Ductal Carcinoma In Situ in a 25-Year-Old Man Presenting with Apparent Unilateral Gynecomastia

Abstract

Ductal carcinoma in situ (dcis) in a young man is rarely reported. Our patient, a 25-year-old man, presented with apparent symptomatic unilateral gynecomastia. He has a strong history of cancer on both the maternal and paternal sides of his family, including breast and lung (maternal) and melanoma, colon, and pancreatic (paternal). His mother tested negative for BRCA1 and BRCA2. There is no information on paternal genetic testing.The patient was treated with left subcutaneous mastectomy. Upon histologic review of the sample, concurrent gynecomastia and dcis were discovered. To date, only 4 cases of gynecomastia and dcis have been described in younger male patients. Because only 30%-50% of patients with dcis eventually develop invasive cancer in the subsequent 10-20 years, dcis prevalence in the general population may be higher than predicted. This case underscores the importance of family history in any patient presenting with a breast mass. Patients must be made aware of the risk, however small it may be, and physicians must remain cautious of cancer in young men with gynecomastia. KEY WORDSGynecomastia, ductal carcinoma in situ, male breast cancer

Is routine pathological evaluation of tissue from gynecomastia necessary? A 15-year retrospective pathological and literature review

“…Serum karyotyping for Kleinfelter syndrome was reported negative postoperatively in six cases (3,12,14,15,18,20). BRCA mutations were reported negative in the three analyzed patients (12,15,17). However, it should be emphasized that these cases represent a select population of incidentally discovered male breast malignancy in routine histopathological examination of gynecomastia tissue samples; thus, they were not expected to present with any of the well-known risk factors for male breast cancer (MBC).…”

Ductal Carcinoma In situ of the Male Breast

“…Of these, pure DCIS only accounts for 5% of cases, while the remaining DCIS cases are associated with invasive carcinoma. Among female breast cancer patients, 20% present with pure DCIS [6]. This discrepancy is thought to be partly due to increased awareness and regular breast screening in female patients, which leads to earlier detection and overall better prognosis.…”

A case report of 29 year old male patient with breast carcinoma: diagnosed on fine needle aspiration cytology

“…3 Besides BRCA, it has been associated PTEN mutation in Cowden syndrome and mutation in androgen receptor, CHEK 2 and CYP17. 4 Other possible associated risk factors for breast neoplasm includes Klinefelter's syndrome, estrogen excess and lack of androgen, obesity, diabetes, radiation exposure. 3 In this case, patient presented at very young age, though he did not have a family history, hormonal history or chromosomal abnormality that could justify the high risk for breast cancer.…”