Presentation
Large painless palpable left breast masses. Familial history of breast cancer in first-degree relatives. BRCA2 mutation carrier.
Patient Data
Three irregular masses are seen in the left breast. The largest one measured about 70 mm, located in the central part of the left breast and infiltrates the skin. Additionally, multiple enlarged lymph nodes are evident in the left axillary and retro-pectoral regions with a maximum SAD of 28 mm. There is also a prominent lymph node in the right lung hilum.
Several nodules, mostly sub-pleural, are noted in both lungs, suggesting metastasis.
Case Discussion
Male breast cancer is extremely rare, and the diagnosis is often delayed due to the patient's hesitancy to seek advice, so the overall prognosis tends to be worse than for female breast cancer. The average age of diagnosis is 60-70 years, and about 30% of cases can have a positive family history.
Histologically, up to 90% of cases are invasive ductal carcinoma. The invasive lobular carcinoma is exceptionally rare in male patients because lobules and acini are not found in normal male breast tissue.
Men with BRCA1/2 mutations are at increased risk for breast, prostate, pancreatic and some other cancers. The average man has a 0.1% breast cancer risk, although the risk is significantly increased to 7-8% with a BRCA2 mutation and 1% with a BRCA1 mutation.
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