Male breast cancer accounts for 1% of all breast cancer cases, and men tend to be diagnosed at an older age than women (mean age is about 67 years). Several risk factors have been identified, such as genetic and hormonal abnormalities.
The present study reported the case of a 25-year-old man who was diagnosed with an advanced invasive ductal carcinoma; however, he did not have any important risk factors.
Even though more data is emerging about this disease, more efforts to understand risk factors, treatment options and survival benefits are needed. In this case, we discussed the risk factors as well as the impaired fertility associated with breast cancer therapies.
Background
Breast cancer in men is rare, and it accounts for about 1% of all malignant breast neoplasm cases [1,2]. The estimated incidence is 1 case for each 100,000 men. In the United States, about 1,910 new cases were diagnosed in 2009, and 440 of these cases resulted in death [3]. Among the histologic types, invasive ductal carcinoma is the most prevalent breast cancer in males, with an incidence varying from 65 to 95% [2,4].
Male breast cancer has unimodal age-frequency distribution with a peak incidence at 71 years old. Conversely, female breast cancer has a bimodal age-frequency distribution with early-onset and late-onset peak incidences at 52 and 72 years old, respectively [5].
This study examined a 25-year-old man without important risk factors who was diagnosed with invasive ductal carcinoma. Although it is rare, there have been instances of breast cancer in younger males [6]. We evaluated the main aspects of the epidemiology of breast neoplasm in men and the best approach for treatment.
Case presentation
A 25-year-old Brazilian male was referred to our institution in August 2007 complaining of a breast tumor of progressive growth for the previous eight months. Previous medical and family history did not appear to contribute to the present illness. He denied using drugs or anabolic steroids and did not drink alcohol. The only medication he was taking was phenobarbital, which he had been taking for four years since he presented with two seizure episodes. The patient was a smoker who consumed 10 cigarettes per day. He also reported a normal sexual life, but he did not have children.
Physical examination revealed a 3.5 cm tumor located on the right breast. There was a retraction of the nipple; the nodule, which could be moved, had a hardened consistency and did not adhere to deep planes. The armpits did not present lymphadenopathy.
Mammographic findings consisted of a noncalcified high density mass (Figure (Figure1)1) and breast ultrasonography revealed a hypoechogenic nodule of irregular shape with partially defined limits measuring 17 × 13 × 11 mm in the right breast. The magnetic nuclear resonance imaging showed a retroareolar nodule in the right breast, which corresponded to an expansive process. There were also signs of infiltration of the pectoralis muscle and a small area of retroareolar highlight in the left breast. Final Breast Imaging Reporting and Data System (BI-RADS) category was 5: highly suggestive of malignancy.
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