Elsevier

The Breast

Volume 12, Issue 5, October 2003, Pages 345-347
The Breast

Case Report
Report of a male patient with brain metastases from breast cancer

https://doi.org/10.1016/S0960-9776(03)00109-7Get rights and content

Abstract

As in female patients, the clinical course in male patients with breast cancer is determined mainly by tumor stage. The literature contains very limited data on either the occurrence or the treatment of CNS metastases.

This paper presents the case report of a 69-year-old man with multiple brain metastases 7 years after a diagnosis of lymph-node positive breast cancer, which had earlier already spread to the bones and liver. Whole-brain irradiation with a total dose of 30 Gy resulted in palliation of symptoms. Nevertheless, survival was very short (7 weeks from diagnosis). Patients with metastatic breast cancer are at risk for the development of brain metastases. When performance status is poor the survival of patients with brain metastases is very limited. Treatment recommendations are the same as those for female patients with brain metastases from breast cancer.

Introduction

Male breast cancer is a rare disease, being diagnosed in approximately 1500 patients per year in the United States.1 A search of the Medline literature database yielded only one report describing the treatment of a male patient with brain metastases from breast cancer.2 If the results recorded in female patients are used as a basis of calculation, an incidence of 5% might be expected across all stages 5 years after the primary diagnosis.3

Section snippets

Case report

In October 2002, a 69-year-old male patient presented with nausea, confusion, somnolence and paresis of his right leg. He had previously been treated for invasive ductal carcinoma of the right breast, which was diagnosed in June 1995. At that time, the patient had been treated with subcutaneous mastectomy and axillary dissection. Tumor stage was pT2 pN1biii (7/13) M0 G3 R0 [estrogen receptor (ER) positive in 80%, progesterone receptor (PR) positive in 60%, Her2/neu score +1]. Adjuvant treatment

Discussion

Recent review articles have summarized current knowledge about male breast cancer, a rare disease that is diagnosed mainly in elderly men (median age 63–67 years).1,4 Risk factors might include positive family history (mother or sister), less physical activity and higher weight and body mass index than average.5 In the majority of cases the tumor type is ductal invasive carcinoma that is both ER and PR positive, under 40% overexpressing Her2/neu or p53. Prognostic factors include stage, tumor

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