Occult medullary breast carcinoma in a male

Dear Editor, I read with interest the case report by Ballal and Rodrigues[1] published in the November–December 2018 issue of the Formosan Journal of Surgery. The authors described the clinical presentation, diagnostic workup, and treatment plan of the occult medullary breast carcinoma (OMBC) in a male Indian patient.[1] Based on the rarity of this neoplastic lesion to develop in a male patient, I assume that the authors ought to take into consideration compromised immune status in the studied patient. Among compromised immune states, human immunodeficiency virus (HIV) infection is of great importance. It is worthy to mention that patients with HIV infection are more liable to have neoplastic lesions compared to healthy individuals. This increased liability has been thought to be related to different factors, including co‐infection with oncogenic viruses, immunosuppression, and life prolongation secondary to the use of antiretroviral therapy.[2] India is among the Asian countries confronting the serious consequences of HIV infection. Although no recent data are yet present on the exact HIV seroprevalence in India, the available data pointed out to 0.26% seroprevalence compared with a global average of 0.2%.[3] I assume that the underlying HIV infection ought to be taken into consideration in the studied patient. Hence, implementing the diagnostic panel of viral overload and CD4 lymphocyte count measurements was envisaged. If that cluster of tests was to reveal HIV positivity, the case in question could be confidently regarded a novel case report. This is because HIV‐associated OMBC in a male patient has never been reported in the world literature so far.