Male breast cancer is a rare disease, accounting for about 1% of all breast cancers. Little is known about the etiology of male breast cancer, especially developed in young man. Genetic and hormonal factors have been reported to be involved in its pathogenesis. But, less is known regarding the role of anthropometric or other endocrine risk factors. It’s extremely rare for breast cancer to occur in young male patient because male breast cancer generally occur in old patients. A 29-year-old male was diagnosed with breast cancer in our institution who was with diabetes and obesity. There was no specific risk of genetic or hormonal factors for his breast cancer.
Breast carcinoma has been dominated disorder in female, whereas breast carcinoma in male is relatively rare accounting for about 1% of all breast cancers [
A 29-year-old Korean man was referred to our institution complaining of progressively enlarging his right breast lump. He had no significant past medical or family history. He was not taking any medication. He was unmarried, but reported normal sexual life and did military service as usual manner. He did not drink alcohol and had a smoking history of 5 pack years. Physical examination revealed 2.5 cm round mass in lower inner quadrant of right breast. He was an obese person with body mass index (BMI) of 30.4 kg/m2. He had the normal testis volume.
Mammography revealed a 3 cm microlobulated, irregular high-density mass at right subareola (
The serum study showed elevated carcinoembryonic antigen (7.44 ng/mL) and hemoglobin A1c (8.9%) level and showed normal cancer antigen 15-3 (15 U/mL), estradiol (21.27 pg/mL) and testosterone (7.42 ng/mL) level. Genetic analysis was confirmed as eukaryote without chromosomal abnormality and no mutations of BRCA 1/2 genes.
He underwent modified radical mastectomy for his breast cancer and the final pathologic diagnosis was a 3.6 cm invasive ductal carcinoma with histologic grade 3, nuclear grade 3, estrogen receptor (ER)-positive, progesterone receptor (PR)-negative, human epidermal growth factor receptor 2 (HER-2)-positive, and Ki-67 labeling index of 50%. The axillary lymph node dissection showed four positive nodes among 24 lymph nodes retrieved. His final stage was IIIA (T2N2M0).
He underwent adjuvant chemotherapy with 6 cycles of docetaxel, doxorubicin, and cyclophosphamide. And he also underwent adjuvant radiotherapy, hormonal therapy with daily tamoxifen 20 mg, and trastuzumab therapy. Up to now, at 2 years after surgery, there was no tumor recurrence.
The etiology of male breast cancer is poorly understood, partly because of its relative rarity. But several risk factors have been identified, such as genetic and hormonal abnormalities.
Approximately 15% to 20% of men with breast cancer report a family history of breast or ovarian cancer [
Estrogen excess and lack of androgens contribute to several conditions associated to the risk of male breast cancer [
It is documented the association of obesity and male breast cancer that is biologically explained by the increased peripheral aromatization of estrogen [
Some studies found slightly elevated risk of male breast cancer associated with a history of diabetes. A history of diabetes was related to a modest but statistically significant risk increase [
Type 2 diabetes has been suggested to increase risk of female breast cancer. Hyperinsulinemia, as occurs in adult-onset diabetes, may promote breast cancer because insulin may be a growth factor for human breast cancer cell [
Alcohol consumption has not been consistently identified as a risk factor for male breast cancer. In a case-control study involving 74 male breast cancers and 1,432 controls, the risk of breast cancer increased 16% per 10 g daily alcohol intake [
Epidemiologic studies of male breast cancer are uncommon, and most to date have been small case–control studies, raising the possibility that identified risk factors could reflect the influence of chance or selection and recall biases [
At the 37th San Antonio Breast Cancer Symposium, Dr Fatima Cardoso from Champalimaud Cancer Centre, Lisbon, Portugal presented the first results of the EORTC (European Organization for Research and Treatment of Cancer) 10085/TBCRC (Translational Breast Cancer Research Consortium)/BIG (Breast International Group)/NABCG (North American Breast Cancer Groups) International Male Breast Cancer Programme [
Overall survival of male breast cancer is similar to that of women with breast cancer. Similar to women with breast cancer, stage, tumor sized, and axillary lymph node status are important factors influencing outcome. The impression that male breast cancer has a worse prognosis may stem from the tendency toward diagnosis at a later stage [
Now, Advancements in the characterization and genomic mapping of male breast cancer have been discussed. It is hoped that these huge efforts for rare disease are able to derive more results for understanding of male breast cancer.
No potential conflict of interest relevant to this article was reported.
This study was supported by Inha University Hospital Research Grant.
Mammogram showed a 3 cm microlobulated, irregular high-density mass (arrows) at right subareola. (A) Craniocaudal view. (B) Mediolateral oblique view.
On ultrasonography, (A) the irregular mass at right subareola was measured 4.19 cm in diameter and (B) a suspicious enlarged lymph node at right axilla was measured 1.31 cm in diameter.
Positron emission tomography-computed tomography scan showed abnormal fluorodeoxyglucose uptakes in right subareolar breast (arrow) and in right level I axilla (arrowhead). There was no other metastatic evidence.