Management of a Case of Male Breast Cancer in a Reference Hospital in Yaoundé: Clinical Case and Review of the Literature

Breast cancer in men is a rare pathology. It represents approximately 1% of breast cancers and 1.2% of male cancers. We report the clinical case of a 54-year-old man referred from a health facility for the management of a non-painful right breast swelling that had been present for 2 months. A breast ultrasound was performed revealing an increase in the glandular parenchyma of the right breast, with the absence of a mass or nodule, classified ACR BI-RADS 2 (American College of Radiology—Breast Imaging Reporting & Data System). There was no significant past medical history. Clinical examination on admission revealed breast asymmetry on inspection, with the right breast being increased in size. On palpation, there was right retro-areolar tumefaction of about 3 cm, and right peri-areolar stiffness. Both breasts were non-tender, and there was no discharge nor palpable axillary lymph nodes bilaterally. The diagnosis of right gynecomastia was made with a differential of right breast cancer. A breast biopsy was done and histopathology analysis was in favor of a carcinoma. A right total mastectomy with axillary lymph node dissection was performed with favorable postoperative outcomes. The histopathological and immuno-histochemical analysis of the surgical specimen revealed foci of atypical ductal hyperplasia associated with cylindrical metaplasia with oestrogen, progesterone and HER2 (Human epidermal growth factor Receptor 2) receptors. The patient was put on Tamoxifen 25 mg 1 tab/day and adjuvant radio-chemotherapy started.