Primary breast lymphoma in a male

Introduction: Primary breast lymphoma (PBL) accounts for less than 0.5% of total breast cancers and 1–2% of extranodal non-Hodgkin lymphomas. It mainly affects women, with male presentations being exceedingly rare and underrepresented in the literature. Primary breast lymphoma presents similarly to primary breast carcinoma, posing diagnostic challenges and risks of delaying treatment. This case emphasizes the importance of maintaining a high index of suspicion when assessing male breast lumps. Case Report: A 68-year-old gentleman presented to his general practitioner with a new left breast lump, present for several weeks, associated with ipsilateral axillary lymphadenopathy. He was referred to the breast clinic, where examination revealed a palpable, solid lesion in the left lower outer quadrant with localized discomfort but no skin or nipple changes. The initial clinical suspicion was that of primary breast carcinoma. Triple assessment demonstrated a lobulated breast lesion measuring 16 × 8 × 14 mm with axillary lymphadenopathy. Sampling of the axillary node showed reactive changes. Core biopsy of the breast lesion revealed grade 3A classic follicular lymphoma. Following multidisciplinary team discussion, the patient was referred to a hematologist. Due to multiple comorbidities, treatment options were carefully considered. He received one cycle of bendamustine and rituximab but subsequently experienced clinical deterioration and elected for palliative care. Conclusion: Primary breast lymphoma in males is rare and can resemble breast carcinoma at presentation. A high index of suspicion and adherence to triple assessment are essential for accurate diagnosis. A proper multidisciplinary approach should be devised based on patient compliance and clinical condition.