Introduction/Background Ductal carcinoma in situ (DCIS) in males is an uncommon occurrence that is usually associated with invasive carcinoma. Male breast DCIS is exceedingly rare, accounting for 0. 1% of all breast cancers and 5% of male ones. The aim of this study is to highlight the relevance of this condition in males and to assess the treatment options for this uncommon malignancy.

Methodology We retrospectively report four cases of pure ductal carcinoma in situ in the male breast treated at Salah Azaiz Institute from 2012 to 2022.

Results The average age of DCIS was 53. 5 years with a mean delay of consultation of 73 days (21–152 days). The symptoms were essentially a retroareolar breast mass (in three cases), nipple retraction (in one case) and unipore bloody discharge (in one case). Gynecomastia was observed in two patients. The main radiological findings were nodules. Microcalcifications were noticed on one case. The median size of the tumor was 25 mm. Two patients had an ipsilateral axillary lymph node. The left side was in 3 cases. All of the patients underwent surgery: three patients had mastectomy and sentinel lymph node and one patient had mastectomy with lymph node dissection. The definitive histopathological assessment showed DCIS associated with papil­lary, cribriform, and comedocarcinoma in situ. There was no evidence of invasive carcinoma. In one case, the DCIS was associated with Paget’s disease of the nipple. Two patients received adjuvant hormonotherapy (Tamoxifen). The mean time of follow-up was 75. 5 months. One patient developed an invasive recurrence after 6 months of surgery.

Conclusion Treatments for males with DCIS have been mostly extrapolated from studies on female breast cancer due to the lack of data. Mastectomy with lymph node sampling is the standard treatment. Hormonotherapy can be recommended based on the hormonal receptors status.