Ductal Breast Cancer in a Male Patient

An 86-year-old male patient with a history of prostate carcinoma presented with a lesion in the perimammillar area of the right breast, which was diagnosed as a low-grade differentiated ductal carcinoma of the breast. Histological examination revealed adenoid tumor cords and malignant cells in the lymph vessels. Immunohistochemical tests showed strong positivity for CEA and estrogen receptors, with over 90% positivity for estrogen receptor-a and over 20% for progesterone receptors, while HER-2 neu was negative. The patient's CEA levels were elevated at 1.65 ng/ml. Imaging diagnostics indicated a suspicious lesion in the right axilla and a retromammillar lesion with irregular borders. The patient underwent ablation of the right breast gland with ipsilateral axillar lymphadenectomy but rejected the suggested Tamoxifen therapy. The document discusses that breast cancer in men is rare, with an incidence below 1%, and is often associated with an imbalance of estrogen-testosterone equilibrium, with factors like Klinefelter's syndrome or BRCA2 gene mutations increasing the risk. The prognosis for men is generally worse than for women due to later occurrence and diagnosis. Treatment typically involves surgical excision and adjuvant hormonal treatment with Tamoxifen for hormone-receptor positive patients.