Synchronous Breast and Prostate Cancer in a 76-Year-Old Male: A Case Report

Abstract

Background:
Synchronous primary malignancies defined as two or more distinct tumors diagnosed within six months are rare clinical entities. Male Breast Carcinoma (MBC) accounts for less than 1% of all breast cancers and about 1% of male malignancies, whereas prostate cancer is among the most common male cancers globally. Their coexistence is extremely uncommon often raising questions of shared hormonal and genetic aetiologies. Mutations in BRCA genes, particularly BRCA2, increase the risk of both cancers, though sporadic cases without genetic predisposition are also observed.
Case Report:
We present a 76-year-old male with type 2 diabetes mellitus, ischemic heart disease, and a family history of breast cancer who presented with left nipple retraction and a palpable retro-areolar mass. Ultrasound breast confirmed presence of spiculated mass with microcalcifications and nipple retraction. A biopsy was done which showed grade 3 invasive ductal carcinoma, ER/PR-positive,
HER2-negative and Ki-67 50%. PET-CT unexpectedly identified a hypermetabolic prostate lesion. Further evaluation with MRI and targeted biopsy confirmed adenocarcinoma, Gleason score 4+3=7. Prostatic tumor was confined to the left lobe. The patient underwent left mastectomy with sentinel node biopsy (pT2N0) followed by tamoxifen. For the prostate cancer, androgen deprivation therapy was initiated, followed by brachytherapy and external beam radiotherapy. The patient tolerated treatment well and achieved excellent biochemical response with PSA suppressed to 0.012 ng/mL at 11 months without evidence of recurrence.
Conclusion:
Synchronous male breast and prostate cancer represents an exceptionally rare clinical scenario. This case highlights the importance of high index of suspicion, multimodal imaging and multidisciplinary planning in elderly patients presenting with atypical findings.