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Male breast cancer

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Palpable, painless nodule under the right nipple for past month or so.

Patient Data

Age: 85 years
Gender: Male
mammography

Right
Soft tissue masses: Mass 1: 1.7 cm, under the nipple, calcifications within the mass.
No pathological calcifications seen other than those within the aforementioned mass.
Fibroglandular tissue - normal.
Skin and nipple shadow - normal.
Impression: mass as described.
BI-RADS: 5 - highly suspicious for malignancy.

Left
No masses seen in the soft tissue.
No pathological calcifications seen.
Fibroglandular tissue - normal.
Skin and nipple shadow - normal.
Impression: no abnormal finding.
BI-RADS: 1 - normal examination.

ultrasound

Right
Sonographic pattern normal.
Solid masses: at 9 o'clock a 1.5 cm mass was demonstrated under the nipple, compatible with the mammographic finding, hard lump palpated manually.
Axilla normal.
Impression: mass as described.
BI-RADS: 5 - highly suspicious for malignancy.

Left
Sonographic pattern normal.
No solid or cystic mass demonstrated.
Axilla normal.
BI-RADS: 1 - normal examination.

Prompt Trucut biopsy should follow.

ultrasound

An ultrasound-guided biopsy of the mass was performed.

Case Discussion

The histopathology report was as follows:
Invasive ductal carcinoma, grade II.
Immunostains: ER positive +1 +2 in 80-90% of the tumor cells, PR positive +1 +2 +3 in 50-60% of the tumor cells, neu/Her2 negative (score +1), Ki67 Index: 17-25%, E-cadherin positive.

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