Management challenges of invasive breast carcinoma in a male patient who refused treatment: a case report

Abstract

Male breast cancer is extremely uncommon, accounting for less than 1% of all male cancers and about 0.1% of male cancer deaths. It tends to occur in an older age group (60–70 s) when compared to women (50–60 s). Male breast cancer does not usually present with large tumor size; normally, it presents with advanced stage due to less breast tissue compared to women. However, when it is left untreated for a long time, it can attain a big size. Studies have reported that some patients with breast cancer may refuse cancer treatment. Our report describes a case of breast cancer in a male patient from Tanzania who refused oncological care. A 74-year-old male came to our facility because of a left breast mass after more than 12 months. On examination, his vital signs were within normal limits. He had an ulcerated left breast mass measuring 24 × 24 cm that was noted to occupy the entire breast. Biopsy results from the lesion confirmed it to be infiltrating ductal carcinoma, of no special type, grade II. Surprisingly, the patient refused to undergo all forms of oncological treatment and opted to go for traditional medicines. The patient was kept on palliative care for controlling symptoms and improving quality of life. To date, 12 months of follow-up, the patient is still alive, although his condition has remarkably deteriorated. Respecting patients’ wishes is always a top priority, but physicians may provide more substantial reasoning to convince patients to undergo the indicated treatments by knowing the effect of dismissing operative treatment on their eventual survival. In addition, understanding why patients refuse treatment is important to effectively address their concerns.