Long-Standing Breast Mass in an Elderly Male: A Rare Case of Invasive Papillary Carcinoma

ABSTRACT: Male breast cancer (MBC) is an uncommon malignancy, accounting for <1% of all breast cancers and often presenting as a diagnostic challenge due to a lack of awareness and absence of screening in males. Invasive papillary carcinoma (IPC) is a rare subtype of MBC, constituting <3% of cases, typically showing strong hormone receptor positivity and better prognosis than other invasive subtypes. A 65-year-old male presented with a left breast lump for 15 years, with intermittent nonprogressive pain for 2 years. Clinical examination revealed a single, nonmobile, nontender mass measuring 2 cm × 1 cm in the upper inner quadrant of the left breast, with a normal nipple-areolar complex and no axillary lymphadenopathy. Ultrasonography showed a mixed solid-cystic lesion with internal vascularity and microcalcifications. FNAC indicated an atypical proliferative lesion/low-grade carcinoma. PET-CT confirmed a solitary FDG-avid lesion with no metastasis. ER and PR were strongly positive. Histopathology revealed Grade I IPC. The patient underwent a modified radical mastectomy with axillary lymph node dissection. Final staging: pT2N0M0 (AJCC 8th edition). This case underscores the need to evaluate persistent breast lumps in males, regardless of duration. IPC carries a favorable prognosis when diagnosed early, and timely histopathological evaluation, along with surgical management, leads to optimal outcomes in MBC.