ◽  
Male Breast ◽  
Brca Mutations ◽  
Estrogen Receptor Positive ◽  
Stage 1

Due to the low incidence of male breast cancer (BC), there are few studies evaluating outcomes. We evaluated the clinicopathologic features and outcomes of male BC. Male patients with BC from January 2006 to December 2018 were identified. Of 49 patients, mean age was 64 (range 33-94) years. Of the 27 (55.1%) patients who had genetic testing, 9 (33.3%) had a Breast Cancer gene (BRCA) 1 or 2 mutation. The majority of patients had a mastectomy (n = 43/49, 87.8%) and had invasive ductal carcinoma (n = 47/49, 95.9%). 20 patients (n = 20/43, 46.5%) had positive lymph nodes. 41 (n = 41/47, 87.2%) patients had estrogen receptor positive disease. The majority of patients were pathologic stage 2 (n = 21/46, 45.7%), followed by stage 1 (n = 15/46, 32.6%), stage 3 (n = 6/46, 13.0%), and stage 4 (n = 4/46, 8.7%). Eight patients had the 21-gene recurrence score performed. Of patients with stage 1-3 BC, 10 (n = 10/43, 23.3%) patients had recurrence. With median follow-up of 4.1 (range .6-10.6) years, 5-year overall survival was 82.9% and 5-year disease-free survival was 65.9%. In conclusion, our cohort of patients with male BC had a high incidence of BRCA mutations and most commonly had high-grade estrogen positive stage 2 tumors. Breast conserving surgery was utilized in 4% of patients and genomic testing utilized in 55% of patients.

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