Male breast cancer

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Palpated a lump in his left chest. His wife convinced him to go get checked.

Patient Data

Age: 80 years
Gender: Male
mammography

Right mammography:

ultrasound

Left breast:

Case Discussion

He went on to have a core needle biopsy and insertion of a tissue marker clip and underwent a sentinel lymph node scan and excision.

Pathology report:

  1. Left breast, 11 o'clock, trucut biopsy: Infiltrating ductal carcinoma.
  2. Left axilla, trucut biopsy: Lymph node fragments with no evidence of malignancy.

Immunohistochemical studies:

  1. Weak, incomplete membranous immunoreactivity for Her-2/Neu protein expression observed in 10% of infiltrating tumor cells (score 1, range 1- 3).
    Interpretation: negative.
    The study was performed with monoclonal Ab-4B5.
  2. Estrogen receptor immunoreactivity positive.
    Quantitation: 90% of tumor cells positive.
    Intensity of staining: strong.
    Internal control: not present.
    The study was performed with monoclonal Ab-SPI. 
  3. Progesterone receptor immunoreactivity positive. 
    Quantitation: 50% of tumor cells positive. 
    Intensity of staining: weak to strong. 
    Internal control: not present. 
    The study was performed with monoclonal Ab-16. 
  4. Ki67 expressed in 30% of tumor cells. (score 3, range 1-4). 
    The study was performed with monoclonal Ab-Mib 1. 
    Positive controls show the expected staining.
    Negative controls show no immunostaining. 

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