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Background: The introduction of the National Health Service (NHS) Breast Screening Programme has led to a considerable increase in the detection of impalpable breast cancer. Patients with impalpable breast cancer typically undergo oncological resection facilitated either by the insertion of guide wires placed stereo-tactically or through ultra-sound guided skin markings to delineate the extent of a lesion. The need for radiological interventions on the day of surgery adds complexity and introduces the risk that a patient may accidentally transferred to the operating room directly without the image guidance procedure. Case report: A case is described of a patient who required a pre-operative ultrasound scan in order to localise an impalpable breast cancer but who was accidentally taken directly to the operating theatre (OR) and anaesthetised without pre-operative intervention. The radiologist was called to the OR and an on-table ultrasound was performed without further consequence. Conclusion: It is evident that breast cancer patients undergoing image-guided resection are exposed to an additional layer of clinical risks. These risks are not offset by the World Health Organisation surgical safety checklist in its present guise. Here, we review a number of simple and inexpensive changes to the system that may improve the safety of the breast cancer patient undergoing surgery. [ABSTRACT FROM AUTHOR]

Male breast cancer (MBC) is rare with an incidence of 1% of all breast cancers. The evidence about the treatment is derived from the data on the management of the female breast cancer because conduction of randomized, controlled trials is impossible due to the rarity of the disease. In this study, we review the special features, overall management, diagnosis, and treatment of patients with MBC managed under our care with a brief review of the current literature. During the period 1998 to 2006, we managed 1103 new patients with breast cancer in St Mary’s Hospital. Among these, 14 patients were men. We retrospectively reviewed the case notes, histology, and follow-up notes of all the newly diagnosed patients with MBC. In this series, 28.6% had only in situ disease. Moreover, in 78.6% there was an in situ component present. One patient was found to have a cancer on the microdochectomy specimen after an operation for single duct nipple discharge, and in a second patient the cancer was found in the gynecomastia operation specimen. All ten invasive tumors were estrogen receptor positive (ER +ve), whereas eight were progesterone receptor positive (PgR +ve). With a median follow-up of 35 months, there was one locoregional recurrence and one disease-associated death. In situ cancer may not be as rare as previously reported among patients with MBC. Increased patient awareness and early assessment by a specialist is a key to early diagnosis and improved outcomes. [ABSTRACT FROM AUTHOR]