A Case Report of Triple Negative, Mixed Invasive Ductal and Lobular Carcinoma of the Male Breast: Uncommon Subtype in a Rare Tumour with Long survival

Abstract

Male breast cancer (MBC) is infrequent, representing about 1% of all breast cancer. Over 90% of MBC are Invasive Ductal Carcinoma and about 1% are Invasive Lobular Carcinoma. A mixture of these two types known as Mixed Invasive Ductal and Lobular carcinoma is quite uncommon as only 3 cases have been reported in literature. MBC are 14% HER-2 over expression, 90% estrogen and 85% Progesterone receptor positive. These three receptors are absent in Triple Negative Breast Cancer which is a very rare tumour subtype in men. We present an obese 52-year-old man who was diagnosed with stage IIA, Triple Negative, Mixed Invasive Ductal and Lobular carcinoma of the right breast in 2015. He had the complete range of treatment with modified radical mastectomy, 6 cycles of first line chemotherapy and external beam radiotherapy. Two years later, he developed pulmonary metastasis which is common with TNBC and had second line chemotherapy using Docetaxel and Xeloda®. He was diagnosed with brain metastasis during his 4th year follow-up and had whole brain radiotherapy with excellent response. Despite the aggressiveness of this tumour our patient is still alive in 2020, five years after presentation emphasizing the need for close follow up, multidisciplinary approach to care and a need to develop innovative funding for cancer patients.