Delayed Presentation of Locally Advanced Male Breast Cancer in a Nigerian Man: A Case Report of Invasive Carcinoma of No Special Type
Uduebor Osazee
*
Department of Surgery, Edo Specialist Teaching Hospital, Benin City, Edo State, Nigeria.
Chrysanthus D. Chiegboka
Department of Family Medicine, Federal Medical Center, Owo, Ondo State, Nigeria.
Akhaine Jesu-oboh P.
Department of Surgery, Edo Specialist Teaching Hospital, Benin City, Edo State, Nigeria.
Edigberhi G. Emmanuel
Department of Surgery, Edo Specialist Teaching Hospital, Benin City, Edo State, Nigeria.
Precious O. Ilenloh
Department of Psychiatry Tees, Esk & Wear Valleys, NHS Foundation Trust, London, United Kingdom.
Emmanuel Okun U.
Department of Trauma and Orthopedics, University Hospital Plymouth, Plymouth, United Kingdom.
Omenazu V. Chidiebere
Department of Internal Medicine, Enugu State University Teaching Hospital, Parklane, Nigeria.
Elvis U. Edokpolor
Department of General Medicine, NHS, England, United Kingdom.
Samuel Oyakhire
Department of Surgery, Edo Specialist Teaching Hospital, Benin City, Edo State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Breast cancer in men is rare, accounting for approximately 1% of breast cancer cases. Hormone-receptor-positive disease accounts for the majority of male breast cancers, whereas triple-negative disease is extremely uncommon. Evidence specific to men remains limited because the disease is rare and men have historically been under-represented in prospective breast cancer studies.
Aim: This report describes the presentation, investigations and initial treatment of a Nigerian patient with invasive carcinoma of no special type.
Case Presentation: A 67-year-old Nigerian man presented with a five-year history of left nipple discharge, which was occasionally bloodstained or milky, and progressive enlargement of the left breast. He reported weight loss but no respiratory, skeletal or neurological symptoms suggestive of clinically apparent distant disease. There was no reported family history of breast, ovarian or colorectal cancer or prior chest irradiation. Examination revealed a large, firm, irregular, poorly defined mass in the left breast. Ultrasonography revealed a left breast mass of 6.3 × 3.8 cm, which was lobulated and heterogeneous with internal vascularity and calcifications, along with enlarged left axillary lymph nodes. The lesion was classified as BI-RADS 4, and core needle biopsy revealed invasive breast carcinoma of no special type, Nottingham grade 2. The patient was started on doxorubicin and cyclophosphamide chemotherapy.
Conclusion: This case highlights the importance of promptly investigating persistent breast symptoms in men, particularly nipple discharge and progressive breast enlargement. Histopathological confirmation is mandatory and the use of receptor testing, adequate staging and multidisciplinary treatment planning are required to inform individualised management. In resource-limited settings, financial constraints may hinder treatment characterisation and decision-making when using biomarker testing. This report highlights the importance of enhancing access to comprehensive diagnostic services for male breast cancer in Nigeria.
Keywords: Male breast cancer, Invasive breast carcinoma of no special type, delayed presentation, nipple discharge, Nottingham grade 2, breast ultrasonography, core needle biopsy, axillary lymphadenopathy, neoadjuvant chemotherapy