1. Introduction

The affected male with carcinoma breast is usually in his sixties of seventies. Histological types and routes of metastasis(lymphatics and vascular) of male breast cancer are similar as in females. Hence the TNM staging system of male breast carcinoma is same as in females. Excess estrogen exposure is a common cause and may result from excess estrogen levels or due to deficient states. Genetic mutation, obesity, alcoholism, liver disease, senescence are important predisposing factors. Men with BRCA1, BRCA2 and Klinefelter’s syndrome are at highest risk of developing breast cancer. Size of the tumour and lymph node status are prognostic determinants.

2. Case Report

Figure 1. Rightt breast shows retracted nipple and sub

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A 65 year old male presented with “deformity of the right side of chest” On examination, the nipple retraction was apparent but there was no nipple discharge. A firm retroareolar mass of size 3 X 3 cm (approx.) was palpable. There were no clinically palpable axillary lymph nodes. The left breast and axilla were normal. FNAC of right breast lesion was done which depicted ductal epithelial carcinoma. Modified radical mastectomy with axillary clearance was done on priority. Patient is now on Tamoxifen which we intend to continue for 5 years.

Figure 2. Shows Modified Radical Mastectomy Dissec Areolar mass

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Figure 3. Shows axillary clearance

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Figure 4. Shows resected breast

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3. Discussion

Male breast cancer has identical pathology as in females, but lesions infiltrate locally faster due to lesser breast tissue. In 50% of cases, lesion in male is in advanced stageIII. Hence the treatment guidelines are based on experience in female breast cancer management doing mastectomy initially followed by relevant adjuvant therapy.

References

[1]	Schottenfeld D, Lilienfeld AM, Diamond H (1963); Some observations on epidemiology of breast cancer among males, American journal of public health 53, 890897.
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[2]	Donegan WL (1991) Cancer of breast in men, CA-A journal of clinicians 41, 339354.
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[3]	Sosco AJ, Lowenfel AB, Pasker de jong P (1993) Epidemiology of male breast cancer, International Journal of Cancer 53, 538549.
	In article
[4]	Stromm HH,Olson J (1999) Risk of breast cancer in offspring of male breast cancer patient, Lancet 353, 209.
	In article		CrossRef
[5]	Johansen Taber KA et al, Male breast cancer; Risk factors, diagnosis, management; Oncology Reports2010; 24; 1115.
	In article		CrossRef