Locally advanced breast cancer in an elderly male with end-stage renal disease: A case report

Male breast cancer (MBC) is uncommon, often diagnosed late and prone to distant metastases. Treating MBC is more challenging than treating female breast cancer. The present study reports a case of end-stage renal disease (ESRD) in a Chinese patient with locally advanced MBC. What distinguishes the present case from previously reported MBCs is the advanced age (90 years), the presence of ESRD with multiple complications and the locally advanced (T4b) ulcerated tumor, a triad rarely documented in the literature. A 90-year-old man presented to the hospital with an itchy, bleeding, ulcerated breast tumor. In addition to ESRD, they had hypertension and urinary retention requiring cystostomy, as well as a 5.0×4.5 cm ulcer on their left breast. A simple left mastectomy was performed as palliative surgery. Postoperative pathology confirmed invasive ductal carcinoma (unspecified type, grade III); immunohistochemistry showed strong estrogen receptor positivity (~95%) and moderate-to-strong progesterone receptor positivity (~10%). After palliative resection, the patient received adjuvant endocrine therapy as scheduled. Due to the systemic condition of the patient and their comorbidities, adjuvant endocrine therapy was chosen over radiation and chemotherapy. The quality of life of the patient improved and recovery was uneventful. In the present case, respecting the preferences of the patient was vital for this very elderly individual with a terminal illness. Striking a balance between tumor control and risk-benefit ratio within a multidisciplinary team framework was essential. A tailored approach based on endocrine and palliative medications should be adopted to improve quality of life and short-term prognosis.