DUCTAL CARCINOMA IN-SITU OF THE MALE BREAST

Background. Ductal carcinoma in situ (DCIS) of the male breast is an u ncommon disease, accounting for approximately 7% of all male breast ca rcinomas. Compared with invasive carcinomas of the breast, the prognos is associated with DCIS in men is excellent; however, clinical feature s, pathology, and treatment of this disease are not well defined in th e literature. Methods. Records of 23 men with carcinoma of the breast treated at the Lahey Clinic from 1968 to 1991 were reviewed, revealing 4 patients with pure DCIS (17%). The reported management of DCIS in w omen is discussed in comparison with that of DCIS in men. Results. Of the four patients with DCIS, the presenting complaint was a retroareol ar mass in three patients and a bloody nipple discharge in one patient . The pathologic subtype was papillary in one patient and intracystic papillary in three patients. Two patients were treated with partial ma stectomy alone. Disease recurred locally as DCIS in both patients, req uiring mastectomy at 30 and 108 months. No lymph node metastases were found in the three patients who underwent axillary dissection. All fou r patients were alive without disease at 133, 120, 36, and 32 months o f follow-up, respectively. Conclusions. Although the sample size was s mall, our patients and a review of the literature suggest that most DC IS in men is of the papillary type and that mastectomy without axillar y dissection is the preferred treatment.