title: Axillary metastasis as the first manifestation of male breast cancer: a case report.
abstract: BACKGROUND
  Breast cancer is very rare in men, and the occurrence of occult breast cancer which present axillary metastasis as the first manifestation is even rarer in men.
  
  
  METHODS
  We report a 72-year-old male Han-Chinese patient who presented axillary metastasis as the first manifestation of breast cancer and got correctly diagnoses by histological examination. He underwent modified radical mastectomy and axillary dissection on 11 Apr 2006. The histopathologic examination showed that no tumor focus was found in his breast tissue, but two out of fifteen of axillary lymph nodes were invaded by infiltrating ductal carcinoma. The IHC stain showed that estrogen receptor (ER) and progestin receptor (PR) were negative, Human epidermal receptor (HER-2) oncoprotein (+++), P53 protein expressed (+++), Bcl-2 oncoprotein (+++), nm23 protein (++), proliferating cell nuclear antigen (PCNA) (+++) and multidrug-resistance protein (MRP) (++). After operation, he did not receive endocrine therapy, chemotherapy and radiotherapy because of his senility. He is alive without any residual or metastasis disease 29 months after being diagnosed.
  
  
  CONCLUSIONS
  This is the first case in our hospital that presents axillary metastases as the first manifestation of male breast cancer.
authors.affiliation: Department of General Surgery, the General Hospital of Chinese PLA Air force, Beijing City, 100142, PR China. kzggl@163.com.
authors.forename: Guo-Li
authors.initials: GL
authors.lastname: Gu
authors.forename: Shi-Lin
authors.initials: SL
authors.lastname: Wang
authors.forename: Xue-Ming
authors.initials: XM
authors.lastname: Wei
authors.forename: Li
authors.initials: L
authors.lastname: Ren
authors.forename: Fu-Xian
authors.initials: FX
authors.lastname: Zou