Invasive lobular carcinoma of male breast: What we don't know-A report of 5 cases

Abstract

Male breast carcinoma is a very rare malignancy. It mostly has invasive ductal histology while invasive lobular histology is exceptionally uncommon constituting no more than 1–2% of male breast cancer cases. Here we present five cases of invasive lobular breast carcinoma arising in male breasts which were diagnosed by histological examination. Immunohistochemistry was performed to evaluate the hormonal receptor status. Early diagnosis of breast carcinoma in males have prognostic implication in patients’ survival and show better response to hormonal therapy when it is reactive for estrogen and progesterone receptors. Therefore it is mandatory for the pathologists to keep this rare condition in their minds while evaluating any case of male breast lump and to perform a vigorous search for any small focus of this tumour in circumstances of male breast lump including gynaecomastia. Majority of information regarding treatment of male breast cancer is retrospective in nature and is derived mainly from small single-institution series; thus, the choice of treatment modalities is generally guided by extrapolation of data from female breast cancer. Due to paucity of data and the extreme rarity, male breast carcinoma should be considered and managed as a distinct entity. The invasive lobular carcinoma perhaps with an added advantage for being reactive of hormonal receptors, which could be treated by adjuvant Tamoxifen. It is hoped that a long term multicentric studies will help us to know the prognostic implication of uncommon invasive lobular histology, as well as trials could be strategically designed to optimize the treatment.