Pure low-grade DCIS in a male patient: a case report

Mammographically and sonographically occult male DCIS seen only on breast MRI

Male breast cancer is a rare entity consisting of less than 1% of all breast cancer diagnoses, in which pure ductal carcinoma in situ (DCIS) without an invasive component accounts for approximately 10% of these diagnoses. Early diagnosis and appropriate management are essential to ensure favorable outcomes. We present a rare case of mammographically and sonographically occult pure DCIS in a male patient presenting with unilateral bloody nipple discharge, highlighting imaging features and the potential utility of breast MRI that aided diagnosis and management.

Male ductal carcinoma in situ: diagnosis and management of a rare disease in men

Ductal carcinoma in situ is very rare in male patients, accounting for approximately 5%-7% of all male breast cancers. We present a case of a man in his early 70s who presented with bloody nipple discharge and gynaecomastia and was subsequently diagnosed with ductal carcinoma in situ (DCIS). We discuss his management with surgical resection and the consideration of adjuvant treatment. We also review the existing literature on the presentation, diagnosis and management of DCIS in men.

Ductal carcinoma in situ of the male breast: clinical radiological features and management in a cancer referral center

Purpose

To present an overview of the management of male patients with Ductal Carcinoma In Situ of the breast (male DCIS).

Methods

We retrospectively studied all male patients with a diagnosis of pure DCIS from January 1999 to December 2018: 20 patients were identified in our cancer referral center. We collected data regarding clinical presentation, age of onset, radiological features, receptor status of the neoplasm, histological type, and the follow-up of those patients.

Results

The median age was 62 years (range 21–80). All patients underwent surgery, in 15/20 (75%) cases a mastectomy was carried out. Two patients (10%) underwent endocrine treatment and 1/20 (5%) underwent radiotherapy. The receptor status for 15/20 patients was documented: 13/15 patients were ER+/Pr+. In 3 cases the Ki 67% was positive (i.e., > 20%). All cases were negative for Her2. The median follow-up time was 9.0 years (IQR 4.0–13.7). Only one patient had an ipsilateral recurrence with the finding of an infiltrating carcinoma in the same breast after 14 years. The 5-year disease-free survival was 92.9%.

Conclusion

Pure DCIS in men is an extremely rare disease: proper diagnosis and management allow an excellent prognosis.