Intracystic papillary carcinoma of breast- A rare disease entity in males

Carcinoma of breast is rare in men with an estimated incidence of one per 100,000 per annum. Of all the histological types of breast cancer, Intra-cystic papillary carcinoma (IPC) of the breast is rare accounting for less than 1% of all breast malignancies. A 61 year old gentleman presented with painless, progressively enlarging lump in his left breast since 3 years associated with serosanginous nipple discharge of 3 months duration. On examination, a single 8 x 3 cm well defined cystic swelling in the retro-areolar region was felt with normal overlying skin and nipple-areola complex. No axillary lymph nodes were palpable. FNAC of the lump showed features of infiltrating ductal carcinoma. Patient was taken up for modified radical mastectomy under general anaesthesia. Histopathological examination of the specimen revealed a cyst measuring 7x4 cm containing hemorrhagic fluid. On gross examination, the cyst wall exhibited grey white papillary excrescences that protruded into the lumen. Histopathological diagnosis of intracystic papillary carcinoma was given. Being a rare entity, there is no definite guideline for the treatment of IPC; however, a surgical excision with a clear resection margin forms the mainstay of the treatment. These patients have very good outcome. The addition of hormonal treatment does not appear to have an impact on the patient outcome.