Temporary spontaneous regression of male breast cancer: a case report

Abstract

Background Spontaneous regression (SR) of a malignant tumor is the partial or complete disappearance of primary or metastatic tumor tissue in the absence of treatment, which can be temporary or permanent. Here, we report an extremely rare case of male breast cancer that exhibited temporary SR followed by reappearance 8 months after tumor disappearance. Case presentation A 70-year-old man presented at our hospital with a primary complaint of pain and a lump in his left breast. Ultrasonography revealed a hypoechoic lesion measuring 12 mm × 10 mm × 8 mm. Fine-needle aspiration cytology revealed numerous necrotic and degenerated cells and few sheet-like clusters of atypical ductal epithelial cells. The atypical cells had mildly enlarged nuclei with nucleoli, were focally overlapped and formed tubular patterns. The cytological diagnosis indicated a suspicion of malignancy. Core needle biopsy (CNB) revealed necrotic and degenerated cells with microcalcification. The pathological diagnosis was indeterminate because there was no area of viable atypical cells. An excisional biopsy of the left breast lesion was scheduled one month later. However, it was difficult to detect the tumor during physical examination and ultrasonography performed 1 month after the patient’s first visit. The operation was canceled, and the patient received follow-up observation. After 8 months of follow-up, ultrasonography and computed tomography (CT) revealed reappearance of a 0.6-cm-diameter breast tumor in the same place. CNB was performed again and revealed invasive ductal carcinoma. A total mastectomy with sentinel lymph node biopsy was performed 13 months after the first tumor disappeared. Histopathological examination revealed invasive cribriform carcinoma without sentinel lymph node metastasis. The patient did not have any complications, and adjuvant therapy with tamoxifen was started. The patient was alive without recurrence 7 months after surgery. Conclusions Temporary SR followed by tumor reappearance can occur in breast cancer cases, and it is important to follow patients even if their breast tumor has seemingly disappeared. When breast tumors disappear without treatment, clinicians must be aware of the possibility of SR of cancer and should follow the patient for early detection of tumor reappearance.

What Can Trigger Spontaneous Regression of Breast Cancer?

“…A thorough search in PubMed was performed in order to find all cases of epithelial BC–SR published so far (December 2022). Twenty-nine reported cases were found [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. The results of our literature search are summarized in Table 1 .…”

“…Although breast carcinoma is a common malignancy, cases of SR described in the literature are extremely rare [ 3 , 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Hundreds of tumor regressions published so far have been reviewed; however, to date, only twenty-nine cases of regressed epithelial breast cancer can be considered reliable [ 3 , 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. We noticed that most of the patients were female in a wide age range.…”

Spontaneous regression of biologically aggressive breast carcinoma: A case report

“…[3] In 2020, there was a case report on the recurrence of an estrogen receptor positive breast cancer in a male patient following temporary spontaneous regression. [4] Hormones and endocrine factors have been cited in the literature as a possible cause of spontaneous regression, and with the wellknown influence of hormones in breast cancer, it is possible that the estrogen receptor status of the breast cancer may have an influence on the frequency of spontaneous regression. e American Journal of Clinical Oncology published a review in 1998, which demonstrated a higher prevalence of relapse in estrogen receptor positive breast cancer cases 8 years after mastectomy, as compared to estrogen receptor negative cases.…”