Introduction
Breast cancer in men is rare accounting for less than 1% of all breast
cancers in the United States.1–3 Given the rarity of
this disease, there are significant knowledge gaps pertaining to the
management of breast cancer in men, and even more so when assessing the
impact of race and other health disparities. The literature as it stands
today consists only of small, single-institution retrospective case
series and many of the clinical decisions regarding the management of
breast cancer in men are not derived from randomized clinical trials but
rather are interpolated from breast studies in women.4This poses a challenge as it has been noted that the presentation
amongst men and women differ significantly with men presenting at an
older age, with an average of 67 years compared to 62 years in women,
more advanced stage, and lower overall survival.5 The
known risk factors associated with male breast cancer include family
history of breast cancer, black or African ancestry, radiation exposure,
predisposition to germline genetic mutation, and
hypoestrogenism.5 Here, we report an unusual finding
of DCIS within a cystic lesion in an elderly black man with a delay in
diagnosis. This case highlights the need for adequate workup with
diagnostic imaging and timely follow-up for men with breast/chest wall
masses to rule out a malignancy given the lack of screening in this
population. Furthermore, we will explore how race contributes to
prognosis and health outcomes.