Ductal carcinoma in situ of the male breast.
BACKGROUND
Ductal carcinoma in situ (DCIS) of the male breast is an uncommon disease, accounting for approximately 7% of all male breast carcinomas. Compared with invasive carcinomas of the breast, the prognosis associated with DCIS in men is excellent; however, clinical features, pathology, and treatment of this disease are not well defined in the 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 women is discussed in comparison with that of DCIS in men.


RESULTS
Of the four patients with DCIS, the presenting complaint was a retroareolar 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 mastectomy alone. Disease recurred locally as DCIS in both patients, requiring mastectomy at 30 and 108 months. No lymph node metastases were found in the three patients who underwent axillary dissection. All four patients were alive without disease at 133, 120, 36, and 32 months of follow-up, respectively.


CONCLUSIONS
Although the sample size was small, our patients and a review of the literature suggest that most DCIS in men is of the papillary type and that mastectomy without axillary dissection is the preferred treatment.
Camus
M G
MG
Department of General Surgery (Surgical Oncology), Lahey Clinic, Burlington, Massachusetts 01805.
Joshi
M G
MG
Mackarem
G
G
Lee
A K
AK
Rossi
R L
RL
Munson
J L
JL
Buyske
J
J
Barbarisi
L J
LJ
Sanders
L E
LE
Hughes
K S
KS
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015411:Mastectomy, Modified Radical; D015409:Mastectomy, Radical; D015412:Mastectomy, Segmental; D015413:Mastectomy, Simple; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012737:Sex Factors; D016896:Treatment Outcome