A case of male inflammatory breast cancer

Abstract

This report describes the case of an 85-year-old male with inflammatory breast cancer. The patient presented with diffuse erythema and induration over the right anterior chest wall. Ultrasonography and mammography demonstrated an ill-defined small mass, 8 mm in diameter, in the right breast with skin thickening. A core needle biopsy of the breast mass confirmed the presence of invasive ductal carcinoma. A skin biopsy revealed a diffuse tumor cell infiltration with dermal lymphatic emboli. These findings were compatible with the diagnosis of inflammatory breast cancer. The tumor cells were triple negative for estrogen receptor, progesterone receptor, and HER2/neu. His bone scintigraphy showed multiple bone metastases. Systemic chemotherapy using capecitabine was introduced, but it failed to control the disease. TS-1, as second-line systemic chemotherapy, also resulted in treatment failure. Third-line chemotherapy using docetaxel and cyclophosphamide was then administered and was effective. However, he developed pneumonia due to febrile neutropenia after two cycles of treatment and the chemotherapy was discontinued. The patient died of carcinomatous lymphangiosis 2 years and 3 months after the initial onset of the disease. Male inflammatory breast cancer is challenging because of its rarity, biological uncertainness, diagnostic difficulty, and the fact that it is associated with a very poor prognosis. The establishment of a reliable diagnostic and treatment strategy for male inflammatory breast cancer is therefore needed.