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Male breast cancer

Male breast cancer

Discussion

A 63-year-old man presents with a painless lump under his left nipple that he noticed about three months ago. The lump has slowly increased in size, and more recently, he observed some skin dimpling and mild discomfort in the area. He denies any history of trauma to the chest or nipple discharge. His family history is notable for breast cancer in his sister, diagnosed at age 55.

On physical examination, a firm, non-tender mass measuring 2.5 cm is palpated beneath the left nipple, with slight retraction of the overlying skin. No axillary lymph nodes are palpable. A mammogram and ultrasound confirm a suspicious lesion, and a core needle biopsy is performed.

The biopsy reveals invasive ductal carcinoma. Immunohistochemical testing shows the tumor is estrogen receptor (ER)-positive, progesterone receptor (PR)-positive, and HER2-negative. Further staging investigations, including a chest CT and bone scan, show no evidence of distant metastasis.

The patient is referred to an oncologist and undergoes a modified radical mastectomy. Based on the hormone receptor status of the tumor, adjuvant hormone therapy with tamoxifen is initiated, along with consideration for radiation therapy.

Questions
1. What was the initial symptom that led the patient to seek medical attention?

a). Nipple discharge

b). Painless lump under the nipple

c). Chest pain

d). Swollen axillary lymph nodes

2. What was the size of the mass detected during the physical examination?

a). 1 cm

b). 2.5 cm

c). 3 cm

d). 4 cm

3. What type of breast cancer was diagnosed in the patient?

a). Lobular carcinoma

b). Invasive ductal carcinoma

c). Ductal carcinoma in situ

d). Paget's disease of the nipple

4. What was the hormone receptor status of the tumor?

a). ER-negative, PR-negative, HER2-positive

b). ER-positive, PR-positive, HER2-negative

c). ER-positive, PR-negative, HER2-positive

d). ER-negative, PR-positive, HER2-negative

Reveal answers

Answers

  1. b). Painless lump under the nipple
  2. b). 2.5 cm
  3. b). Invasive ductal carcinoma
  4. b). ER-positive, PR-positive, HER2-negative