The presence of cancer cells in axillary lymph nodes through tissue diagnosis delineates the extent of spread of disease. Distant metastases include bone, lung, lymph node, liver and brain involvement. Radical mastectomy with subcutaneous reconstruction is the most frequently used procedure, while simple mastectomy remains limited to patients either with good prognosis and/or to those patients with very poor prognosis and at high risk for extensive surgery. Hill et al, reported an overall five year and ten year survival rate in patients with localized disease to 86% and 64% respectively. With positive lymph nodes, the five and ten year survival rate decreased to 73% and 50% respectively.

Radiation therapy is used for patients with localized disease and a high risk for surgery, but it is given more often to alleviate symptoms in patients with advanced disease. Patients with extensive metastatic disease are treated by hormonal manipulation where two thirds of these patients respond to hormonal therapy. Chemotherapy is another alternative mode of treatment.

Ablation treatment has been successful in some cases. Orchidectomy is the initial procedure in this option, due to the relatively good response and relatively decreased side effects and complications. If this is not successful, adrenalectomy and hypophysectomy show comparable results. These therapies lead to tumor regression, relief of symptoms and an increase in the survival rate. Finally, additive hormonal therapy; synthetic estrogen (DES) Diethylstilbestrol showed relative effectiveness in one study.

Male breast cancer, though very rare, does exist. Efforts to increase awareness among patients and physicians will lead to earlier presentation, and therefore diagnosis before spreading to the axilla and other organs. Like the majority of cancers, male breast cancer can be cured or controlled if diagnosed and treated properly at its early stages. Clinical presentation of our Saudi male patient resembled those reported in literature. However, conclusions regarding therapeutic modalities and related prognosis need further larger studies.