Diagnóstico e caracterização de carcinoma mamário masculino em paciente idoso: relato de caso

Abstract

The aim of this study is to report the case of male breast carcinoma in an older patient, highlighting the diagnostic challenges and the molecular characterization of the tumor. The study uses a case report based on a 71- year-old patient who presented with a palpable nodule in the right breast and signicant weight loss. Mammography, ultrasonography, and magnetic resonance imaging were performed to assess the lesions. A biopsy was conducted to conrm the diagnosis. The methodology includes a literature review on the epidemiology, clinical characteristics, and molecular subtypes of male breast cancer, as well as a critical analysis of the data obtained from the examinations. Mammography and ultrasonography identied an irregular nodule in the right breast, classied as Category 4 BI-RADS, suggesting malignancy. Magnetic resonance imaging conrmed the presence of a malignant nodule in the right breast with dynamic enhancement characteristics typical of malignant lesions, and differentiated it from a benign nodule in the left breast, suggestive of gynecomastia. The biopsy revealed an inltrating carcinoma of the non-special type, moderately differentiated, grade 2, with positive estrogen receptor (ER 100%), Ki-67 proliferation index between 20-30%, and doubtful HER-2. The case highlights the importance of a comprehensive diagnostic approach and the use of multiple imaging methods for the accurate identication and characterization of male breast lesions. Despite the relatively favorable prognosis for some subtypes of male breast cancer, early detection is critical to improving outcomes, as these cases are generally diagnosed at more advanced stages. The study reinforces the need for increased awareness of male breast cancer and the importance of a complete diagnostic evaluation to appropriately differentiate between malignant and benign conditions.