A Case of Locally Advanced Breast Cancer in a 59-Year-Old Man Requiring a Modified Approach to Management

Abstract

Patient: Male, 59 Final Diagnosis: Invasive ductal carcinoma Symptoms: Foul-smelling discharge • painful breast mass Medication: — Clinical Procedure: Modified radical mastectomy Specialty: Surgery Objective: Rare disease Background: Male breast cancer is rare, accounting for approximately 1% of all malignancies in men. The lack of awareness of this rare cancer results in delayed diagnosis and its aggressive behavior can result in poor prognosis. This report is of a case of locally advanced, high-grade breast cancer in a 59-year-old man who was reluctant to undergo diagnostic procedures, and describes the approach to clinical management. Case Report: A 59-year-old man presented with a large left breast mass with enlarged axillary lymph nodes. The patient had ignored the mass and declined all diagnostic procedures. After modifying the diagnostic workup and involving a psychiatrist, the patient agreed to undergo a modified radical mastectomy. Histopathology showed a high-grade invasive ductal carcinoma with lymph node metastasis. The breast cancer was triple-positive for human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER), and progesterone receptor (PR). Adjuvant treatment included herceptin, tamoxifen, and radiation therapy. Conclusions: This case demonstrates the importance of raising public awareness of breast cancer in men, and to assess and overcome the factors leading to delay in accessing medical attention. In challenging cases, modifying the diagnostic workup and the treatment approach with the least deviation from the standard of care, including counseling may be required.

The Application of Whole-Process Case Management in Patients with Triple-Negative Breast Cancer

“…Patients are mostly troubled by negative moods [ 19 ]. The humanistic care-centered case management provides patients with good management of postoperative recovery [ 20 ], which facilitates the patients' psychological recovery and elimination of negative emotions [ 21 ]. Our findings indicated that the observation group was superior to the control group in terms of posttraumatic growth ( P < 0.05), which may be attributed to the close monitoring of abnormal conditions.…”

Exosomes Mediated Transfer of Circ_UBE2D2 Enhances the Resistance of Breast Cancer to Tamoxifen by Binding to MiR-200a-3p

“…Currently, around 70% to 75% of breast cancer is reported to highly express estrogen receptor alpha (ERα), and the most ERα-positive breast cancer depends on estrogen signaling, which makes these cancers respond well initially to endocrine therapies [ 1 – 3 ]. Tamoxifen, an estrogen antagonist, is the most successful endocrine therapy for ERα-positive breast cancer [ 4 , 5 ]. Unfortunately, although remarkable benefits of tamoxifen in these treatment settings have been reported, many cases eventually acquired resistance to tamoxifen, thus resulting in relapse and death [ 6 , 7 ].…”

Efficacy of the Whole-Course Case Management Model on Compliance and Satisfaction of Breast Cancer Patients with Whole-Course Standardized Treatment

“…It is presumably due to the fact that the one-to-one case management boosts the patient's selfconfidence in disease management, thereby promoting the recovery of the patient's body function, improving the patient's self-efficacy and self-management behavior, and thus lowering the incidence of postoperative adverse reactions in cancer patients [16]. As previously noted, surgical trauma, disease recurrence, anxiety, and uncertainty of prognosis adversely affect the patients physiologically and psychologically, thereby compromising the patient's treatment compliance [17]. Here, the results revealed that the whole case management mode resulted in higher compliance versus the routine nursing intervention.…”