The case of an invasive ductal carcinoma in a middle-aged man with a history of cardiac transplantation and long-term immunosuppressant use highlights the importance of maintaining clinical suspicion for breast malignancy in male patients presenting with a new breast mass.
Abstract
Male breast cancer is rare, representing less than 1% of breast cancer cases, and is often diagnosed at a later stage due to a low index of clinical suspicion. This is the case of an invasive ductal carcinoma in a middle-aged man with a history of cardiac transplantation and long-term immunosuppressant use. The patient presented with a breast lump found on self-examination, which was then evaluated with diagnostic mammography and US. Imaging demonstrated a suspicious retroareolar mass with associated nipple retraction, and subsequent US-guided core biopsy confirmed moderately differentiated invasive ductal carcinoma (ER-positive, PR-positive, HER2-negative). This case highlights the importance of maintaining clinical suspicion for breast malignancy in male patients presenting with a new breast mass, even in the absence of traditional risk factors such as family history of breast cancer. Thorough clinical evaluation and appropriate diagnostic imaging can facilitate early detection and treatment of male breast cancer.
ACC can be misdiagnosed as other types of breast cancer when clinical awareness is insufficient, potentially leading to unnecessary chemotherapy and inappropriate treatment, and using a combination of imaging modalities may improve diagnostic accuracy and facilitate earlier detection.
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