Male breast cancer treated by wide resection and latissimus dorsi flap: a case report

Abstract

A 62-year-old Caucasian male presented at the certified Breast Cancer Center with a newly diagnosed large, symptomatic mass in the left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation; his previous surgeries included circumcision as a child and he was a nonsmoker. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. At ultrasound, the lesion was scored BI-RADS 5. Axillary lymph nodes were suspicious on sonography. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors (both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical (non-invasive) solid papillary carcinoma and was classified as invasive solid papillary carcinoma. OncotypeDX Recurrence Score indicated low risk (RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after one year of follow up.