MN MN - Minneapolis, WhtMale 30-45, UP124186, "Cindy" Keychain, Found in MS river and taken to shore, Sep'95

[Nate_Bro]

Canada's Missing | Case details

www.services.rcmp-grc.gc.ca

 

[PeriwinkleE]

Why aren’t there more photographs for this case? I hope there’s a photo in the case file that hasn’t been uploaded yet of the keyring! What kind of key is on the keyring? Maybe “Cindy” was the name of his car?

 

[PeriwinkleE]

List of exclusions.

 

[PeriwinkleE]

Canada's Missing | Case details

www.services.rcmp-grc.gc.ca

View attachment 627419

This man is edentulous. There’s no note about JD wearing dentures or having missing teeth?

 

[cenazoic]

Personally, the removal of breast tissue and nipple sounds like a unilateral mastectomy for breast cancer or possibly Paget's disease of the breast. In males, breast cancer or Paget's disease of the breast is exceedingly rare.

Could be gynecomastia, which apparently can affect up to 70% of (mostly older) men.

 

[Dogwithabone]

Could be gynecomastia, which apparently can affect up to 70% of (mostly older) men.

Hi. The assessment of the surgical necessity, confirmed by the descriptive details on NamUs and the news article, strongly suggests male breast cancer over benign gynecomastia. The evidence rests on three key clinical discrepancies: the extent of tissue removal, the size and placement of the incision, and the laterality of the condition.

The most compelling indicator of breast cancer is the surgical removal of the right nipple. Due to the small size of the male breast and the high prevalence of retroareolar involvement, nipple removal (excision of the NAC) is a standard and often non-negotiable component of a mastectomy to achieve clear margins.

Surgical management of gynecomastia — even in the cases prior to 1995 involving a subcutaneous mastectomy — has always prioritized NAC preservation. Complete nipple excision for a benign condition is exceptionally rare, reserved only for extreme skin redundancy or tissue necrosis.

Secondly, the size and location of the resultant scar are consistent with a therapeutic cancer procedure. The 22cm scar extending from the midline to the armpit directly aligns with the incision required for a Modified Radical Mastectomy (MRM). This extensive scar is necessary to remove the entire breast footprint and perform a possible axillary dissection (lymph node removal) to stage the disease which is an essential step in managing invasive cancer.

Procedures for gynecomastia typically utilize minimal, strategically placed incisions (e.g., periareolar or inframammary) and prioritise nipple preservation to maximize cosmetic results. These scars are significantly shorter and are designed to avoid the deep tissue plane and axillary extension seen in this case.

Furthermore, the John Doe presented with a unilateral procedure, which statistically favors malignancy. Gynecomastia is overwhelmingly bilateral (affecting both sides), though asymmetry is possible. Interestingly, unilateral gynecomastia is more common in the left breast. In male breast cancer, the malignancy is typically unilateral (affecting only one breast).

The combination of unilateral excision, complete NAC removal, and the necessity of a 22cm incision extending to the axilla definitively shifts the clinical probability toward male breast carcinoma over benign gynecomastia

References
NamUs
News Article
Modified Radical Mastectomy for Male Breast Cancer
Historically Significant: Mastectomy for Gynaecomastia Through Semicircular Intra-Areolar Incision, Webster (1946)
Invited Commentary - The Case for Nipple Preservation Over Grafts in Gynecomastia Surgery
Men and breast reconstruction surgery
Surgery for Breast Cancer in Men
Breast reshaping in gynecomastia by the pull-through technique: Considerations after 15 years
An interesting case of gynaecomastia
Unilateral male breast masses: cancer risk and their evaluation and management

Not a direct reference, but an interesting and supporting read on cosmetic prioritisation: Contemporary mastectomy options for male breast cancer: nipple-sparing and areolar-sparing mastectomy—a case series - Anderson - Annals of Breast Surgery

 

[cenazoic]

No argument from me - just offering as a possibility a more common condition than the ‘exceedingly rare’ male breast cancer / Paget’s you mentioned in your earlier comment.

Appreciate the very thorough and convincing response, @Dogwithabone!