Breast discharge on one side of a male is cause for a diagnostic work-up. Mammograms are very helpful in identifying the presenting symptom as a malignancy. However, on a thin male it may be difficult to obtain. Ultrasound is a helpful tool. Needle biopsies, FNA or core, are used to obtain a histological diagnosis.
Mastectomy is usually the surgery of choice.
A modified radical is most often used, unless there is chest wall involvement of the muscle, which requires a radical mastectomy with removal of the pectoralis muscles. Radiation therapy is often used because of the close proximity of the tumor to the chest wall. More men present with later stage disease than women because of the lack of screening programs. Chemotherapy protocol drugs are identical to female breast cancer drugs. Cytoxan, Methotrexate, and 5FU are usually used in combination as first round chemotherapy.