Male ductal carcinoma in situ (DCIS) at a young age

In this case, a man in his late 20s visited his general practitioner with unilateral left nipple discharge. Initially, he was treated with antibiotics and the nipple discharge stopped. When the discharge recurred after a few weeks, the patient was referred to the multidisciplinary breast centre in UZ Leuven. Clinical examination revealed an otherwise healthy but obese man (body mass index of 31 kg/m²). On examination, we were able to evacuate bloody discharge from a single duct by mild compression of the left nipple. The bilateral mammography and ultrasound showed an irregular retroareolar density of 40×50 mm with adjacent, multiple clustered microcalcifications over a total distance of 20 mm on the left side. The histopathological report after core needle biopsy revealed a poorly differentiated ductal carcinoma in situ. Genetic testing for hereditary breast-ovarian cancer genes was negative. A simple left mastectomy with sentinel lymph node biopsy was performed. There was no indication for adjuvant chemotherapy or radiotherapy, nor for adjuvant endocrine therapy.