Dr. Dinesh Kumar
Surgical Oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My father is 72-year-old. He was diagnosed with liver cirrhosis five years back. He is recently diagnosed with 2.6 cm hepatocellular carcinoma in segment seven. It does not show any symptoms and not spreading to the abdomen, pelvis, or chest. Resection and radiofrequency ablation were the two treatment options given. He is taking tablets for gout and blood pressure.
When he did his CT chest, the following were also found:
Spiculated right retro-areolar breast mass with nipple retraction. Correlate to palpable abnormality. Appearance may be related to asymmetric gynecomastia. However, malignancy should be excluded.
I was not aware my dad had a retracted nipple. He told me he had it for three to four years.
He was also on Spironolactone treatment five years back when he developed male boobs, and they were sore.
What could the retracted nipple be? If it was cancer, would it have got worse or spread by now? Treatment for his liver cancer is on hold until they investigate his breast, which makes no sense since the nipple has been visible for three to four years.
Kindly help.
Hi,
Welcome to icliniq.com.
Sorry to hear about it. It makes perfect sense to investigate breast mass first and rule out malignancy before tackling liver cancer.
I assume liver HCC (hepatocellular carcinoma) diagnosis is based on imaging only, rather than by an FNA (fine needle aspiration) or biopsy. It is quite possible that primary cancer might be in the breast, and a part of liver lesion spread there. As the CT scan showed spiculated margin, this feature is more towards cancer rather than some benign pathology. The treatment strategy would be entirely different for both scenarios.
I would pray for his speedy recovery.
Regards.
Patient's Query
Hi doctor,
Thanks for the reply.
All his tests reports came back fine. It has not spread to the chest, abdomen, and pelvis. Would not the breast have a more visible lump by now? He has not lost weight and does not have pain.
Kindly help.
Hi,
Welcome back to icliniq.com.
Your concerns and queries are correct, but diseases tend to appear and behave in strange ways sometimes. Breast cancers generally do not cause weight loss or pain. The lump may be palpable only if it is big enough. Sometimes, we may miss the finding if whole breast tissue is irregular. As you said, he has a retracted nipple; this particular finding is common in cancer and few other chronic infections.
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Surgical Oncology
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