Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 10, 2016; 7(5): 420-424
Published online Oct 10, 2016. doi: 10.5306/wjco.v7.i5.420
Male papillary breast cancer treated by wide resection and latissimus dorsi flap reconstruction: A case report and review of the literature
Malgorzata Banys-Paluchowski, Eike Burandt, Joanna Banys, Stefan Geist, Guido Sauter, Natalia Krawczyk, Peter Paluchowski
Malgorzata Banys-Paluchowski, Department of Obstetrics and Gynecology, Marienkrankenhaus Hamburg, 22087 Hamburg, Germany
Eike Burandt, Guido Sauter, Department of Pathology, University of Hamburg, 20246 Hamburg, Germany
Joanna Banys, Wroclaw Medical University, 50-367 Wroclaw, Poland
Stefan Geist, Peter Paluchowski, Department of Obstetrics and Gynecology, Regio Klinikum Pinneberg, 25421 Pinneberg, Germany
Natalia Krawczyk, Department of Obstetrics and Gynecology, University of Duesseldorf, 40225 Duesseldorf, Germany
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Institutional review board statement: This publication has been approved by the Institutional Review Board.
Informed consent statement: The patient provided informed written consent prior to publication.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Peter Paluchowski, MD, Chief, Department of Obstetrics and Gynecology, Regio Klinikum Pinneberg, Fahltskamp 74, 25421 Pinneberg, Germany. peter.paluchowski@regiokliniken.de
Telephone: +49-4101-217222 Fax: +49-4101-217462
Received: June 1, 2016
Peer-review started: June 3, 2016
First decision: July 5, 2016
Revised: July 21, 2016
Accepted: September 13, 2016
Article in press: September 15, 2016
Published online: October 10, 2016
Processing time: 128 Days and 20.1 Hours
Abstract

Breast cancer (BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors (both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical (non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; pT3 (10 cm), pN0 (0/15), M0, R0; OncotypeDX Recurrence Score indicated low risk (RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.

Keywords: Male breast cancer; Papillary carcinoma; Reconstruction; Latissimus dorsi flap; Rare tumors

Core tip: Male breast cancer (BC) is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.