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Carter MM, Whitrock JN, Pratt CG, Shaughnessy EA, Meier TM, Barrord MF, Hanseman DJ, Reyna CR, Heelan AA, Lewis JD. Nationwide Analysis of Locoregional Management for Ductal Carcinoma In Situ in Males: An NCDB Analysis of the Surgical Approach to DCIS in Males. Ann Surg Oncol 2024; 31:1599-1607. [PMID: 37978114 DOI: 10.1245/s10434-023-14579-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Limited data exist regarding the optimal locoregional approach for males with ductal carcinoma in situ (DCIS). This study examined trends in management and survival for males with DCIS. METHODS The National Cancer Database (NCDB) was queried for males with a diagnosis of DCIS from 2006 to 2017. Patients were categorized by locoregional management. Continuous variables were evaluated by Kruskal-Wallis and categorical variables by chi-square or Fisher's exact test. Univariable and multivariable logistic regressions were performed to evaluate for predictors of patients receiving partial mastectomy (PM) with radiation. Survival was analyzed by Kaplan-Meier. RESULTS Between 2006 and 2017, 711 males with DCIS were identified. Most received mastectomy alone (57.1%). No change was observed in management approach from 2006 to 2017. Patients who underwent mastectomy alone were mostly hormone-positive (95.9% were estrogen-positive, 90.9% were progesterone-positive), although this cohort was least likely to receive hormone therapy (17.2%). Among those who underwent PM with radiation, only 61% of those who were hormone-positive received hormone therapy. Univariable analysis demonstrated that those of black race had lower odds of receiving PM with radiation (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.36-0.84), which persisted in the multivariable analysis with control for age and tumor size (OR, 0.32; 95% CI, 0.15-0.67). Overall survival did not differ significantly between the four treatment methods (p = 0.08). CONCLUSIONS The management approach to male DCIS did not change from 2006 to 2017. Survival did not differ between treatment methods. Demographic and clinicopathologic features, including race, may influence locoregional treatments received, and further studies are needed to further understand this.
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Affiliation(s)
- Michela M Carter
- Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Jenna N Whitrock
- Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Catherine G Pratt
- Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Elizabeth A Shaughnessy
- Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Surgical Oncology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Teresa M Meier
- Department of Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michelle F Barrord
- Department of Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Radiation Oncology, Kettering Health Cancer Center, Kettering, OH, USA
| | - Dennis J Hanseman
- Division of Research and Biostatistics, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Chantal R Reyna
- Division of Surgical Oncology, Department of Surgery, Loyola University Chicago's Stritch School of Medicine, Maywood, IL, USA
| | - Alicia A Heelan
- Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Surgical Oncology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jaime D Lewis
- Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Surgical Oncology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Mada SR, Zay HH, Bies JJ, Massebo E, Didia C. A Rare Case of Remittent Male Invasive Ductal Carcinoma With New Metastasis After Incomplete Adjuvant Therapy. Cureus 2023; 15:e50400. [PMID: 38213367 PMCID: PMC10783793 DOI: 10.7759/cureus.50400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
Breast cancer is a rare disease in men with many barriers to effective management such as limited research and treatment modalities. While the current standard of care utilizes mastectomy and axillary dissection with chemotherapy, clinicians must follow the female-staged breast cancer protocol, as there is no established regimen for men. In this case presentation, we report a 43-year-old male with a prior history of ER-positive invasive ductal carcinoma (IDC) who presented with a recurrent breast lesion. The patient had previously undergone left breast mastectomy with sentinel node biopsy with negative margins. The patient declined adjuvant chemotherapy and tamoxifen therapy after the initial dissection. Three years after the primary dissection, the patient presents with a breast lesion and metastasis to bilateral axillary lymph nodes, lungs, and spine. The diagnosis was supported by a right axillary biopsy which revealed an ER-positive and PR-positive lesion. We want to shed light on the importance of complete and thorough treatment of primary IDC in men while highlighting the implications of incomplete treatment. We hope that this clinical case will serve as a guide for physicians in promoting adjuvant treatments after primary tumor removal in male IDC.
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Affiliation(s)
- Sanjana R Mada
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Hein H Zay
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Jared J Bies
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Eyoab Massebo
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Claudia Didia
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
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Parise CA, Caggiano V. The association of race/ethnicity in male breast cancer survival within similar comorbidity cohorts. Cancer 2023; 129:750-763. [PMID: 36597579 DOI: 10.1002/cncr.34592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/03/2022] [Accepted: 11/04/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Concomitant disease is associated with poor breast cancer survival in women and is more prevalent in racial/ethnic minority groups than individuals who are non-Hispanic White. The purpose of this study was to determine if race/ethnicity is associated with survival among men with breast cancer when stratifying analyses by level of comorbidity. METHODS We used the California Cancer Registry to identify 1730 cases of men and 259,828 cases of women with breast cancer and documented Charlson Comorbidity Index (CCI). Kaplan-Meier survival and Cox regression analyses were used to compare breast cancer-specific survival and risk of mortality for African American/Black, Hispanic, and Asian/Pacific Islander men with White women and White men. RESULTS When compared with White women, Black men with a CCI of 0 (hazard ratio [HR], 3.09; 95% CI, 1.10-1.16) and a CCI of 2+, (HR, 2.51; 95% CI, 1.42-4.42) had an increased risk of mortality when compared with White women. When compared with White men, African American men with a CCI of 0 (HR, 2.36; 95% CI, 1.45-3.85) and 2+ (HR, 2.44; 95% CI, 1.26-4.74) had an increased unadjusted risk of mortality, but these disparities were neutralized when controlling for sociodemographic and clinical factors. CONCLUSIONS Black men with both low and high levels of concomitant disease have an increased risk of mortality when compared with both White men and women, but demographic and clinical factors are contributors to this disparity.
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Affiliation(s)
- Carol A Parise
- Sutter Center for Health Systems Research, Sacramento, California, USA.,Sutter Institute for Medical Research, Sacramento, California, USA
| | - Vincent Caggiano
- Sutter Institute for Medical Research, Sacramento, California, USA
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Xin Y, Wang F, Ren D, Zhao F, Zhao J. Male Breast Cancer: Three Case Reports and a Literature Review. Anticancer Agents Med Chem 2023; 23:2161-2169. [PMID: 37605409 DOI: 10.2174/1871520623666230821124008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/01/2023] [Accepted: 07/24/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Male breast cancer (MBC) accounts for 0.5%-1% of all breast cancers diagnosed worldwide. However, its biological characteristics can be distinguished from that of female breast cancer (FBC). CASE REPRESENTATION The diagnostic and treatment approaches for MBC are mainly similar to that of FBC due to the lack of male breast cancer-related studies, clinical trials, and literature. An increasing number of retrospective and prospective studies have been conducted to clarify the individualized care for MBC. Herein, we report three cases of advanced MBC to describe the diagnostic approaches, treatment process, and survival prognosis. CONCLUSION MBC patients had older age, later stage at first diagnosis, higher expression of hormone receptors, and poor prognosis. A literature review was conducted to determine the incidence, risk factors, disease features, diagnosis, treatment, survival, and management of MBC.
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Affiliation(s)
- Yuanfang Xin
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Fengmei Wang
- Pathology Department of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Dengfeng Ren
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Fuxing Zhao
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Jiuda Zhao
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
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Niver HE, Foxhall E, Lahiry A. KEYNOTE-522 and male spindle cell carcinoma of the breast: A case report. Rare Tumors 2023; 15:20363613231163730. [PMID: 36937820 PMCID: PMC10021088 DOI: 10.1177/20363613231163730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Metaplastic Breast Cancer (MBC) is a rare group of tumors often presenting as triple-negative. MBC accounts for less than 1% of all breast cancers with the spindle cell variant comprising less than 0.5%. While rare, spindle cell carcinoma is the commonest subtype in the western world. It has a more aggressive biological behavior with increased risk of recurrence and death due to disease compared to triple negative breast cancers. There is no treatment guideline for management of MBC due to the rarity of the disease. Instead, treatment is theorized based off success with other types of aggressive breast and metaplastic cancers of different tissue. We present the first known case report of male spindle cell carcinoma of the breast treated with KEYNOTE-522 regimen. Therapy included a first phase with pembrolizumab (dose of 200 mg) every 3 weeks plus paclitaxel and carboplatin and second phase, with four cycles of pembrolizumab with doxorubicin-cyclophosphamide.
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Affiliation(s)
- Harper E Niver
- Northeast Georgia Medical Center and Health System, Gainesville, GA, United States
| | - Edward Foxhall
- Northeast Georgia Medical Center and Health System, Gainesville, GA, United States
| | - Anup Lahiry
- Northeast Georgia Medical Center and Health System, Gainesville, GA, United States
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Wang M, Liu D, Zhang Z, Dai X, Chen G, Zhu L. Molecular subtypes predict the prognosis of male breast cancer: a retrospective cohort study. TRANSLATIONAL BREAST CANCER RESEARCH : A JOURNAL FOCUSING ON TRANSLATIONAL RESEARCH IN BREAST CANCER 2022; 4:4. [PMID: 38751485 PMCID: PMC11093005 DOI: 10.21037/tbcr-22-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/12/2022] [Indexed: 05/18/2024]
Abstract
Background Male breast cancer is rare, and something different from female breast cancer. The characteristics of molecular subtype in male breast cancer is unclear and lack of large-sample study. Methods A retrospective study was conducted to investigate the characteristics and prognosis of patients with male breast cancer using the data recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010-2014. A total of 1,597 cases were enrolled with median age of 66 years. The study endpoint was considered as patient death. The molecular subtype was defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status, hormone receptor (HR) positive was defined as ER positive with or without PR positive, including 1,373 cases of HR+/HER2- tumor (86%), 182 cases of HR+/HER2+ tumor (11.4%), 13 cases of HR-/HER2+ tumor (0.8%) and 29 cases with triple negative (TN) tumor (1.8%), respectively. Results There were significant differences in distributions of age, race, grade, tumor size and American Joint Committee on Cancer (AJCC) stage between different molecular subtypes. Patients of different molecular subtypes differed significantly in 5 years overall survival and cause-specific survival (CSS). Five-year CSS (5y-CSS) rates of different molecular subtypes was 89.2% (HER2-/HR+), 78.4% (HER2+/HR+), 72.6% (HER2+/HR-) and 43.2% (TN), respectively. According to Cox regression, age ≥65 years [P=0.001, hazard ratio (HR) =2.136 (1.372, 3.324)], ER negative [P=0.02, HR =2.481 (1.159, 5.319)], PR negative [P=0.007, HR =2.294 (1.256, 4.184)], TN subtype [P<0.001, HR =10.676 (4.441, 25.665)], AJCC stage IV [P<0.001, HR =21.222 (10.377, 43.4)], tumor size >5 cm or T4 [P<0.001, HR =2.577 (0.978, 6.792)], Stage M1 [P=0.001, HR =4.519 (1.929, 10.587)] and Black race [P=0.002, HR =2.322 (1.442, 3.74)] were independent prognostic factors for poorer CSS. Conclusions Just like female, molecular subtypes also varied in male breast cancer. It could be a predictor for survival and improve the strategy making in clinical practice.
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Affiliation(s)
| | | | - Zhaoqi Zhang
- Department of Breast and Thyroid Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xueming Dai
- Department of Breast and Thyroid Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yıldırım HÇ, Mutlu E, Chalabiyev E, Özen M, Keskinkılıç M, Ön S, Çelebi A, Dursun B, Acar Ö, Kahraman S, Aykan MB, Kaman Ö, Doğan A, Erdoğan AP, Melisa Celayir Ö, Günenç D, Güven DC, Vedat Bayoğlu İ, Yavuzşen T, Hacıbekiroğlu İ, İnanç M, Kılıçkap S, Yalçın Ş, Aksoy S. Clinical outcomes of cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors in patients with male breast cancer: A multicenter study. Breast 2022; 66:85-88. [PMID: 36208540 PMCID: PMC9547301 DOI: 10.1016/j.breast.2022.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4-6 inhibitors in a multicenter real-life cohort. METHODS Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4-6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. RESULTS A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04-25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4-6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. CONCLUSION In our study, we found that CDK 4-6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4-6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer.
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Affiliation(s)
- Hasan Çağrı Yıldırım
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey.
| | - Emel Mutlu
- Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Turkey
| | - Elvin Chalabiyev
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Miraç Özen
- Sakarya University Faculty of Medicine, Department of Medical Oncology, Sakarya, Turkey
| | - Merve Keskinkılıç
- 9 Eylül University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - Sercan Ön
- Ege University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - Abdussamet Çelebi
- Marmara University Faculty of Medicine, Department of Medical Oncology, İstanbul, Turkey
| | - Bengü Dursun
- Ankara University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Ömer Acar
- Manisa Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Manisa, Turkey
| | - Seda Kahraman
- Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Musa Barış Aykan
- Gulhane Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Ömür Kaman
- Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Akif Doğan
- Kartal Dr. Lütfi Kirdar City Hospital, Department of Medical Oncology, İstanbul, Turkey
| | - Atike Pınar Erdoğan
- Manisa Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Manisa, Turkey
| | | | - Damla Günenç
- Ege University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - Deniz Can Güven
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - İbrahim Vedat Bayoğlu
- Marmara University Faculty of Medicine, Department of Medical Oncology, İstanbul, Turkey
| | - Tuğba Yavuzşen
- 9 Eylül University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - İlhan Hacıbekiroğlu
- Sakarya University Faculty of Medicine, Department of Medical Oncology, Sakarya, Turkey
| | - Mevlüde İnanç
- Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Turkey
| | - Saadettin Kılıçkap
- İstinye University Liv Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Şuayib Yalçın
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Sercan Aksoy
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
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Profile of Male Breast Cancer in Makkah Region of Saudi Arabia: A 4-Year Retrospective Analysis of Radiology and Histopathology. Int J Breast Cancer 2022; 2022:8831011. [PMID: 35784659 PMCID: PMC9242822 DOI: 10.1155/2022/8831011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 05/08/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mammography is a method widely used for the diagnosis of breast disorders in women and may help detect breast cancer in its early stages. Male breast cancer often remains undiagnosed or is poorly controlled until serious complications arise; therefore, the use of screening methods is needed to help with early diagnosis. Methods From a total of 1,667 registered mammography cases screened, 17 male breast disease cases were included in this study. Mammography and ultrasound data were analyzed by Statistical Package of Social Sciences v.22 (SPSS). Diagnosis was made following biopsy in suspicious cases, and histopathological and immunological findings of all such patients were obtained for final diagnosis. Results The mean age of the patients was 35 years (range, 14-70 years); 17.6% of the cases were aged 37 yrs, and 2 cases were aged 51 and 52 yrs. Of the 17 cases, 11 had breast lesions, and skin thickening was observed in only 1 case. The different patterns of lesions detected were asymmetry of the parenchyma, mastitis, and hamartoma (n = 1 each), malignant lesions (n = 2), and gynecomastia (n = 6). According to the BI-RADS categorization, 8 cases were benign, one case was probably benign, and 2 cases were likely malignant. In the 2 cases with malignant lesions, pathological diagnosis was made after hematoxylin and eosin and immunocytochemistry examination as invasive ductal carcinoma (IDC) of no special type (NST), grade II and grade III. Conclusions Most breast lesions in this study population were benign, while IDC was the most common malignancy encountered. Mammography is currently the most accurate and cost-effective method for detecting breast lesions. The findings of our study may help increase awareness of male breast cancer and encourage Saudi men at risk to perform self-breast exam and undergo routine breast screening.
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Pensabene M, Von Arx C, De Laurentiis M. Male Breast Cancer: From Molecular Genetics to Clinical Management. Cancers (Basel) 2022; 14:2006. [PMID: 35454911 PMCID: PMC9030724 DOI: 10.3390/cancers14082006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 12/18/2022] Open
Abstract
MBC is a rare disease accounting for almost 1% of all cancers in men and less than 1% of breast cancer. Emerging data on the genetic drivers of predisposition for MBC are available and different risk factors have been associated with its pathogenesis. Genetic alterations, such as pathogenetic variants in BRCA1/2 and other moderate-/low-penetrance genes, along with non-genetic risk factors, have been recognized as pathogenic factors for MBC. Preventive and therapeutic implications could be related to the detection of alterations in predisposing genes, especially BRCA1/2, and to the identification of oncogenic drivers different from FBC. However, approved treatments for MBC remain the same as FBC. Cancer genetic counseling has to be considered in the diagnostic work-up of MBC with or without positive oncological family history. Here, we review the literature, reporting recent data about this malignancy with a specific focus on epidemiology, and genetic and non-genetic risk factors. We introduce the perspective of cancer genetic counseling for MBC patients and their healthy at-risk family members, with a focus on different hereditary cancer syndromes.
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Affiliation(s)
- Matilde Pensabene
- National Cancer Institute, IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (C.V.A.); (M.D.L.)
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Dondi F, Albano D, Giubbini R, Bertagna F. 18F-FDG PET/CT for the evaluation of male breast cancer: a systematic review. Nucl Med Commun 2022; 43:123-128. [PMID: 34783719 DOI: 10.1097/mnm.0000000000001508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the last years, some studies on the usefulness of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) for the evaluation of male breast cancer (MBC) have been produced. The aim of this review is to analyze the usefulness of 18F-FDG PET/CT and its diagnostic performances for the assessment of MBC. METHODS A wide literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane library databases was made to find relevant published articles on the role of 18F-FDG PET/CT for the evaluation of MBC. Moreover, quality assessment including the risk of bias and applicability concerns was carried out using QUADAS-2 evaluation. RESULTS The comprehensive computer literature search revealed 3178 articles. On reviewing the titles and abstracts, 3170 articles were excluded because the reported data were not within the field of interest and finally eight studies were included in the review, for a total of 176 male patients. The studies considered revealed high diagnostic accuracy of 18F-FDG PET/CT for the evaluation of MBC both at staging and restaging of disease. Moreover, its added values compared to conventional imaging are starting to emerge and insight into its controversial prognostic importance is growing. CONCLUSION Despite some limitations affecting our review, 18F-FDG PET/CT seems to be a valuable tool to assess MBC. Further research studies are required to better underline the role of hybrid imaging with 18F-FDG for the evaluation of MBC, especially in comparison with female breast cancer.
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Affiliation(s)
- Francesco Dondi
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
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Park S, Hur H, Lee JS, Yoon J, Hur SM, Chung IY, Lee JW, Youn HJ, Oh SJ, Lim CW, Lee J. Prognostic Factors in Male Breast Cancer: A Retrospective Nationwide Study in South Korea by the Study of SMARTSHIP Group. J Breast Cancer 2022; 24:561-568. [PMID: 34979600 PMCID: PMC8724376 DOI: 10.4048/jbc.2021.24.e54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 10/12/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022] Open
Abstract
This study evaluated the incidence, the survival outcomes and its prognostic factors for male breast cancer (MBC) in Korea. Using the National Health Insurance Service database of Korea, we identified MBC patients who had the new claim code of C50. Medical records including type of surgeries and radiotherapy within one year of the first claim and death records were reviewed. Between 2005 and 2016, 838 newly diagnosed MBC patients were included (median follow-up, 1,769 days). The 70–74-year age group had the highest incidence of MBC. The 5-year survival rate was 73.7%. Age > 65 years, low income, no surgical intervention, no tamoxifen use, and > 2 comorbidities correlated with a worse outcome. MBC incidence has increased over time, and its peak is noted at age > 70 years. Age > 65 years, > 2 comorbidities, no surgical intervention, and no tamoxifen use correlate to poor prognosis.
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Affiliation(s)
- Sungmin Park
- Department of Breast Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Ho Hur
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - JaeSun Yoon
- Department of Biostatistics, Korea University, Seoul, Korea
| | - Sung Mo Hur
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Il Yong Chung
- Department of Surgery, Asan Medical Center, Seoul, Korea
| | - Jong Won Lee
- Department of Surgery, Asan Medical Center, Seoul, Korea
| | - Hyun Jo Youn
- Department of Surgery, Chonbuk National University Hospital, Jeonju, Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Cheol Wan Lim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
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Ambalathandi R, Polavarapu H, Reddy RR, Balasubramanian A, Meenakshisundaram M. Rarest of the rare-male triple negative breast cancer. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2022. [DOI: 10.4103/jdrntruhs.jdrntruhs_17_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Abstract
Objective We aimed to describe the differences in clinicopathological characteristics and overall survival (OS) between male and female breast cancer patients, and to develop a prognostic nomogram to predict survival in patients with male breast cancer (MBC). Methods Using the Surveillance, Epidemiology, and End Results database, we compared age, race, histological type, histological grade, tumor size, lymph node status, metastases, estrogen/progesterone receptor (ER/PR) and HER-2 status between male and female patients, and analyzed their relationships with OS. We established a nomogram and produced a calibration curve to observe its predictive effect. Results Age, race, T stage, N stage, bone and lung metastases, and histological type and grade differed between male and female patients. OS in male patients was related to age, tumor size, metastatic site, ER/PR status, and histological grade, but not to race or lymph node status. A nomogram was established, which showed good predictive performance for survival in MBC patients (area under the curve = 0.7). Conclusion MBC has a worse prognosis than female breast cancer, mainly characterized by late onset age, late staging, high proportion of invasive non-specific histological types, high histological grade, and luminal breast cancer.
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Affiliation(s)
- Xinli Wang
- Xi'an International Medical Center Hospital, Xi'an, Shaanxi province, China
| | - Shusong Liu
- Xi'an International Medical Center Hospital, Xi'an, Shaanxi province, China
| | - Yan Xue
- Xi'an International Medical Center Hospital, Xi'an, Shaanxi province, China
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14
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Kraus AL, Yu-Kite M, Mardekian J, Cotter MJ, Kim S, Decembrino J, Snow T, Carson KR, Motyl Rockland J, Gossai A, Wilner K, Wang DD, Huang Bartlett C, Oharu N, Schnell P, VanArsdale T, Lu DR, Tursi JM. Real-World Data of Palbociclib in Combination With Endocrine Therapy for the Treatment of Metastatic Breast Cancer in Men. Clin Pharmacol Ther 2021; 111:302-309. [PMID: 34668577 DOI: 10.1002/cpt.2454] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/06/2021] [Indexed: 12/27/2022]
Abstract
This report examined the benefits and risks of palbociclib plus endocrine therapy (ET) in men with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC). Palbociclib was evaluated using three independent data sources: real-world data from pharmacy and medical claims, a de-identified real-world data source derived from electronic health records (EHRs), and a global safety database. From medical and pharmacy records, 1,139 men with MBC were identified; in the first-line setting, median duration of treatment was longer with palbociclib plus ET (n = 37, 8.5 months, 95% confidence interval (CI), 4.4-13.0) than ET alone (n = 214, 4.3 months, 95% CI, 3.0-5.7) and specifically, was longer with palbociclib plus letrozole (n = 26, 9.4 months, 95% CI, 4.4-14.0) than letrozole alone (n = 63, 3.0 months, 95% CI, 1.8-4.8). In the EHR-derived database, 59 men received treatment for MBC; real-world response across all lines of therapy in the metastatic setting was reported in 4 of 12 patients (33.3%) in the palbociclib plus ET group vs. 1 of 8 (12.5%) patients in the ET group. Review of the global safety database did not identify any new safety signals in palbociclib-treated men. Real-world data indicated that men with MBC benefit from palbociclib plus ET, with a safety profile consistent with previous observations in women with MBC. Collective data on palbociclib in women and men in this report, including clinical trial data, real-world data, and a well-established risk/benefit profile, led to US approval of an expansion of the palbociclib indication to include men with MBC.
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Affiliation(s)
| | | | | | | | - Sindy Kim
- Pfizer Inc, San Diego, California, USA
| | | | - Tamara Snow
- Flatiron Health, Inc, New York, New York, USA
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15
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Oke O, Niu J, Chavez-MacGregor M, Zhao H, Giordano SH. Adjuvant tamoxifen adherence in men with early-stage breast cancer. Cancer 2021; 128:59-64. [PMID: 34597415 DOI: 10.1002/cncr.33899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Most breast cancers (BCs) in men are hormone receptor-positive. Adjuvant tamoxifen is part of the standard treatment of these patients. Small, single-institution studies have suggested that men have high rates of discontinuing adjuvant endocrine treatment. The authors examined rates of tamoxifen discontinuation and medication adherence in a large population-based cohort of male patients with BC. METHODS In the Surveillance, Epidemiology, and End Results-Medicare database, male patients with invasive nonmetastatic BC, diagnosed between 2007 and 2013, who were ≥65 years old, had Part D coverage, and had tamoxifen prescriptions within 1 year of diagnosis were identified. Adherence was defined as a medication possession ratio of ≥80% among those patients who were filling tamoxifen prescriptions. Logistic regression model was used to assess predictors of tamoxifen adherence. RESULTS A total of 451 patients met eligibility criteria. The median age at diagnosis was 75 years. The median follow-up was 32.5 months. The rates of tamoxifen discontinuation were 15.8%, 24.3%, 31.3%, 36.9%, and 48.3% at 1, 2, 3, 4, and 5 years after diagnosis, respectively. Among the men who were still taking tamoxifen, the corresponding adherence rates were 76.9%, 73.6%, 68.7%, 64.8%, and 60.2%. In the adjusted model, significant predictors of lower adherence included residing in a high poverty area (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.28-2.12) and a Charlson comorbidity score of ≥2 (OR, 0.46; 95% CI, 0.22-0.97). CONCLUSION Older men with breast cancer have high rates of tamoxifen discontinuation, with 48% of all patients discontinuing tamoxifen before the end of year 5. Additionally, even among those patients continuing tamoxifen, a substantial number of patients are nonadherent. Further research should evaluate potentially modifiable reasons for treatment discontinuation and lack of adherence to tamoxifen.
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Affiliation(s)
- Oluchi Oke
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jiangong Niu
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mariana Chavez-MacGregor
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hui Zhao
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sharon H Giordano
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
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16
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Male breast cancer: an update. Virchows Arch 2021; 480:85-93. [PMID: 34458944 DOI: 10.1007/s00428-021-03190-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/23/2021] [Accepted: 08/03/2021] [Indexed: 12/13/2022]
Abstract
Male breast cancer (MBC) is rare, accounting for less than 1% of all breast cancer but the incidence has increased worldwide. Risk factors include increased longevity, obesity, testicular diseases and tumours, and germline mutations of BRCA2. BRCA2 carriers have 80 times the risk of the general population. Men generally present with breast cancer at an older age compared with women. Histologically, MBC is often of grade 2, hormone receptor positive, HER2 negative, and no special type carcinoma although in situ and invasive papillary carcinomas are common. Reporting and staging are similar to female breast cancer. Metastatic lesions to the male breast do occur and should be differentiated from primary carcinomas. Until recently, MBC was thought to be similar to the usual ER positive post-menopausal female counterpart. However, advances in MBC research and trials have highlighted significant differences between the two. This review provides an up to date overview of the biology, genetics, and histology of MBC with comparison to female breast cancers and differential diagnosis from histological mimics.
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17
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Comparison between male and female breast cancer survival using propensity score matching analysis. Sci Rep 2021; 11:11639. [PMID: 34079019 PMCID: PMC8172634 DOI: 10.1038/s41598-021-91131-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/10/2021] [Indexed: 01/21/2023] Open
Abstract
Male breast cancer (MBC) is a rare disease. The few studies on MBC reported conflicting data regarding survival outcomes compared to women. This study has two objectives: to describe the characteristics of a single-cohort of MBC and to compare overall survival (OS) and disease-free survival (DFS) between men and women using the propensity score matching (PSM) analysis. We considered MBC patients (n = 40) diagnosed between January 2004 and May 2019. Clinical, pathological, oncological and follow-up data were analyzed. Univariate analysis was performed to determine the prognostic factors on OS and DFS for MBC. We selected female patients with BC (n = 2678). To minimize the effect of the imbalance of the prognostic factors between the two cohorts, the PSM method (1:3 ratio) was applied and differences in survival between the two groups were assessed. The average age of MBC patients was 73 years. The 5-year OS and DFS rates were 76.7% and 72.2% respectively. The prognostic factors that significantly influenced OS and DFS were tumor size and lymph node status. After the PSM, 5 year-OS was similar between MBC and FBC (72.9% vs 72.3%, p = 0.70) while we found a worse DFS for MBC (72.2% vs 91.4%, p = 0.03). Our data confirmed previous reported MBC characteristics: we found a higher risk of recurrence in MBC compared to FMC but similar OS. MBC and FMC are different entities and studies are needed to understand its epidemiology and guide its management.
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18
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Abstract
Male breast cancer is a rarely encountered disease, when compared with female breast cancer, often detected in more advanced stage at the time of diagnosis, and associated with more lymph node metastasis rates, more estrogen receptors positivity, and less human epidermal growth factor receptor-2 expression (HER-2) rates. Surgical management also shows some difference, where the most common operative technique of male breast cancer patients is mastectomy and/or axillary surgery. Triple-negative breast cancer is less frequent than other subtypes and is associated with poorer prognosis. This is because of its association with higher histopathological grade than that in other types of breast cancer. Only fewer treatment options are available compared to hormone-positive, HER-2 positive breast cancer. We are present a case of 71-year-old gentleman with triple-negative breast cancer.
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Affiliation(s)
- Qasif Qavi
- Surgery, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Firas Alkistawi
- Surgery, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Shashi Kumar
- Surgery, Mid and South Essex NHS Foundation Trust, Basildon, GBR
| | - Rizwan Ahmed
- Surgery, Princess Royal University Hospital, Orpington, GBR
| | - Abdalla Saad Abdalla Al-Zawi
- Breast Surgery, Anglia Ruskin University, Chelmsford, GBR.,Breast Surgery, Basildon and Thurrock University Hospital, Basildon, GBR.,General Surgery, Mid and South Essex NHS Foundation Trust, Basildon, GBR
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19
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Tumor subtypes and survival in male breast cancer. Breast Cancer Res Treat 2021; 188:695-702. [PMID: 33770314 DOI: 10.1007/s10549-021-06182-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Male breast cancer is an uncommon disease, and population-based information regarding prognostic factors is limited. Most cases are hormone receptor (HR) positive; however, the association of tumor subtype with overall survival (OS) and breast cancer-specific survival (BCSS) is unclear. METHODS Using SEER data, we identified men with invasive breast cancer between 2010 and 2017 with known HR and HER2 status. We examined tumor subtypes by patient characteristics and performed multivariate Cox proportional hazards analyses to determine the associations of each variable with OS and BCSS. RESULTS We included 2389 men with a median follow-up of 43 months (IQR 19-68). Median age was 66 years. Tumor subtype distribution was 84.1% HR+/HER2-, 12.7% HR+/HER2+ , 0.8% HR-/HER2+, and 2.3% triple-negative (TN). In univariate analysis, OS at 5 years was 76.5% for HR+/HER2-, 65.1% for HR+/HER2+ , 84.2% for HR-/HER2+, and 48.1% for TN (p < 0.0001). Of all subtypes, TN had the worst BCSS (p < 0.0001). Stage, tumor subtype and race were significantly associated with OS and BCSS in multivariate analysis. Adjusted Cox hazard ratios for OS by tumor subtype with HR+/HER2- as reference were 1.55 for HR+/HER2+ (p = 0.001), 1.1 for HR-/HER2+ (p = 0.888), and 3.59 for TN (p < 0.001). CONCLUSION We observed significant differences in survival outcomes by tumor subtype. Poor outcomes among men with HER2+ and TN disease suggest possible under-treatment, aggressive tumor biology, and/or more advanced disease at presentation. Studies to better understand the inferior survival for men with these subtypes are warranted and will likely require international collaboration.
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20
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Khan NAJ, Tirona M. An updated review of epidemiology, risk factors, and management of male breast cancer. Med Oncol 2021; 38:39. [PMID: 33721121 DOI: 10.1007/s12032-021-01486-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 02/24/2021] [Indexed: 01/21/2023]
Abstract
Unlike female breast cancer, male breast cancer (MBC) is rare and not very well understood. Prospective data in the management of MBC are lacking and majority of treatment strategies are adopted from the established guidelines for breast cancer in women. The understanding of biology, clinical presentation, genetics, and management of MBC is evolving but there still remains a large knowledge gap due to the rarity of this disease. Older age, high estradiol levels, klinefelter syndrome, radiation exposure, gynecomastia, family history of breast cancer, BRCA2 and BRCA1 mutation are some of the known risk factors for MBC. Routine screening mammography is not recommended for asymptomatic men. Diagnostic mammogram with or without ultrasound should be considered if there is a suspicion for breast mass. Majority of men with early-stage breast cancer undergo mastectomy whereas breast conserving surgery (BCS) with sentinel lymph node biopsy (SLNB) remains an alternative option in selected cases. Since the majority of MBC are hormone receptor positive (HR+), adjuvant hormonal therapy is required. Tamoxifen for a total of 5 to 10 years is the mainstay adjuvant hormonal therapy. The role of neoadjuvant and adjuvant chemotherapy for early-stage breast cancer is uncertain and not commonly used. The role of gene recurrence scores like oncotype Dx and mammaprint is evolving and can be used as an aid for adjuvant chemotherapy. Majority of metastatic MBC are treated with hormonal therapy with either tamoxifen, gonadotropin-releasing hormone agonist (GnRH) with aromatase inhibitors (AI), or fulvestrant. Chemotherapy is reserved for patients with visceral crisis or rapidly growing tumors.
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Affiliation(s)
- Noman Ahmed Jang Khan
- Department of Hematology and Oncology, Joan C. Edwards School of Medicine at Marshall University, 1400 Hal Greer Blvd, Huntington, WV, 25701, USA.
| | - Maria Tirona
- Department of Hematology and Oncology, Joan C. Edwards School of Medicine at Marshall University, 1400 Hal Greer Blvd, Huntington, WV, 25701, USA
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21
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Presentation and Spectrum of Male Breast Cancer in a Rural Cancer Center in a Subunit of Tata Memorial Center, India. Indian J Surg Oncol 2021; 12:330-334. [PMID: 34295077 DOI: 10.1007/s13193-021-01306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/01/2021] [Indexed: 10/21/2022] Open
Abstract
This is a retrospective study of the incidence and clinical profile of male breast cancer (MBC) presenting to a rural cancer center in Punjab, India. All MBC cases registered over a period of 4.5 years from January 2015 to July 2019 were included. The study included 34 MBC patients accounting for 1.9% of all breast cancer cases with median age of 62.5 years. All patients were from Punjab except one, with majority from district Sangrur. Family history was present in 7 (20.6%) patients. Mean BMI (n = 23) was 24.8. The median duration of symptoms was 6 months (range 1-60 months). Main complaint was lump in 58.8% of patients followed by lump with ulceration (41.2%). All cases were mostly unilateral, left in 21 (61.8%) and right in 13 (38.2%), and one had bilateral breast cancer. Most tumors were centrally located (70.6%). Infiltrating ductal carcinoma and grade 3 were the commonest histology. ER positivity was high seen in 76.5% cases. In our study, 16 (47.1%) patients presented with distant metastasis at the time of diagnosis, and 10 (39.1%) were locally advance. Bone (41%) followed by lung (17%) were the most common sites of metastasis. Thirteen patients were treated radically, nine were treated with palliative intent, and twelve patients defaulted. Median follow-up period was 16.5 months. MBC constituted 1.9% of all breast cancers registered at our institute, which is higher than worldwide average. Our study population had a longer time to presentation, and majority were metastatic.
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22
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The prognostic significance of metastatic pattern in stage IV male breast cancer at initial diagnosis: a population-based study. Breast Cancer Res Treat 2021; 187:237-244. [PMID: 33389398 DOI: 10.1007/s10549-020-06052-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/07/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE Metastatic pattern (MP) is a prognostic factor in women with breast cancer. However, the prognostic significance of MP in male breast cancer patients remains unknown. METHODS Using the SEER database, we gathered demographic information and disease characteristics for men diagnosed with de novo metastatic breast cancer from 2010 to 2017. Metastases to bone, brain, liver, and lung were used to define MP (bone-only, visceral, bone and visceral [BV], or other). Statistical analyses were performed to identify associations between overall survival (OS) and MP, as well as other patient and tumor features. We used multivariate logistic regression to evaluate factors associated with sites of metastases. RESULTS We included 250 patients. MP distribution was bone = 38.8%, visceral = 14.8%, BV = 33.2%, and other = 13.2%. Median OS for each was bone = 33 months, visceral = 23 months, BV = 20 months, and other = 46 months (p = 0.046). Patients with brain metastases had significantly shorter OS compared with no brain metastases (median OS = 9 months vs. 30 months; p < 0.001). Compared with other subtypes, triple negative had the shortest OS (median 9 months, p < 0.001). Logistic regression modeling revealed that compared with HR+/HER2- breast cancers, HR-/HER2+ had higher odds of liver metastases and triple negative had higher odds of brain metastases. Patients younger than 50 years had a significantly greater risk of developing brain metastases. CONCLUSIONS MP and tumor subtype can predict OS outcomes in men with metastatic breast cancer at diagnosis. Brain metastases confer very poor prognosis.
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23
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Li X, Zhang X, Liu J, Shen Y. Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study. BMC Cancer 2020; 20:1102. [PMID: 33187507 PMCID: PMC7666499 DOI: 10.1186/s12885-020-07593-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 10/30/2020] [Indexed: 12/25/2022] Open
Abstract
Background Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer. Methods Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively. Results A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR−/HER2-, and 7.39% were HR−/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at 5 years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p < 0.05). Multivariate Cox regression analysis showed that age of 55–59 (HR = 1.270), black race (HR = 1.317), grade III or IV (HR = 1.960), HR−/HER2- (HR = 2.808), lung metastases (HR = 1.378), liver metastases (HR = 2.085), and brain metastases (HR = 1.903) were independent risk factors for prognosis; married status (HR = 0.819), HR+/HER2+ (HR = 0.631), HR−/HER2+ (HR = 0.716), insurance (HR = 0.587) and surgery (HR = 0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR = 0.694, 95% CI: 0.485–0.992), but the interaction between race and subtype did not reach significance for prognosis. Conclusions There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.
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Affiliation(s)
- Xiao Li
- Department of Medical Affairs, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xiaoli Zhang
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Jie Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Yinzhong Shen
- Department of Medical Affairs, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. .,Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
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24
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Srour MK, Amersi F, Mirocha J, Giuliano AE, Chung A. Male Breast Cancer: 13-Year Single Institution Experience. Am Surg 2020; 86:1345-1350. [PMID: 33103460 DOI: 10.1177/0003134820964444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Due to the low incidence of male breast cancer (BC), there are few studies evaluating outcomes. We evaluated the clinicopathologic features and outcomes of male BC. Male patients with BC from January 2006 to December 2018 were identified. Of 49 patients, mean age was 64 (range 33-94) years. Of the 27 (55.1%) patients who had genetic testing, 9 (33.3%) had a Breast Cancer gene (BRCA) 1 or 2 mutation. The majority of patients had a mastectomy (n = 43/49, 87.8%) and had invasive ductal carcinoma (n = 47/49, 95.9%). 20 patients (n = 20/43, 46.5%) had positive lymph nodes. 41 (n = 41/47, 87.2%) patients had estrogen receptor positive disease. The majority of patients were pathologic stage 2 (n = 21/46, 45.7%), followed by stage 1 (n = 15/46, 32.6%), stage 3 (n = 6/46, 13.0%), and stage 4 (n = 4/46, 8.7%). Eight patients had the 21-gene recurrence score performed. Of patients with stage 1-3 BC, 10 (n = 10/43, 23.3%) patients had recurrence. With median follow-up of 4.1 (range .6-10.6) years, 5-year overall survival was 82.9% and 5-year disease-free survival was 65.9%. In conclusion, our cohort of patients with male BC had a high incidence of BRCA mutations and most commonly had high-grade estrogen positive stage 2 tumors. Breast conserving surgery was utilized in 4% of patients and genomic testing utilized in 55% of patients.
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Affiliation(s)
- Marissa K Srour
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Farin Amersi
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James Mirocha
- Department of Biostatistics and Bioinformatics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Armando E Giuliano
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alice Chung
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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25
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Corti C, Crimini E, Criscitiello C, Trapani D, Curigliano G. Adjuvant treatment of early male breast cancer. Curr Opin Oncol 2020; 32:594-602. [PMID: 32852309 DOI: 10.1097/cco.0000000000000678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Male breast cancer (MaBC) is a rare disease, and some challenges exist in its management because current treatment recommendations are extrapolated from trials that mostly excluded men. This review will revise all available data that could improve the treatment of MaBC, with a special focus on adjuvant systemic treatments. RECENT FINDINGS To date, men with hormone receptor-positive breast cancer, who are candidates for adjuvant endocrine therapy, should be offered tamoxifen (TAM) for five years. Additional five years are possible, according to tolerance and recurrence risk. If TAM is contraindicated, a gonadotropin-releasing hormone (GnRH) agonist or antagonist and aromatase inhibitor should be proposed. Chemotherapy and targeted therapy in the other breast cancer subtypes should be used with the same indications offered to women with breast cancer. All men with breast cancer should be offered genetic counseling and germline genetic testing of cancer predisposition genes. SUMMARY For decades, men with breast cancer have been treated suboptimally and denied the participation in clinical trials. Recently, many clinical trials started enrolling both genders, as strongly endorsed by the Food and Drug Administration. Hopefully, this turnaround will help subdue the disparities in the quality of care.
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Affiliation(s)
- Chiara Corti
- Department of Oncology and Haematology (DIPO), University of Milan.,Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Edoardo Crimini
- Department of Oncology and Haematology (DIPO), University of Milan.,Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Carmen Criscitiello
- Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Dario Trapani
- Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Haematology (DIPO), University of Milan.,Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
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26
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Zheng A, Zhang L, Ji Z, Fan L, Jin F. Oncotype DX for Comprehensive Treatment in Male Breast Cancer: A Case Report and Literature Review. Am J Mens Health 2020; 13:1557988319847856. [PMID: 31068065 PMCID: PMC6509981 DOI: 10.1177/1557988319847856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Male breast cancer (MBC) is uncommon in clinical practice. Using the 21-gene assay to facilitate decision-making on comprehensive treatment of MBC is rarely reported. This study reports the case of a 53-year-old man with left breast cancer. Modified radical mastectomy was performed. Endocrine treatment was chosen for the patient according to the result of the 21-gene assay, a recommended genomic test of breast cancer. The patient remained in good health without evidence of recurrence at 18-month follow-up. This case provides a reference mode for the comprehensive management of early-stage, estrogen receptor–expressing and lymph node–negative MBC patients.
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Affiliation(s)
- Ang Zheng
- 1 Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Lin Zhang
- 2 NingBo Huamei Hospital, University of Chinese Academy of Sciences, People's Republic of China
| | - Ziyao Ji
- 3 Department of Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Lijuan Fan
- 1 Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Feng Jin
- 1 Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
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27
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Moosavi L, Kim P, Uche A, Cobos E. A Synchronous Diagnosis of Metastatic Male Breast Cancer and Prostate Cancer. J Investig Med High Impact Case Rep 2020; 7:2324709619847230. [PMID: 31053047 PMCID: PMC6505228 DOI: 10.1177/2324709619847230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In this article, we present a patient diagnosed synchronously with metastatic
male breast cancer and prostate cancer. This is a 63-year-old male and recent
immigrant from Nigeria, who sought medical attention for progressively worsening
of shortness of breath and acute progression of a chronic right breast mass. An
invasive breast carcinoma was diagnosed by the core biopsy of the right breast
mass. Within 2 months of his breast cancer diagnosis, the patient also was
diagnosed with prostate adenocarcinoma after being worked up for urinary
retention. By presenting this patient with a synchronous diagnosis with
metastatic male breast cancer and prostate cancer, history of chronic right
breast mass, and gynecomastia, we speculate on possible cancer etiologies and
risk factors.
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Affiliation(s)
| | - Phyllis Kim
- 2 Kaiser Permanente Medical Center, Los Angeles, CA, USA
| | - An Uche
- 3 Los Angeles County Harbor-UCLA Medical Center, Torrance, CA, USA
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28
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Machado MCA, Ocarino NM, Serakides R, Moroz LR, Sementilli A, Damasceno KA, Cruz CH, Estrela-Lima A. Triple-negative mammary carcinoma in two male dogs. J Vet Diagn Invest 2020; 32:94-98. [PMID: 31924140 DOI: 10.1177/1040638719898686] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Triple-negative tumors are characterized immunohistochemically by the absence of positivity to sex hormone receptors and to human epidermal growth factor receptor 2. Additionally, they are differentiated into basal-like and non-basal (or null) subtypes, based on the presence of basal cytokeratin expression (CK5/6, 14, and17). Triple-negative subtypes are yet to be characterized in male dogs, to our knowledge. We report herein the clinical and pathologic findings and molecular characterization of carcinoma in the mammary glands of 2 male dogs. Case 1 was diagnosed as a grade II tubulopapillary carcinoma; case 2 was diagnosed as a grade II carcinoma in a mixed tumor. The tumors were characterized phenotypically as triple-negative basal and triple-negative non-basal, respectively.
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Affiliation(s)
- Marília C A Machado
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
| | - Natalia M Ocarino
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
| | - Rogéria Serakides
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
| | - Ludmila R Moroz
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
| | - Angelo Sementilli
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
| | - Karine A Damasceno
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
| | - Claudia H Cruz
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
| | - Alessandra Estrela-Lima
- Programa de Pós-Graduação Ciência Animal nos Trópicos (Machado, Cruz, Estrela-Lima), and Laboratório de Análises Clínicas (Moroz), Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Laboratório de Patologia da Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Ocarino, Serakides).,Universidade Metropolitana de Santos, Santos, São Paulo, Brazil (Sementilli).,Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil (Damasceno)
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Overall Survival of Men and Women With Breast Cancer According to Tumor Subtype: A Population-based Study. Am J Clin Oncol 2019; 42:215-220. [PMID: 30499840 DOI: 10.1097/coc.0000000000000497] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To analyze differences in overall survival (OS) between male breast cancer (MBC) and female breast cancer (FBC) according to tumor subtype compared with other factors. MATERIALS AND METHODS We evaluated men and women with breast cancer between 2010 and 2013 with known hormone receptor (HR) status and human epidermal growth factor receptor 2 (HER2) status reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results program. Patient characteristics were compared between groups. Univariate and multivariate analyses were performed to determine the effect of each variable on OS. Breast cancer-specific survival was a secondary endpoint. RESULTS We included 1187 MBC and 166,054 FBC. Median follow-up was 21 months (range, 1 to 48) for both groups. OS at 3 years for MBC and FBC was 85.6% and 90.4%, respectively (P=0.0002). MBC were more ductal, had higher grade, presented with more advanced stage and were often HR+/HER2- (each P<0.0001). MBC had worse OS than FBC in HR+/HER2- (Hazard ratio [HaR], 1.5; P=0.0005), HR+/HER2+ (HaR, 2.8; P<0.0001) and triple negative (HaR, 4.3; P<0.0001) (Pinteraction<0.02). MBC had significantly worse OS than FBC in stages I and II, but similar OS in stages III and IV (Pinteraction<0.01). In multivariate analysis, HR+/HER2+ was the only subtype with significant differences in OS between MBC and FBC (HaR, 2.0; P=0.002). CONCLUSIONS OS was significantly different in both groups. Men had worse OS in early stages while similar OS in stages III and IV. There were significant differences in OS according to tumor subtype; compared with women, men with HR+/HER2+ tumors had twice the risk of death.
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Chen L, Weng YM, Hu MX, Peng M, Song QB. Effects of HER2 status on the prognosis of male breast cancer: a population-based study. Onco Targets Ther 2019; 12:7251-7260. [PMID: 31564908 PMCID: PMC6733350 DOI: 10.2147/ott.s209949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/31/2019] [Indexed: 01/03/2023] Open
Abstract
Objective This study was designed to analyze the effects of human epidermal growth factor receptor-2 (HER2) status on the prognosis of male breast cancer (MBC). Methods The SEER database was used to identify MBC patients diagnosed between 2010 and 2015. Patients were divided into HER2-negative and HER2-positive groups and chi-square test was used to compare the demographics. Propensity score matching (PSM) was used to remove confounding factors. The log-rank test was used to compare the overall survival (OS) and disease-specific survival (DSS) between the two groups. Univariate and multivariate Cox regression analyses were used to evaluate the effects of different variables on the prognosis of MBC patients. Subgroup analysis was conducted by using R software to explore the benefit of OS and DSS in the subgroup of MBC patients. Results In the matched cohort, the log-rank test showed that there was a longer OS (P=0.044) in the HER2-negative group, and the 4-year OS rate in HER2-negative patients was significantly improved (P=0.008), but there was no difference in the DSS (P=0.408) and the 4-year DSS rates (P=0.198) between the two groups. Univariate and multivariate Cox regression also showed that the HER2 status did not independently associate with DSS (P=0.444). Subgroup analysis showed that HER2-negative patients experienced a longer OS in the subgroup of tumors 2–4 cm in size, no distant metastasis and who had received radiotherapy, but none of subgroup was found a significant difference in DSS between different HER2 status. Conclusion This study identified that HER2 status had a clear influence on OS in patients with MBC, and there was a longer OS and a higher 4-year OS rate in the HER2-negative group. In addition, we observed that HER2 status had no significant effect on DSS in patients with MBC.
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Affiliation(s)
- Liang Chen
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060, People's Republic of China
| | - Yi Ming Weng
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060, People's Republic of China
| | - Meng Xue Hu
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060, People's Republic of China
| | - Min Peng
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060, People's Republic of China
| | - Qi Bin Song
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060, People's Republic of China
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31
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Cottenet J, Dabakuyo-Yonli TS, Mariet AS, Roussot A, Arveux P, Quantin C. Prevalence of patients hospitalised for male breast cancer in France using the French nationwide hospital administrative database. Eur J Cancer Care (Engl) 2019; 28:e13117. [PMID: 31231921 DOI: 10.1111/ecc.13117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/22/2018] [Accepted: 05/14/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Breast cancer (BC) in men is a rare and neglected disease representing <1% of all cancers in men and only 1% of all incident BC in western countries. OBJECTIVE This study aimed to describe trends in the prevalence of patients hospitalised for male BC in France from 2009 to 2013, using the national administrative database (PMSI). METHODS We included all men aged ≥18 admitted to hospital for BC during this period and estimated the prevalence of male breast cancer hospitalised in France over 5 years. We also describe clinical characteristics and treatments in men with surgery for BC over the 5-year period of the study. RESULTS The prevalence of patients hospitalised for BC significantly decreased from 7.5 per 100,000 adult male inhabitants in 2009 to 6.3 per 100,000 in 2013. Considering the entire period, 2009-2013, we found a prevalence of 25.5 per 100,000 adult male inhabitants over 5 years. At 1 year of follow-up, we found a significant trend for at least one comorbidity (from 44.6% in 2009 to 51.2% in 2013, p = 0.04) but not for malignant nodes and metastasis. CONCLUSIONS Ours is the first study to analyse the prevalence of patients hospitalised for male breast cancer and its changes over time in the whole population of a country. Our study also provides data on the clinical characteristics and treatments of male BC in France.
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Affiliation(s)
- Jonathan Cottenet
- Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, France.,Université de Bourgogne, Dijon, France.,INSERM, CIC 1432, Dijon, France.,Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, Dijon, France
| | | | - Anne-Sophie Mariet
- Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, France.,Université de Bourgogne, Dijon, France
| | - Adrien Roussot
- Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, France.,Université de Bourgogne, Dijon, France
| | - Patrick Arveux
- Côte-d'Or Breast Cancer Registry, Georges-François-Leclerc Center, Dijon, France
| | - Catherine Quantin
- Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, France.,Université de Bourgogne, Dijon, France.,INSERM, CIC 1432, Dijon, France.,Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, Dijon, France.,Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
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Alsayed B, Abdulla HA, Alaskar H, Dhaif A. Male occult triple-negative breast cancer. BMJ Case Rep 2019; 12:12/4/e229482. [PMID: 31005873 DOI: 10.1136/bcr-2019-229482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Male breast cancer is a rare but important condition accounting for only 1% of breast cancer worldwide and less than 1% of all male malignancies. Occult male breast cancer is an extremely rare type of male breast cancer that manifests as axillary metastases without an identifiable breast lesion. We report a case of triple-negative occult male breast cancer who underwent modified radical mastectomy.
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Affiliation(s)
- Basma Alsayed
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
| | | | - Hadi Alaskar
- Department of Surgery, King Fahad Hospital, Hofuf, Saudi Arabia
| | - Ali Dhaif
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
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Bolf EL, Sprague BL, Carr FE. A Linkage Between Thyroid and Breast Cancer: A Common Etiology? Cancer Epidemiol Biomarkers Prev 2018; 28:643-649. [PMID: 30541751 DOI: 10.1158/1055-9965.epi-18-0877] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/11/2018] [Accepted: 12/07/2018] [Indexed: 01/06/2023] Open
Abstract
Breast and thyroid cancers are two malignancies with highest incidence in women. These cancers often occur metachronously. Women with thyroid cancer are at increased risk for subsequent breast cancer; women with breast cancer have an increased incidence of later development of thyroid cancer, suggesting a common etiology. This bidirectional relationship is reported worldwide; however, the underlying reasons for this co-occurrence are unknown. In this review, we summarize the current epidemiologic evidence and putative mechanisms of these metachronous or synchronous cancers. Key potential causative factors are chemotherapy and radiotherapy of the primary tumor, genetic variants linking the two diseases, hormonal signaling both from the thyroid gland and from estrogens, and lifestyle and environmental factors. There is a critical need for additional epidemiologic studies focused on gender and regional incidence together with molecular investigations on common tumorigenic pathways in these endocrine cancers. Understanding the putative mechanisms will aid in the diagnosis and clinical management of both diseases.
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Affiliation(s)
- Eric L Bolf
- Department of Pharmacology, Larner College of Medicine, University of Vermont, Burlington, Vermont.,University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Brian L Sprague
- University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, Vermont.,Department of Biochemistry, Larner College of Medicine, University of Vermont, Burlington, Vermont.,Department of Surgery, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Frances E Carr
- Department of Pharmacology, Larner College of Medicine, University of Vermont, Burlington, Vermont. .,University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, Vermont
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MESH Headings
- Aftercare
- Antineoplastic Agents, Hormonal/adverse effects
- Antineoplastic Agents, Hormonal/therapeutic use
- Aromatase Inhibitors/therapeutic use
- Breast Neoplasms, Male/diagnosis
- Breast Neoplasms, Male/drug therapy
- Breast Neoplasms, Male/genetics
- Breast Neoplasms, Male/surgery
- Chemotherapy, Adjuvant
- Diagnosis, Differential
- Genes, BRCA1
- Genes, BRCA2
- Humans
- Male
- Mutation
- Prognosis
- Risk Factors
- Tamoxifen/adverse effects
- Tamoxifen/therapeutic use
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Affiliation(s)
- Sharon H Giordano
- From the Departments of Health Services Research and Breast Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston
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Lautrup MD, Thorup SS, Jensen V, Bokmand S, Haugaard K, Hoejris I, Jylling AMB, Joernsgaard H, Lelkaitis G, Oldenburg MH, Qvamme GM, Soee K, Christiansen P. Male breast cancer: a nation-wide population-based comparison with female breast cancer. Acta Oncol 2018; 57:613-621. [PMID: 29276849 DOI: 10.1080/0284186x.2017.1418088] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Describe prognostic parameters of Danish male breast cancer patients (MBCP) diagnosed from 1980-2009. Determine all-cause mortality compared to the general male population and analyze survival/mortality compared with Danish female breast cancer patients (FBCP) in the same period. MATERIAL AND METHODS The MBCP cohort was defined from three national registers. Data was extracted from medical journals. Data for FBCP is from the DBCG database. Overall survival (OS) was quantified by Kaplan-Meier estimates. Standardized mortality ratios (SMRs) were calculated based on mortality rate among patients relative to the mortality rate in the general population. The association between SMR and risk factors were analyzed in univariate and multivariable Poisson regression models. Separate models for each gender were used for the analyses. RESULTS We found a marked difference in OS for the two genders. For the total population of MBCP, 5- and 10-year survivals were 55.1% and 31.7%, respectively. For FBCP, the corresponding figures were 76.8% and 59.3%. Median age at diagnosis for FBCP was 61 years and 70 years for MBCP. By applying SMR, the difference in mortality between genders equalized and showed pronounced age-dependency. For males <40 years, SMR was 9.43 and for females 19.56 compared to SMR for males 80 + years (0.95) and females 80 + years (0.89). During the period 1980-2009, the risk of dying gradually decreased for FBCP (p < .0001). The risk 1980-1984 was 35% higher than 2005-2009 (RR 1.35). Although the risk of dying for MBCP was also lowest in 2005-2009, there was no clear tendency (p = .1439). The risk was highest in 1990-1994 (RR =2.48). CONCLUSION We found better OS for FBCP than for MBCP. But SMR showed similar mortality rate for the two genders, except for very young FBCP, who had higher SMR. Furthermore, significantly improved survival over time for FBCP was observed, with no clear tendency for MBCP.
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Affiliation(s)
- Marianne D. Lautrup
- Department of Organ and Plastic Surgery, Breast Centre, Lillebaelt Hospital, Vejle, Denmark
| | - Signe S. Thorup
- Department 2501, DBCG-Secretary, Rigshospitalet, Copenhagen, Denmark
| | - Vibeke Jensen
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne Bokmand
- Department of Breast Surgery, Copenhagen University Hospital, Herlev, Denmark
| | - Karen Haugaard
- Department of Breast Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Inger Hoejris
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Hjoerdis Joernsgaard
- Department of Organ and Plastic Surgery, Breast Centre, Sydvestjyst Hospital, Esbjerg, Denmark
| | | | | | - Gro M. Qvamme
- Department of Breast Surgery, Copenhagen University Hospital, Herlev, Denmark
| | - Katrine Soee
- Department of Plastic Surgery, Breast Surgery Unit, Odense University Hospital, Odense, Denmark
| | - Peer Christiansen
- Aarhus University Hospital/Randers Regional Hospital, Breast Surgery Unit, Aarhus, Denmark
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Martin-Marcuartu J, Alvarez-Perez R, Sousa Vaquero J, Jimenez-Hoyuela García J. Selective sentinel lymph node biopsy in male breast cancer. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Massarweh SA, Sledge GW, Miller DP, McCullough D, Petkov VI, Shak S. Molecular Characterization and Mortality From Breast Cancer in Men. J Clin Oncol 2018; 36:1396-1404. [PMID: 29584547 DOI: 10.1200/jco.2017.76.8861] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Limited data exist on the molecular biology, treatment, and outcomes of breast cancer in men, and much of our understanding in this area remains largely an extrapolation from data in women with breast cancer. Materials and Methods We studied men and women with hormone receptor-positive breast cancer and the 21-gene Breast Recurrence Score (RS) results. Differences in clinical characteristics and gene expression were determined, and distribution of RS results was correlated with 5-year breast cancer-specific survival (BCSS) and overall survival. Results There were 3,806 men and 571,115 women. Men were older than women (mean age, 64.2 v 59.1 years; P < .001). RS < 18 predominated in both genders, but RS ≥ 31 was more frequent in men (12.4% v 7.4%; P < .001), as were very low scores (RS < 11; 33.8% v 22.1%; P < .001). Mean gene expression was higher in men for the estrogen receptor (ER), proliferation, and invasion groups. ER was lowest and progesterone receptor was highest in women younger than 50 years of age, with a progressive increase in ER with age. Men younger than 50 years of age had slightly lower ER and progesterone receptor compared with older men. Survival data were available from SEER for 322 men and 55,842 women. Five-year BCSS was 99.0% (95% CI, 99.3% to 99.9%) and 95.9% (95% CI, 87.6% to 98.7%) for men with RS < 18 and RS 18-30, respectively, and for women, it was 99.5% (95% CI, 99.4% to 99.6%) and 98.6% (95% CI, 98.4% to 98.8%), respectively. RS ≥ 31 was associated with an 81.0% 5-year BCSS in men (95% CI, 53.3% to 93.2%) and 94.9% 5-year BCSS (95% CI, 93.9% to 95.7%) in women. Five-year BCSS and overall survival were lower in men than in women. Conclusion This study reveals some distinctive biologic features of breast cancer in men and an important prognostic role for RS testing in both men and women.
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Affiliation(s)
- Suleiman Alfred Massarweh
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - George W Sledge
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Dave P Miller
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Debbie McCullough
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Valentina I Petkov
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Steven Shak
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
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The biology of male breast cancer. Breast 2018; 38:132-135. [PMID: 29316513 DOI: 10.1016/j.breast.2018.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/15/2017] [Accepted: 01/04/2018] [Indexed: 12/16/2022] Open
Abstract
Important differences have begun to emerge concerning the molecular profile of female and male breast cancer which may prove to be of therapeutic value. This review examined all the available data on the genomics of MBC. Most male cancers are ER+ve but without a corresponding increase in PR positivity and only a weaker association with estrogen-controlled markers such as PS2, HSP27 and Cathepsin-D. HER2 +ve cancers are rare in males and the role of androgen receptor is controversial. Although the Luminal A phenotype was the most frequent in both MBC and FBC, no Luminal B or HER2 phenotypes were found in males and the basal phenotype was very rare. Using hierarchical clustering in FBC, ERα clustered with PR, whereas in MBC, ERα associated with ERβ and AR. Based on limited data it appears that Oncotype DX is effective in determining recurrence risk in selected MBC. In future, tailored therapies based on genomics will probably yield the most promising approach for both MBC and FBC.
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Martin-Marcuartu JJ, Alvarez-Perez RM, Sousa Vaquero JM, Jimenez-Hoyuela García JM. Selective sentinel lymph node biopsy in male breast cancer. Rev Esp Med Nucl Imagen Mol 2017; 37:146-150. [PMID: 29246402 DOI: 10.1016/j.remn.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/18/2017] [Accepted: 09/26/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the reproducibility of the sentinel lymph node (SLN) technique in male breast cancer. MATERIAL AND METHODS We retrospectively analysed 21 male patients diagnosed with breast cancer in our hospital from 2008 to 2016 with, at least, 18 months follow-up. Fifteen patients underwent selective sentinel lymph node biopsy (SLNB) following the usual protocols with peritumoral injection of 18.5-111MBq of 99mTc-nanocoloides and acquisition of planar images 2hours after the injection. In 2 cases it was necessary to perform a SPECT/CT to locate the SLN. Immunohistochemistry and molecular techniques (OSNA) were used for their analysis. Six patients did not undergo SLNB because they had pathological nodes or distant disease at the time of diagnosis. RESULTS SLNB was performed in 15 patients. The SLN was negative in 6 patients and positive in the remaining 9. Three patients with positive SLNB did not need axillary lymphadenectomy because of the low number of copies by molecular analysis OSNA. Axillary lymphadenectomy was performed in the remaining 6 patients with the result of 4 positive axillary lymphadenectomies and 2 that did not show further extension of the disease. CONCLUSIONS According to our experience, SLNB in males is a reproducible, useful, safe and reliable technique which avoids unnecessary axillary lymphadenectomy and prevents the appearance of undesirable effects.
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Affiliation(s)
- J J Martin-Marcuartu
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - R M Alvarez-Perez
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J M Sousa Vaquero
- Servicio de Ginecología y Obstetricia, Hospital Universitario Virgen del Rocío, Sevilla, España
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Zhang L, Zhang C, Yang Z, He M, Zhang L, Ezzat S, Liang X. Male occult triple-negative breast cancer with dermatomyositis: a case report and review of the literature. Onco Targets Ther 2017; 10:5459-5462. [PMID: 29180879 PMCID: PMC5694202 DOI: 10.2147/ott.s151260] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Occult breast cancer is defined by the presence of axillary metastases without an identifiable primary breast tumor. Here, we report a rare case of a male occult breast cancer with dermatomyositis. We performed a modified radical mastectomy consisting of whole breast mastectomy and axillary lymph node dissection. Immunohistochemistry and fluorescent in situ hybridization analyses demonstrated an adenocarcinoma likely of breast origin, which was an occult triple-negative breast cancer. Interestingly, the patient’s previously noted periorbital dermatomyositis resolved promptly following surgical excision.
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Affiliation(s)
- Le Zhang
- Department of Breast Surgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Chenghua Zhang
- Endoscopy Department, Jilin Cancer Hospital, Changchun, Jilin, China
| | - Zhaoying Yang
- Department of Breast Surgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Miao He
- Department of Anesthesia, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Lijuan Zhang
- Department of Breast Surgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China
| | - Shereen Ezzat
- Ontario Cancer Institute and The Endocrine Oncology Site Group, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - Xi Liang
- Department of Breast Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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McKinley N, McCain S, Kirk S. Long Term Follow Up of Male Breast Cancer. THE ULSTER MEDICAL JOURNAL 2017; 86:177-180. [PMID: 29581629 PMCID: PMC5849974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/05/2017] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Male breast cancer accounts for less than 1% of breast cancers with published overall and disease free survival being lower than in females. AIMS To determine treatment and long term outcomes for male breast cancer patients in our unit. METHODS A database has been maintained for all breast cancer patients diagnosed in our unit since 1993. Patients were identified using the database and information was collated on patient demographics, tumour pathology, treatment and outcomes using the database and retrospective chart review. Patients were followed to cause of death. RESULTS From 1994-2009 twenty-four cancers were diagnosed in twenty-two patients. Mean age at diagnosis was 69. Male breast cancer patients were treated using similar principles to female breast cancer. Twenty patients underwent mastectomy, two patients underwent wide local excision. No patients developed local recurrence. One patient died from their breast cancer with systemic metastases. 10-year overall survival was 22%, 10 year disease-specific survival was 80%. Other causes of death included medical co-morbidity and secondary cancers. DISCUSSION Disease free survival in our unit is comparable to other published studies. High age at diagnosis and co-morbidity are the most important factors in determining overall outcome. Treatment pathways for male breast cancer should follow guidelines for female disease in order to optimise outcomes. Future research at national or international level is necessary to ensure the most effective treatments are implemented for male breast cancer patients.
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Affiliation(s)
- N McKinley
- South Eastern Health and Social Care Trust,Correspondence to: Nicola McKinley
| | - S McCain
- South Eastern Health and Social Care Trust
| | - S Kirk
- South Eastern Health and Social Care Trust
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Impact of Primary Tumor Surgery in Stage IV Male Breast Cancer. Clin Breast Cancer 2017; 17:e143-e149. [DOI: 10.1016/j.clbc.2016.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 10/27/2016] [Accepted: 11/13/2016] [Indexed: 11/18/2022]
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Clinicopathological characteristics and survival outcomes of male breast cancer according to race: A SEER population-based study. Oncotarget 2017; 8:69680-69690. [PMID: 29050233 PMCID: PMC5642508 DOI: 10.18632/oncotarget.18265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 05/15/2017] [Indexed: 01/01/2023] Open
Abstract
To investigate the clinicopathological characteristics and survival outcomes of breast cancer in the male population, 8,607 cases of patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database, including white males (n = 7122), black males (n = 1111), and other males (American Indian/AK Native, Asian/Pacific Islander) (n = 374). Black male breast cancer patients were more likely to be in stages II–IV and have more advanced tumors. The rate of lymph node (LN) involvement at diagnosis was higher in black men than in whites and others. The ER- and PR-positive rates were lower in black men than in whites and others. The distant metastasis rate was higher in blacks than in whites and others. Furthermore, the overall survival (OR) rates and breast cancer-specific survival rates were significantly poorer in blacks than in whites and others (χ2 = 29.974, P < 0.001; χ2 = 7.285, P = 0.026, respectively). In a multivariate analysis, the results showed that race could also be a prognostic indicator (P < 0.001). Moreover, significant differences were also observed in OS among 1:1:1 matched white, black, and other groups (P < 0.001). Differences in outcomes may be partially explained by differences in tumor grades, LN status, and ER and PR status between the 3 groups. This study might provide insights into a better understanding of male breast cancer.
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Controversies in clinicopathological characteristics and treatment strategies of male breast cancer: A review of the literature. Crit Rev Oncol Hematol 2017; 113:283-291. [DOI: 10.1016/j.critrevonc.2017.03.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 02/17/2017] [Accepted: 03/11/2017] [Indexed: 01/01/2023] Open
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Abstract
Male breast cancer is a rare disease, accounting for only 1% of breast cancer diagnoses in the USA. The current literature suggests that genetic factors including BRCA2 mutations, family history, age, androgen/estrogen imbalance, and environmental exposures may predispose to male breast cancer. In this manuscript, we will review known and possible risk factors for male breast cancer, as well as describe the clinical patterns of the disease.
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Affiliation(s)
- Raina M Ferzoco
- Department of Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
| | - Kathryn J Ruddy
- Department of Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
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Male breast cancer: a clinicopathological study of an Egyptian population (Alexandria experience). Contemp Oncol (Pozn) 2016; 20:335-40. [PMID: 27688732 PMCID: PMC5032163 DOI: 10.5114/wo.2016.61855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 08/01/2016] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY The purpose of this retrospective study is to evaluate the clinicopathological features and treatment results of male breast cancer presented to our tertiary referral center. MATERIAL AND METHODS Between January 1998 and December 2005, a total of 39 men with breast cancer treated at Alexandria Main University Hospital and their medical records were reviewed. RESULTS The median age of patients was 59 years. Only 3 (7.7%) patients had positive family history. All patients presented by breast swellings that were associated with axillary mass in about one third of them. Around 80% had hormone receptor positive (estrogen and/or progesterone receptors). Two third of patients had advanced T-stage (T3 and T4). Left sided breast cancer occurred in 51.3%. Infiltrating ductal carcinoma was the most common type of histology encountered and grade 2 was the predominant grade of tumor. Modified radical mastectomy was the most common (87.2%) type of surgery done followed by chemotherapy for 32 patients and loco-regional radiotherapy for 20 patients. Tamoxifen was administered in 31 patients. Distant relapse occurred in 7 patients (17.9%) and local recurrence occurred in 2 patients (5.1%). The 5-year disease-free survival (DFS) was 82% and the 5-year overall survival (OS) rate was 84%. Only negative axillary lymph node and positive hormone receptor status were significantly associated with favorable DFS and OS. T-stage, grade of tumor and type of chemotherapy given had no statistically significant impact on either DFS or OS. CONCLUSIONS Male breast cancer is still under-investigated and further researches are warranted.
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Massarweh SA, Choi GL. Special considerations in the evaluation and management of breast cancer in men. Curr Probl Cancer 2016; 40:163-171. [PMID: 27793424 DOI: 10.1016/j.currproblcancer.2016.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 12/29/2022]
Abstract
Breast cancer in men is relatively uncommon but its incidence has been rising. Traditionally, the management of breast cancer in men is based on extrapolation from clinical trials of breast cancer in women, due to the much more extensive data available in women with this disease. There are, however, unique characteristics that distinguish breast cancer in men and these should be taken into consideration when managing this patient population. Breast cancer in men is more frequently estrogen receptor (ER) and progesterone receptor (PgR) positive, and less frequently HER2 amplified. Lobular carcinoma, which accounts for 10-15% of breast cancers in women, is exceptionally rare in men. Genetic risk factors, particularly BRCA2 mutations, are increasingly recognized as a key risk factor for breast cancer in men and genetic testing is now routinely recommended for all men diagnosed with breast cancer. Tamoxifen remains the gold standard endocrine therapy for breast cancer in men, but other endocrine agents such as the aromatase inhibitors (AI) and fulvestrant are increasingly being used. While superior to tamoxifen in postmenopausal women, the use of AIs for adjuvant therapy in men with breast cancer may not be optimal since the physiology of hormonal regulation in men resembles that of premenopausal rather than postmenopausal women. Emerging areas of investigation include the role of genomic risk stratification to gain further insight into the biology of breast cancer in men, the study of the androgen receptor (AR) as a therapeutic target, and the role of gonadal suppression in the management of the disease. There is clearly a more consorted effort to study breast cancer in men as a unique disease in order to have a better understanding of its biology and we are likely to witness further advances that will help us better manage this unique disease situation.
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Affiliation(s)
- Suleiman Alfred Massarweh
- Division of Oncology, Stanford University School of Medicine; Stanford Cancer Institute, Stanford, CA, USA.
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Cokmert S, Bahadir F, Guler T, Tanriverdi O. Male breast cancer exhibiting features of basal-like subtype female breast cancer. JOURNAL OF ONCOLOGICAL SCIENCES 2016. [DOI: 10.1016/j.jons.2016.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Jiagge E, Jibril AS, Chitale D, Bensenhaver JM, Awuah B, Hoenerhoff M, Adjei E, Bekele M, Abebe E, Nathanson SD, Gyan K, Salem B, Oppong J, Aitpillah F, Kyei I, Bonsu EO, Proctor E, Merajver SD, Wicha M, Stark A, Newman LA. Comparative Analysis of Breast Cancer Phenotypes in African American, White American, and West Versus East African patients: Correlation Between African Ancestry and Triple-Negative Breast Cancer. Ann Surg Oncol 2016; 23:3843-3849. [PMID: 27469125 DOI: 10.1245/s10434-016-5420-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Triple-negative breast cancer (TNBC) is more common among African American (AA) and western sub-Saharan African breast cancer (BC) patients compared with White/Caucasian Americans (WA) and Europeans. Little is known about TNBC in east Africa. METHODS Invasive BC diagnosed 1998-2014 were evaluated: WA and AA patients from the Henry Ford Health System in Detroit, Michigan; Ghanaian/west Africans from the Komfo Anokye Teaching Hospital in Kumasi, Ghana; and Ethiopian/east Africans from the St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. Histopathology and immunohistochemistry for estrogen receptor (ER), progesterone receptor (PR), and HER2/neu expression was performed in Michigan on formalin-fixed, paraffin-embedded samples from all cases. RESULTS A total of 234 Ghanaian (mean age 49 years), 94 Ethiopian (mean age 43 years), 272 AA (mean age 60 years), and 321 WA (mean age 62 years; p = 0.001) patients were compared. ER-negative and TNBC were more common among Ghanaian and AA compared with WA and Ethiopian cases (frequency ER-negativity 71.1 and 37.1 % vs. 19.8 and 28.6 % respectively, p < 0.0001; frequency TNBC 53.2 and 29.8 % vs. 15.5 and 15.0 %, respectively, p < 0.0001). Among patients younger than 50 years, prevalence of TNBC remained highest among Ghanaians (50.8 %) and AA (34.3 %) compared with WA and Ethiopians (approximately 16 % in each; p = 0.0002). CONCLUSIONS This study confirms an association between TNBC and West African ancestry; TNBC frequency among AA patients is intermediate between WA and Ghanaian/West Africans consistent with genetic admixture following the west Africa-based trans-Atlantic slave trade. TNBC frequency was low among Ethiopians/East Africans; this may reflect less shared ancestry between AA and Ethiopians.
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Affiliation(s)
- Evelyn Jiagge
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA.,Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Aisha Souleiman Jibril
- Department of Pathology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Jessica M Bensenhaver
- Department of Surgery, Henry Ford Health System, Detroit, MI, USA.,International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA
| | - Baffour Awuah
- Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Mark Hoenerhoff
- In Vivo Animal Core, Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ernest Adjei
- Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Mahteme Bekele
- Department of Surgery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Engida Abebe
- Department of Surgery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - S David Nathanson
- Department of Surgery, Henry Ford Health System, Detroit, MI, USA.,International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA
| | - Kofi Gyan
- International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA
| | - Barbara Salem
- International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA
| | - Joseph Oppong
- Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Francis Aitpillah
- Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Ishmael Kyei
- Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Ernest Osei Bonsu
- Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Erica Proctor
- Department of Surgery, Henry Ford Health System, Detroit, MI, USA.,International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA
| | - Sofia D Merajver
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - Max Wicha
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - Azadeh Stark
- Department of Pathology, Henry Ford Health System, Detroit, MI, USA
| | - Lisa A Newman
- Department of Surgery, Henry Ford Health System, Detroit, MI, USA. .,International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA.
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