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Xiao Z, Li L. Breast cancer mortality in Chinese women and men from 1990 to 2019: Analysis of trends in risk factors. J Obstet Gynaecol Res 2024; 50:970-981. [PMID: 38561241 DOI: 10.1111/jog.15931] [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: 11/26/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aimed to examine the relative risk of risk factor in male and female breast cancer (BC) deaths in China and analyzed the changing trends in BC mortality rates from 1990 to 2019. METHODS Open data from the Global Burden of Disease database from 1990 to 2019 were analyzed to assess the number of BC deaths and age-standardized mortality rates (ASMR) in China. The age-period-cohort model was employed to study age effects, period effects, cohort effects, as well as local drift and net drift of the data, determining the impact of changing risk factors on crude mortality rates and ASMR of BC. RESULTS In 2019, the number of BC deaths across all age groups in China increased by 130.38% compared to 1990, with an increase of 125.68% in females and 648.80% in males. The ASMR for BC and male BC increased in 2019, while female BC ASMR declined. Overall, alcohol consumption and smoking as risk factors contributed to increased mortality rates of BC with advancing age. Over the entire study period, the net drift of alcohol consumption in females for BC was 0.06% (95% confidence interval [CI]: -0.24% to 0.36%), while for smoking it was -0.64% (95% CI: -0.83% to -0.45%). For males, the net drift of alcohol consumption for BC was 6.75% (95% CI: 5.55% to 7.96%), and for smoking, it was 6.09% (95% CI: 2.66% to 9.64%). CONCLUSION Hence, improving awareness of BC-related risk factors and implementing prevention strategies are necessary to alleviate future BC burdens.
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Affiliation(s)
- Ziwei Xiao
- Hunan Normal University, Changsha, Hunan, China
| | - Lin Li
- Hunan Normal University, Changsha, Hunan, China
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Mannix J, Duke H, Almajnooni A, Ongkeko M. Imaging the Male Breast: Gynecomastia, Male Breast Cancer, and Beyond. Radiographics 2024; 44:e230181. [PMID: 38752766 DOI: 10.1148/rg.230181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
The number of men undergoing breast imaging has increased in recent years, according to some reports. Most male breast concerns are related to benign causes, most commonly gynecomastia. The range of abnormalities typically encountered in the male breast is less broad than that encountered in women, given that lobule formation rarely occurs in men. Other benign causes of male breast palpable abnormalities with characteristic imaging findings include lipomas, sebaceous or epidermal inclusion cysts, and intramammary lymph nodes. Male breast cancer (MBC) is rare, representing up to 1% of breast cancer cases, but some data indicate that its incidence is increasing. MBC demonstrates some clinical features that overlap with those of gynecomastia, including a propensity for the subareolar breast. Men with breast cancer tend to present at a later stage than do women. MBC typically has similar imaging features to those of female breast cancer, often characterized by an irregular mass that may have associated calcifications. Occasionally, however, MBC has a benign-appearing imaging phenotype, with an oval shape and circumscribed margins, and therefore most solid breast masses in men require tissue diagnosis. Histopathologic evaluation may alternatively reveal other benign breast masses found in men, including papillomas, myofibroblastomas, and hemangiomas. Radiologists must be familiar with the breadth of male breast abnormalities to meet the rising challenge of caring for these patients. ©RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Jaimee Mannix
- From the Department of Radiology, Breast Imaging Section, Mallinckrodt Institute of Radiology (J.M., H.D.) and Department of Pathology (A.A., M.O.), Washington University in St. Louis School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Heather Duke
- From the Department of Radiology, Breast Imaging Section, Mallinckrodt Institute of Radiology (J.M., H.D.) and Department of Pathology (A.A., M.O.), Washington University in St. Louis School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Abdullah Almajnooni
- From the Department of Radiology, Breast Imaging Section, Mallinckrodt Institute of Radiology (J.M., H.D.) and Department of Pathology (A.A., M.O.), Washington University in St. Louis School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Martin Ongkeko
- From the Department of Radiology, Breast Imaging Section, Mallinckrodt Institute of Radiology (J.M., H.D.) and Department of Pathology (A.A., M.O.), Washington University in St. Louis School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
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3
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Orlandi AM, Alcaraz G, Bielski L, Brenta G, Jozami LC, Cavallo A, Guerra J, Zund S. Thyroid gland: a rare site of metastasis. Endocrine 2024; 84:607-614. [PMID: 38224445 DOI: 10.1007/s12020-023-03626-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/22/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE Despite its rich vascularity, metastasis (MTS) to the thyroid tissue is unusual, ranging from 1 to 3%. This entity is not usually considered as differential diagnosis and is not included in the upfront approach in patients with thyroid nodules. Once diagnosed, treatment is controversial. The aim of this study was to evaluate diagnosis, treatment, and outcome at the end of follow-up in patients with a diagnosis of MTS to the thyroid. METHODS A retrospective multicenter study was designed from 1985 to 2022; 29 patients with MTS to the thyroid gland were included in the analysis. RESULTS Clinical presentation included the presence of a nodular goiter (65.5%), compression symptoms (17.2%), diffuse goiter (10.3%), and suspicious lymph nodes in the neck (7%). Primary tumor sites were: kidney (44.8%), breast (24.1%), lung (13.8%), neuroendocrine system (6.9%), colon (3.4%), cervix (3.4%), and ovary (3.4%). In 18/23 patients, suspicious ultrasound criteria for malignancy were described. Preoperative diagnosis was made in 23/27 patients by FNA and confirmed in 18 cases by immunohistochemistry. Seventeen patients underwent surgery. At the end of the follow-up, 19 patients had died of oncological disease, and six were alive (2/6 disease-free with isolated intrathyroidal MTS). CONCLUSION Renal carcinoma was the tumor that most frequently metastasized to the thyroid gland. Immunodiagnosis was a very useful tool for etiological confirmation. Patients with MTS to the thyroid gland as a unique site had a more favorable course compared to patients with multiple metastatic sites. Finally, outcomes and prognosis essentially depended on the biology of the primary tumor.
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Affiliation(s)
- Ana María Orlandi
- Endocrinology Department, Hospital Dr. T. Álvarez, Buenos Aires, Argentina.
| | - Graciela Alcaraz
- Endocrinology Department, Hospital Dr. C. Durand, Buenos Aires, Argentina
| | - Laila Bielski
- Endocrinology Department, Sanatorio Güemes, Buenos Aires, Argentina
| | - Gabriela Brenta
- Endocrinology Department, Unidad Asistencial Dr. C. Milstein, Buenos Aires, Argentina
| | | | - Andrea Cavallo
- Endocrinology Department Hospital Alta Complejidad, Formosa, Argentina
- Endocrinology Department Hospital Universitario Austral, Buenos Aires, Argentina
| | - Jorgelina Guerra
- Endocrinology Department Hospital Universitario Austral, Buenos Aires, Argentina
| | - Santiago Zund
- Head and Neck Surgery Department, Instituto de Oncología A. Roffo, Buenos Aires, Argentina
- Head and Neck Surgery Department Hospital Español de La Plata, Buenos Aires, Argentina
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4
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Wang S, Zhang Q, Mao X. Invasive papillary carcinoma of the breast. Front Oncol 2024; 14:1374091. [PMID: 38601769 PMCID: PMC11004302 DOI: 10.3389/fonc.2024.1374091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/15/2024] [Indexed: 04/12/2024] Open
Abstract
Invasive papillary carcinoma is a rare form of breast cancer that is more likely to occur in postmenopausal women. Previous studies have been limited to case reports and small retrospective studies, leading to low awareness of this type of tumor and difficult clinical management. According to the available literature, invasive papillary carcinoma exhibits unique pathological features and biological behaviors. Invasive papillary carcinoma is mostly luminal type, with a low rate of lymph node metastasis, which underlies its favorable prognosis. The effectiveness of adjuvant therapy in reducing tumor burden and improving prognosis in patients with invasive papillary carcinoma remains uncertain. Due to the rarity of the lesion, conducting prospective clinical trials is impractical. The use of biological models, such as organoids, can help alleviate the impact of the scarcity of this condition on research. In addition, invasive papillary carcinoma is affected by specific genomic events, and more extensive studies of gene expression profiling may provide molecular-level insights to make optimal therapeutic decisions.
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Affiliation(s)
- Shijing Wang
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qingfu Zhang
- Department of Pathology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaoyun Mao
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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D’Angelo A, Portaluri A, Caprini F, Sofia C, Ferrara F, Condorelli E, Iaccarino L, Catanzariti F, Mancino M, Trombadori CML, Belli P, Marino MA. Male Breast: A Review of the Literature and Current State of the Art of Diagnostic Imaging Work-Up. Diagnostics (Basel) 2023; 13:3620. [PMID: 38132204 PMCID: PMC10743117 DOI: 10.3390/diagnostics13243620] [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: 09/21/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Pathological conditions affecting the male breast (MB) share some similarities with those found in women, while others are specific to men. The first part of this review provides an overview of MB disorders, exploring the most common types of MB diseases. The second part then emphasizes the state-of-the-art approaches proposed in the literature for screening and follow-up with MB cancer patients, which highlights the importance of tailored strategies for diagnosis, follow-up, and identifying high-risk populations. Considering the increasing attention in recent years on the topic, transgender individuals are also included in this review. Together with the MB, it is an understudied category thus far. This review aims to raise awareness among radiologists that MBs should be approached differently from female breasts, contributing to the advancement of medical knowledge, improving patient outcomes, and promoting early detection of MB disorders. The review also provides an update on breast cancer and screening in the transgender population.
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Affiliation(s)
- Anna D’Angelo
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.C.); (F.F.); (L.I.); (M.M.); (C.M.L.T.); (P.B.)
| | - Antonio Portaluri
- Department of Biomedical Sciences and Morphologic and Functional Imaging, AOU G. Martino, University of Messina, 98100 Messina, Italy; (A.P.); (C.S.); (E.C.); (F.C.); (M.A.M.)
| | - Flavia Caprini
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.C.); (F.F.); (L.I.); (M.M.); (C.M.L.T.); (P.B.)
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphologic and Functional Imaging, AOU G. Martino, University of Messina, 98100 Messina, Italy; (A.P.); (C.S.); (E.C.); (F.C.); (M.A.M.)
| | - Francesca Ferrara
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.C.); (F.F.); (L.I.); (M.M.); (C.M.L.T.); (P.B.)
| | - Elvira Condorelli
- Department of Biomedical Sciences and Morphologic and Functional Imaging, AOU G. Martino, University of Messina, 98100 Messina, Italy; (A.P.); (C.S.); (E.C.); (F.C.); (M.A.M.)
| | - Ludovica Iaccarino
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.C.); (F.F.); (L.I.); (M.M.); (C.M.L.T.); (P.B.)
| | - Francesca Catanzariti
- Department of Biomedical Sciences and Morphologic and Functional Imaging, AOU G. Martino, University of Messina, 98100 Messina, Italy; (A.P.); (C.S.); (E.C.); (F.C.); (M.A.M.)
| | - Matteo Mancino
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.C.); (F.F.); (L.I.); (M.M.); (C.M.L.T.); (P.B.)
| | - Charlotte M. L. Trombadori
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.C.); (F.F.); (L.I.); (M.M.); (C.M.L.T.); (P.B.)
| | - Paolo Belli
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.C.); (F.F.); (L.I.); (M.M.); (C.M.L.T.); (P.B.)
| | - Maria Adele Marino
- Department of Biomedical Sciences and Morphologic and Functional Imaging, AOU G. Martino, University of Messina, 98100 Messina, Italy; (A.P.); (C.S.); (E.C.); (F.C.); (M.A.M.)
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Shalata W, Abu Jama A, Abu Salman A, Golosky M, Solomon A, Abu Saleh O, Michlin R, Shalata S, Agbarya A, Yakobson A. Unexpected and Rare Sites of Metastasis in Oncologic Patients. J Clin Med 2023; 12:6447. [PMID: 37892585 PMCID: PMC10607747 DOI: 10.3390/jcm12206447] [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: 08/25/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Case studies of rare oncologic metastases are an important source of clinical data for health care professionals and researchers. While infrequent, the knowledge base and clinical recommendations derived from such cases aid in advancements in the field. As such, we aim to add five cases to the growing body of literature. The first two male patients, aged 69 and 73, were diagnosed with colon adenocarcinoma, suspected to be a second primary prostate carcinoma, following positron emission tomography-computer tomography (PET-CT). This suspicion was ruled out by prostatectomy and histopathological investigations, which instead found adenocarcinoma of colonic origin. The next two male patients, ages 63 and 68, were diagnosed, respectively, with metastatic pancreatic adenocarcinoma with cardiac metastases and metastatic melanoma with distant metastases to the pancreas. The final patient was a 73-year-old male diagnosed with metastatic breast cancer after a radiological investigation of suspected renal cell carcinoma.
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Affiliation(s)
- Walid Shalata
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
| | - Ashraf Abu Jama
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
| | - Amjad Abu Salman
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Cardiology Division, Soroka Medical Center, Beer Sheva 84105, Israel
| | - Mitchell Golosky
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Medical School for International Health and Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Adam Solomon
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Medical School for International Health and Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Omar Abu Saleh
- Department of Dermatology and Venereology, The Emek Medical Centre, Afula 18341, Israel
| | - Regina Michlin
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
| | - Sondos Shalata
- Nutrition Unit, Galilee Medical Center, Nahariya 22000, Israel;
| | - Abed Agbarya
- Department of Oncology, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Alexander Yakobson
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
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Mukherjee AG, Gopalakrishnan AV, Jayaraj R, Renu K, Dey A, Vellingiri B, Malik T. The incidence of male breast cancer: from fiction to reality - correspondence. Int J Surg 2023; 109:2855-2858. [PMID: 37222665 PMCID: PMC10498864 DOI: 10.1097/js9.0000000000000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/25/2023]
Affiliation(s)
- Anirban Goutam Mukherjee
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu
| | - Rama Jayaraj
- Jindal Institute of Behavioral Sciences (JIBS), Jindal Global Institution of Eminence Deemed to Be University, Sonipat
- Director of Clinical Sciences, Northern Territory Institute of Research and Training, Darwin, Northern Territory, Australia
| | - Kaviyarasi Renu
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, India
| | - Balachandar Vellingiri
- Stem Cell and Regenerative Medicine/Translational Research, Department of Zoology, School of Basic Sciences, Central University of Punjab (CUPB), Bathinda
| | - Tabarak Malik
- Department of Biomedical Sciences, Institute of Health, Jimma University, Ethiopia
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Niver HE, Strom P. Axillary chest wall solid-papillary carcinoma: A case report on presentation and management. Rare Tumors 2023; 15:20363613231155957. [PMID: 36761373 PMCID: PMC9905025 DOI: 10.1177/20363613231155957] [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: 10/06/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023] Open
Abstract
Papillary breast carcinomas comprise <1% of all breast cancers. They are notorious among surgical pathologists for posing diagnostic difficulty, especially with small sample sizes, such as a core-needle biopsy and carry potential for overtreatment. Solid-papillary carcinoma is a subtype of papillary breast carcinomas that affects elderly females and generally has a favorable diagnosis in its in-situ form. This report focuses on the unique and clinically aggressive presentation and treatment of invasive solid-papillary carcinoma that was discovered along the axillary chest wall after an ipsilateral mastectomy for multifocal ductal carcinoma in situ.
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Affiliation(s)
- Harper E. Niver
- Harper E Niver, Northeast Georgia Medical Center, 743 Spring Street, Gainesville, GA 30501, USA.
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Lerttiendamrong B, Vongsaisuwon M. First report of bilateral synchronous male accessory breast cancer. BMJ Case Rep 2022; 15:e250927. [PMID: 35985745 PMCID: PMC9396125 DOI: 10.1136/bcr-2022-250927] [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] [Indexed: 11/03/2022] Open
Abstract
Accessory breast occurs due to the persistence of milk line in the non-thoracic region. Malignant transformation in male accessory breast is very rare, with 16 reports documented across the world. No bilateral synchronous accessory male breast cancer has been reported. We present the first case reported globally of a man in his 70s with a complaint of left axillary lump and chronic rash for 3 years. About 1 year ago, additional reddish rash was detected in the right axilla. Initial skin biopsy from a private hospital confirmed mammary carcinoma with skin invasion. Subsequent left breast mastectomy with left axillary lymph node dissection and right wide excision was performed. Final pathological result was grade 2 invasive ductal carcinoma in the left accessory breast and Paget's disease in the contralateral axilla. Postoperative treatment of adjuvant paclitaxel and trastuzumab was prescribed, which was followed by adjuvant radiation therapy.
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Affiliation(s)
| | - Mawin Vongsaisuwon
- Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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10
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Jung HK, Lim YJ. Sonographic Features of Palpable Breast and Axillary Lesions in Adult Male Patients: A Pictorial Essay. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:830-845. [PMID: 36238906 PMCID: PMC9514573 DOI: 10.3348/jksr.2021.0122] [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: 06/29/2021] [Revised: 07/28/2021] [Accepted: 10/15/2021] [Indexed: 11/15/2022]
Abstract
The male breast is a non-functional and rudimentary organ, but similarly to the female breast, it can be affected by various diseases. In contrast to female breast cancer, male breast cancer has a low incidence, and there is no established breast cancer screening program for male patients. Therefore, the diagnostic evaluation is usually performed in male patients with symptoms such as palpability or pain in the breasts. Furthermore, most adult male patients who visit breast clinics sometimes present with not only breast symptoms but also axillary symptoms, and both the breast and axilla are usually examined during breast ultrasonography in daily clinical practice. The purpose of this pictorial essay was to present the sonographic features of various palpable breast and axillary lesions in adult male patients.
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11
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Towfighi P, Deldar R, Haffner ZK, Aminpour N, Sogunro O, Abu El Hawa AA, Boisvert M, Fan KL. A comparative analysis of males and females with breast cancer undergoing mastectomy using the American College of Surgeon's National Surgical Quality Improvement Project (NSQIP). Breast Cancer Res Treat 2022; 194:201-206. [PMID: 35622242 DOI: 10.1007/s10549-022-06628-x] [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: 02/27/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION There is a paucity of literature comparing the postoperative outcomes of males and females with breast cancer who undergo mastectomy. The aim of this study is to evaluate the comorbidities and 30-day post-mastectomy complication rates among males and females. METHODS We performed a retrospective analysis of breast cancer patients who underwent mastectomy from 2014 to 2016 using the American College of Surgeon's National Surgical Quality Improvement Project database. Data including patient demographics, comorbidities, and 30-day surgical and medical complications were collected. Statistical analysis included Chi-square and Fisher's exact tests for categorical variables and Student T-tests for continuous variables. Statistical significance was defined as p < 0.05. RESULTS A total of 15,167 patients were identified. There were 497 males (3.3%) and 14,670 females (96.7%). Age was significantly higher in females compared to males (63.5 vs. 57.6 years, p < 0.001). Body mass index (BMI) at time of surgery was also higher in males (30.0 vs. 29.3 kg/m2, p = 0.011). There was a higher prevalence of diabetes in males (20.1 vs. 16.5%, p = 0.032). Operative duration was significantly longer in females (114.9 vs. 95.0 min, p < 0.001). Median postoperative length of stay was also longer in females (1.2 vs. 0.8 days, p < 0.001). There were no significant differences in 30-day medical or surgical complication rates between the two sexes. CONCLUSION Our findings suggest that differences in age, BMI, and comorbidities between males and females do not significantly impact 30-day medical or surgical complications following total mastectomy for breast cancer. Further research is warranted to identify perioperative risk factors that influence post-mastectomy complication rates. LEVEL OF EVIDENCE 3 (Retrospective cohort study).
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Affiliation(s)
- Parhom Towfighi
- Georgetown University School of Medicine, Washington, DC, USA
| | - Romina Deldar
- Department of Plastics and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC, 20007, USA
| | - Zoe K Haffner
- Georgetown University School of Medicine, Washington, DC, USA.,Department of Plastics and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC, 20007, USA
| | - Nathan Aminpour
- Georgetown University School of Medicine, Washington, DC, USA
| | - Olutayo Sogunro
- Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | | | - Marc Boisvert
- Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA
| | - Kenneth L Fan
- Department of Plastics and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.
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12
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Moayeri H, Rezagholi P. Inflammatory Breast Cancer in a 53-Year-Old Man. Adv Biomed Res 2022; 11:9. [PMID: 35284351 PMCID: PMC8906088 DOI: 10.4103/abr.abr_117_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/04/2022] Open
Abstract
Diagnosing breast cancer (BC) in early stages increases the chances of treating this cancer in men. However, because BC is very rare in men, especially inflammatory BC (IBC), it is unlikely that screening men for BC by mammography or other tests would yield promising outcomes. The aim of this study was to report IBC in a 53-year-old man. The case was a 53-year-old man with a history of mass in the left breast and trauma to the same side as well as swelling and severe redness of the breast skin. The patient underwent neoadjuvant chemotherapy and relative responded to medical treatment. He then underwent modified mastectomy surgery and initial chest wall repair followed by radiotherapy. IBC in men is challenging due to its rarity, unknown biological behaviors, and difficulty in early diagnosis. This tumor is usually detected in advanced stages in the elderly and has a poor prognosis.
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Affiliation(s)
- Hassan Moayeri
- Department of Surgery, School of Medicine, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Payman Rezagholi
- Department of Operating Room, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran,Address for correspondence: Mr. Payman Rezagholi, Department of Operating Room, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran. E-mail:
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13
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Pollack EB, O’Keefe MC. Breast Imaging in Special Populations: Indications and Findings in Pregnant and Lactating, Male, and Transgender Patients. CURRENT BREAST CANCER REPORTS 2021. [DOI: 10.1007/s12609-021-00428-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Fentiman IS. Prognostic difficulties of men with breast cancer. Breast J 2021; 27:877-882. [PMID: 34652050 DOI: 10.1111/tbj.14297] [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: 07/26/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
Most adequately powered studies confirm a worse prognosis for males versus matched females with breast cancer. There is in-stage migration for stage I cancers with a different ratio of tumor/normal breast tissue in males. Younger men have a better prognosis, largely the result of increased morbidity in the elderly, exacerbated by smoking, low socioeconomic differences, and ethnic disparity. BRCA2 carriers with MBC have a worse outcome than noncarriers as do men with amplification of EMSY. Men with tumors having a high cytosol level of plasminogen activator inhibitor 1 (PAI-1) may have more invasive cancers leading to earlier spread and hence a worse outcome. PREDICT+ is a useful prognostic model for MBC and multigene testing enables more specific systemic therapies to be used.
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Affiliation(s)
- Ian S Fentiman
- Professor of Surgical Oncology, Research Oncology, Guy's Hospital, London, UK
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15
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Li R, Saluja K, Mai B, Covinsky M, Sun H. Cystic Encapsulated Papillary Carcinoma in the Male Breast: An Unusual Feature With a Diagnostic Challenge. Int J Surg Pathol 2021; 30:63-67. [PMID: 34304607 DOI: 10.1177/10668969211018754] [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: 11/16/2022]
Abstract
Papillary carcinoma in the male breast is uncommon. Here, we report a case of a large encapsulated papillary carcinoma (EPC) in a 62-year-old male. The patient presented with a left breast mass of 1-year duration and bloody nipple discharge for several days. Mammography and breast ultrasonography showed a large left breast mass. The initial biopsy demonstrated fat necrosis with acute and chronic inflammation only. Due to clinical suspicion, a repeat biopsy was performed and revealed scant fragments of papillary carcinoma in a background of inflammation. The patient underwent left total mastectomy. Grossly, the breast contained a 9.0 cm entirely cystic lesion lined by a hemorrhagic thick fibrotic wall. No solid area was identified in the cyst. The entire cyst wall was examined under microscopy; only a few sections with papillary carcinoma were identified. The lesion was confined to the cyst wall; so, a diagnosis of EPC was made. Compared to the previously reported EPC cases of male breast, the lesion of this case was unusually cystic, which making the diagnosis challenging. Therefore, awareness of this unusual feature, repeat biopsy when the pathology result is discordant, and extensive sampling of the lesion are essential for making the correct diagnosis and guiding patient management.
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Affiliation(s)
- Rongying Li
- 12340The University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA
| | - Karan Saluja
- 12340The University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA
| | - Brenda Mai
- 12340The University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA
| | - Michael Covinsky
- 12340The University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA
| | - Hongxia Sun
- 12340The University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA
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16
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Camejo N, Castillo C, Schiavone A, Alfonso AL, Amarillo D, Xavier F, Alvarez E, Krygier G, Delgado L. Male breast cancer diagnosis stages, treatment and survival in Uruguay: a retrospective analysis of a case series. BREAST CANCER MANAGEMENT 2021. [DOI: 10.2217/bmt-2020-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Male breast cancer (MBC) is a rare condition which, while sharing some similarities with breast cancer in women, has a unique disease profile of its own. Aim: To understand the characteristics of MBC and its management in Uruguay. Patients & methods: Retrospective observational study that included patients diagnosed with MBC. Results: 22 cases of MBC were found. The median age at diagnosis was 62.5 years. Symptoms included self-detected lump in 17 patients (77.3%) and nipple retraction in seven (22.7%). Ductal carcinomas of histological grade 2–3 were found in 20 patients (90.9%) and stage I–II disease was most commonly encountered (15 patients, 68.1%). Neoadjuvant chemotherapy, adjuvant chemotherapy, adjuvant radiotherapy and tamoxifen were offered to 16 (73%), 12 (54.5%), 17 (65.4%) and 20 (90.9%) patients, respectively. Conclusion: MBC behaves and is treated in many aspects like postmenopausal breast cancer. Further multi-institutional, prospective studies are needed for better understanding and management of male breast cancers.
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Affiliation(s)
- Natalia Camejo
- Department of Clinical Oncology, School of Medicine, University of Uruguay, Montevideo, Uruguay
| | - Cecilia Castillo
- Department of Clinical Oncology, School of Medicine, University of Uruguay, Montevideo, Uruguay
| | - Andrea Schiavone
- Department of Clinical Oncology, School of Medicine, University of Uruguay, Montevideo, Uruguay
| | - Ana L Alfonso
- Department of Clinical Oncology, Servicio Médico Integral, Montevideo, Uruguay
| | - Dahiana Amarillo
- Department of Clinical Oncology, School of Medicine, University of Uruguay, Montevideo, Uruguay
| | - Franco Xavier
- Department of Clinical Oncology, CASMER, Rivera, Uruguay
| | - Esteban Alvarez
- Department of Clinical Oncology, School of Medicine, University of Uruguay, Montevideo, Uruguay
| | - Gabriel Krygier
- Department of Clinical Oncology, School of Medicine, University of Uruguay, Montevideo, Uruguay
- Department of Clinical Oncology, Servicio Médico Integral, Montevideo, Uruguay
- Department of Clinical Oncology, CASMER, Rivera, Uruguay
| | - Lucía Delgado
- Department of Clinical Oncology, School of Medicine, University of Uruguay, Montevideo, Uruguay
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17
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Brogi E, Krystel-Whittemore M. Papillary neoplasms of the breast including upgrade rates and management of intraductal papilloma without atypia diagnosed at core needle biopsy. Mod Pathol 2021; 34:78-93. [PMID: 33106592 DOI: 10.1038/s41379-020-00706-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/02/2020] [Accepted: 10/02/2020] [Indexed: 11/09/2022]
Abstract
Papillary neoplasms of the breast are a heterogeneous group of epithelial tumors nearly entirely composed of papillae. Their classification rests on the characteristics of the epithelium and the presence and distribution of the myoepithelial cells along the papillae and around the tumor. Papillary neoplasms of the breast can be diagnostically challenging, especially if only core needle biopsy (CNB) material is available. This review summarizes salient morphological and immunohistochemical features, clinical presentation, and differential diagnoses of papillary neoplasms of the breast. We include a contemporary appraisal of the upgrade rate to carcinoma (invasive carcinoma and ductal carcinoma in situ [DCIS]) and atypical hyperplasias in surgical excision specimens obtained following CNB diagnosis of papilloma without atypia, and a review of the available follow-up data in cases without immediate surgical excision.
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Affiliation(s)
- Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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18
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Purohit V, Hosseini H, Unger P, Cai S. Solid papillary breast carcinoma arising in the male axilla: A case report. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2020. [DOI: 10.1016/j.cpccr.2020.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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19
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Viana MP, Tucunduva TCDM, Torres US, Aguillar VLN, Bresciani BH, Shimizu C, Chala LF, Barros ND, Mello GGND. Imaging of male breast disease: the good, the bad and the ugly - A pictorial review. Clin Imaging 2020; 68:45-56. [PMID: 32570009 DOI: 10.1016/j.clinimag.2020.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 10/24/2022]
Abstract
The male breast is affected by a broad spectrum of conditions, ranging from benign to malignant, many of which are similar to those occurring in its female counterpart. Despite the challenge motivated by different imaging characteristic features, correct imaging interpretation in male breast disease may aid at differentiation between benign and suspected conditions, narrow the differential diagnosis and guide subsequent management. The purpose of this review is to showcase a wide array of male breast diseases, discuss their imaging presentations and key features for diagnosis.
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Affiliation(s)
- Marcela Pacheco Viana
- Grupo Fleury, São Paulo, Brazil; Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tatiana Cardoso de Mello Tucunduva
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil; Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Bárbara Helou Bresciani
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil; Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Shimizu
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil; Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Nestor de Barros
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil
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20
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Manai M, Abdeljaoued S, Goucha A, Adouni O, Bettaieb I, Bouzaien H, Rahal K, Birnbaum D, Bertucci F, Gamoudi A. MARCKS protein overexpression is associated with poor prognosis in male breast cancer. Cancer Biomark 2020; 26:513-522. [PMID: 31771045 DOI: 10.3233/cbm-190637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Male breast cancer (MBC) is a rare and aggressive disease. Thus, identification of new therapeutic targets is crucial. OBJECTIVE Our objective was to evaluate the protein expression of MARCKS (Myristoylated Alanine-Rich C-Kinase Substrate) in MBC and to investigate its prognostic value. MATERIALS AND METHODS MARCKS protein expression in tumor and stromal cells was analyzed by immunohistochemistry (IHC) in a retrospective series of 96 pre-chemotherapy MBC samples and 80 normal breast samples, from Tunisian patients treated at Salah Azaiez Institute. Correlations were searched between MARCKS expression and clinicopathological features including overall survival (OS). RESULTS MARCKS was overexpressed in epithelial tumor cells in 66% of the MBC samples versus 26% of normal samples (p= 1.40 × 10-7). Such positive MARCKS expression in epithelial tumor cells was associated with positive HER2 status (p= 4.0 × 10-3). It was associated with shorter OS in uni-and multivariate analysis. By contrast, stromal IHC MARCKS expression was correlated only with tumor grade. CONCLUSION MARCKS tumor cell overexpression might in part explain the aggressiveness and the poor prognosis of MBC. MARCKS can represent a potential therapeutic target for MBC.
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Affiliation(s)
- Maroua Manai
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia.,Laboratory of Biochemistry and Molecular Biology, Department of Biology, Faculty of Sciences, University of Tunis El Manar, Ariana, Tunisia.,Predictive Oncology Laboratory, Cancer Research Center of Marseille, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France.,Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia
| | - Syrine Abdeljaoued
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia.,Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia
| | - Aïda Goucha
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia
| | - Olfa Adouni
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia
| | - Ilhem Bettaieb
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia
| | - Hatem Bouzaien
- Department of Surgery, Salah Azaiez Institute, Tunis, Tunisia
| | - Khaled Rahal
- Department of Surgery, Salah Azaiez Institute, Tunis, Tunisia
| | - Daniel Birnbaum
- Predictive Oncology Laboratory, Cancer Research Center of Marseille, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France
| | - François Bertucci
- Predictive Oncology Laboratory, Cancer Research Center of Marseille, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France.,UFR of Medicine, Aix Marseille University, Marseille, France.,Department of Medical Oncology, Paoli-Calmettes Institute, Marseille, France
| | - Amor Gamoudi
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, Tunis, Tunisia
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21
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Papillary Lesions of the Male Breast: A Study of 117 Cases and Brief Review of the Literature Demonstrate a Broad Clinicopathologic Spectrum. Am J Surg Pathol 2020; 44:68-76. [PMID: 31403965 DOI: 10.1097/pas.0000000000001340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Papillary lesions of the male breast (PLMB) are uncommon. To date, PLMB have been reported as individual case reports and in relatively small series. We reviewed cases of PLMB diagnosed at our medical center over a 19-year (2000-2019) period. A total of 117 cases were identified, with an age range of 7 months to 88 years. These cases included 3 of papillary ductal hyperplasia, 5 intraductal papillomas, 1 adenomyoepithelioma, 5 atypical papillomas (ie, papillomas with atypia), 51 papillary ductal carcinoma in situ, 14 encapsulated papillary carcinomas, 38 solid papillary carcinomas, and 8 invasive papillary carcinomas. Malignant papillary neoplasms, including invasive and noninvasive ones, had a mean size of 1.3 cm (range: 0.3 to 4.4 cm), and all were ER and HER2. Fifty-four percent (19/35) of carcinomas were treated with excision alone, 46% (16/35) underwent mastectomy, and 63% (22/35) had axillary lymph node sampling. Only one case had metastatic involvement of axillary lymph nodes. Of the cases with follow-up, no (0/8) invasive carcinoma showed distant metastasis or proved fatal, and no (0/23) noninvasive papillary carcinoma recurred. Two notable cases of PLMB were encountered: one of a 7-month-old boy with NF1 mutation and florid papillary hyperplasia, and another of a 57-year-old man with Klippel-Feil syndrome and bilateral solid papillary carcinoma, invasive and oligometastatic on one side and noninvasive on the other. On the basis of this study of PLMB cases, the largest to date, and review of literature, we conclude that PLMB span a broad clinicopathologic spectrum, and that both invasive and noninvasive papillary carcinomas have relatively good prognosis.
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22
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O'Leary TR, Shriver CD, Wind G. Metachronous Contralateral Male Breast Cancer: Case Report and Literature Review. Mil Med 2019; 184:e581-e586. [PMID: 30938815 DOI: 10.1093/milmed/usz049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/05/2019] [Accepted: 02/26/2019] [Indexed: 12/30/2022] Open
Abstract
Male breast cancer (MBC) is rare and consequently understudied. Here we present the case of contralateral breast cancer in a male patient nearly a quarter century following his initial breast cancer diagnosis and treatment. The epidemiology, risk factors, diagnosis, characterization, treatment, and prognosis of male breast cancer are reviewed. MBC accounts for <1% of all breast cancer with an estimated incidence nearly 1.25 per 100,000 person years. Our patient tested positive for ATM mutation of undetermined significance. More commonly in males, a BRCA2 mutation confers a >1 in 15 lifetime risk of breast cancer and is present in >11% of MBC patients, while BRCA1 is present in an estimated <1.5% of MBC patients. The risk of contralateral breast cancer developing in a male with a unilateral lesion is much higher than for a primary male breast cancer in the general population. Men tend to be diagnosed at a later age and stage than females. Prognosis for male and female breast cancer is similar considering both age of patient and stage of the tumor at diagnosis, and similar treatment paradigms have resulted in similar outcomes. Although lumpectomy with radiation therapy may have the same prognosis as mastectomy, the standard of care for male breast cancer continues to be simple mastectomy with sentinel lymph node biopsy.
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Affiliation(s)
- Thomas R O'Leary
- Department of Surgery, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Craig D Shriver
- Department of Surgery, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Gary Wind
- Department of Surgery, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
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23
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Abstract
Male breast cancer is rare, accounting for 1% of all breast cancer diagnoses in the USA. Because of its rarity, most major breast cancer trials have included only female patients. This has resulted in limited prospective data to guide the clinical management of men with breast cancer. As a result, treatment decisions are typically extrapolated from data generated in female patients. This approach may be suboptimal, particularly considering the differing hormonal milieus between men and women with respect to both breast cancer development and treatment. Herein, we summarize current knowledge of the biology and clinicopathology of male breast cancer and review current approaches to locoregional and systemic management of this rare disease.
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24
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Sood N. Cytological evaluation in males presenting with bloody nipple discharge, with or without breast mass: Report of two cases depicting two poles of the disease spectrum. Diagn Cytopathol 2018; 47:121-126. [PMID: 30353710 DOI: 10.1002/dc.24080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 11/09/2022]
Abstract
Nipple discharge (ND) either in the presence or in the absence of underlying mass is a very uncommon presentation in males and its bloody nature is still rarer. ND cytology in males has not been reported much in the literature. Spontaneous and expressed ND, however, can be very useful in establishing the diagnosis. Two males with bloody ND, one, without any palpable mass and another with underlying mass, were evaluated on ND cytology. The presence of loose papillaroid clusters and cell sheets with mild atypia was seen in ND smears itself in case 1. The discharge was more copious in case 2, but the ND smears were paucicellular. The presence of tall columnar cells in ND smears as well as in the FNA from underlying mass with clear features of malignancy was helpful in reaching the diagnosis of papillary carcinoma in case 2. Histopathology in case 1 was a spectrum of ADH to DCIS, whereas in case 2, was tubulopapillary carcinoma. Following two cases highlight the importance of the cytological evaluation of ND smears.
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Affiliation(s)
- Neelam Sood
- Department of Pathology and Lab Medicine, Deen Dayal Upadhyay Hospital, Government of NCT, Delhi, New Delhi, India
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25
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Aghahowa ME, Salu IK, Ezike KN, Bassey OS, Umar MU, Etim OA, Okwudire-Ejeh IA. ADVANCED, RECURRENT, INVASIVE CRIBIFORM CARCINOMA OF THE BREAST IN A 17-YEAR-OLD MALE: A CASE REPORT. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2018; 8:114-124. [PMID: 33553054 PMCID: PMC7861190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Male breast cancers (MBC) are relatively rare, accounting for about 1% of all male cancers in the US and 0.6% of breast cancers worldwide. In Nigeria, though the incidence varies per region, with a range of 3.4 to 9%, it is noted to be increasing. Gynaecomastia is a well-documented predisposing factor as well as endogenous and exogenous oestrogen. The most common histological subtype of male breast cancer is the invasive ductal carcinoma. Invasive cribriform carcinoma, ICC, is an extremely rare variant, with no more than 10 cases reported worldwide and, when present, has been diagnosed in patients above 40 years old. CASE REPORT We present the case of a 17 year-old, male undergraduate student, who presented to our clinic on account of a recurrent, painless, right breast lump. Three years earlier he had had a right breast lump excised at another health facilityand this was diagnosed histopathologicallyas invasive cribriform carcinoma. The only known predisposing factor was an initial lump, excised when he was 10 years old, and diagnosed histologically as gynaecomastia.He had surgical excision and axillary lymph node clearance,and histopathology re-confirmed high grade invasive cribriform carcinoma with multiple lymph node metastases, while immunohistochemistry showed a triple negative signature. He was thereafter referred for adjuvant treatment and has responded well to radiotherapy. CONCLUSION There is need for a high index of suspicion in all cases of gynaecomastia, and all such patients should be followed up. Prompt intervention, recourse to histology, and where indicated, immunohistochemistry, are important.
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Affiliation(s)
- M E Aghahowa
- Department of Surgery, Asokoro District Hospital, Abuja, Nigeria
| | - I K Salu
- Department of Surgery, Asokoro District Hospital, Abuja, Nigeria
| | - K N Ezike
- Department of Anatomic Pathology, Asokoro District Hospital, Abuja, Nigeria
| | - O S Bassey
- Department of Radiology, Asokoro District Hospital, Abuja, Nigeria
| | - M U Umar
- Department of Radiology, Asokoro District Hospital, Abuja, Nigeria
| | - O A Etim
- Department of Surgery, Asokoro District Hospital, Abuja, Nigeria
| | - I A Okwudire-Ejeh
- Department of Anatomic Pathology, Asokoro District Hospital, Abuja, Nigeria
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26
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Male breast cancer: a disease distinct from female breast cancer. Breast Cancer Res Treat 2018; 173:37-48. [PMID: 30267249 DOI: 10.1007/s10549-018-4921-9] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE Male breast cancer (BC) is rare, representing approximately 1% of cancers that occur in men and approximately 1% of all BCs worldwide. Because male BC is rare, not much is known about the disease, and treatment recommendations are typically extrapolated from data available from clinical trials enrolling female BC patients. METHODS We review the epidemiology, risk factors, prognosis, and the varied molecular and clinicopathologic features that characterize male BC. In addition, we summarize the available data for the use of systemic therapy in the treatment of male BC and explore the ongoing development of targeted therapeutic agents for the treatment of this subgroup of BCs. RESULTS There are important biological differences between male and female BC. Male BC is almost exclusively hormone receptor positive (+), including the androgen receptor (AR), and is associated with an increased prevalence of BRCA2 germline mutations, especially in men with increased risk for developing high-risk BC. Additional research is warranted to better characterize male BC. To accomplish this, a multi-national consortium approach, such as the International Male Breast Cancer Program, is needed in response to the scarcity of patients. This approach allows the pooling of information from a large number of men with BC and the creation of registries for future therapeutic-focused clinical trials. CONCLUSIONS Given the unique biology of BC in men, promising new therapeutic targets are currently under investigation, including the use of poly-ADP-ribose polymerase inhibitors or AR-targeted agents either as monotherapy or in combination with other agents.
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27
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Value of FNAC in abnormal axillary lymph nodes with non specific mammograms. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2017.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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28
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Bazzocchi M, Vianello E, Linda A, Londero V, Zuiani C. Male Breast Lesions: Which Abnormalities Really Need Core Needle Biopsy? TUMORI JOURNAL 2018; 96:266-70. [DOI: 10.1177/030089161009600213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background The purpose of the study was to identify clinical, mammographic or sonographic abnormalities of the male breast that require histological characterization. Methods and study design Clinical and imaging features of 31 male patients with breast lesions were retrospectively evaluated and correlated with core needle biopsy results. Results Seven of 31 (22.6%) lesions proved to be malignant and 24 of 31 (77.4%) benign, with a benign/malignant ratio of 4.4:1. In the case of a suspicious clinical presentation (firm mass, nipple retraction) and/or the presence of risk factors for breast cancer (BRCA2 mutation, previous breast cancer), core needle biopsy always demonstrated malignancy. All malignant lesions identified on mammography (4 of 7) appeared as a mass. Benign lesions detected on mammography (21 of 24) presented as an area of increased density (20 of 21) more frequently than a mass (1 of 21). Conclusions Sonographic features of cancers were not different from those of benign lesions. Clinical and mammographic findings, along with patient history, can be useful in the identification of male breast lesions that require core needle biopsy.
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Affiliation(s)
- Massimo Bazzocchi
- Istituto di Radiologia, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Elena Vianello
- Istituto di Radiologia, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Anna Linda
- Istituto di Radiologia, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Viviana Londero
- Istituto di Radiologia, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Chiara Zuiani
- Istituto di Radiologia, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
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29
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Mango VL, Goodman S, Clarkin K, Wynn RT, Friedlander L, Hibshoosh H, Ha R. The unusual suspects: A review of unusual benign and malignant male breast imaging cases. Clin Imaging 2018; 50:78-85. [PMID: 29328960 DOI: 10.1016/j.clinimag.2017.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/05/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022]
Abstract
Male breast disease is uncommon. Men presenting with breast symptoms may represent unique diagnostic challenges for the radiologist, particularly if imaging findings are not classic for gynecomastia or carcinoma. In this paper we review 10 unusual male breast cases, 5 benign and 5 malignant, including the radiologic findings, differential diagnosis, pathology and management.
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Affiliation(s)
- Victoria L Mango
- Memorial Sloan Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, Suite 715, New York, NY 10065, United States.
| | - Sarah Goodman
- Columbia University Medical Center Department of Radiology, Herbert Irving Pavilion, 161 Fort Washington Ave, New York, NY 10032, United States.
| | - Kim Clarkin
- Columbia University Medical Center Department of Radiology, Herbert Irving Pavilion, 161 Fort Washington Ave, New York, NY 10032, United States
| | - Ralph T Wynn
- Columbia University Medical Center Department of Radiology, Herbert Irving Pavilion, 161 Fort Washington Ave, New York, NY 10032, United States.
| | - Lauren Friedlander
- Columbia University Medical Center Department of Radiology, Herbert Irving Pavilion, 161 Fort Washington Ave, New York, NY 10032, United States.
| | - Hanina Hibshoosh
- Columbia University Medical Center Department of Pathology, 630 West 168th Street, New York, NY 10032, United States.
| | - Richard Ha
- Columbia University Medical Center Department of Radiology, Herbert Irving Pavilion, 161 Fort Washington Ave, New York, NY 10032, United States.
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Merino MJ, Gil S, Macias CG, Lara K. The Unknown microRNA Expression of Male Breast Cancer. Similarities and Differences with Female Ductal Carcinoma. Their Role as Tumor Biomarker. J Cancer 2018; 9:450-459. [PMID: 29483949 PMCID: PMC5820911 DOI: 10.7150/jca.23151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/27/2017] [Indexed: 12/03/2022] Open
Abstract
Mature microRNAs (miRNAs) are small non-protein coding RNAs that modulate gene expression after transcription. Few studies have shown that male breast cancer (MBC) shows distinctive miRNAs pattern, suggesting its relevance in this pathology. To study this, we performed a profile of 800 miRNAs in 9 MBC samples and in normal epithelial cells of 3 MBC cases. Experimental Design: Of FFPE tissues, miRNA was extracted for profiles using the NanoString method. miRNAs were obtained by comparing tumor samples versus normal epithelium. Quantitative real-time PCR analyzes were performed by the TaqMan approach for specific miRNAs. Results: The profile of 800 miRNAs showed a different microRNA expression pattern between MBC and its normal counterpart, suggesting a specific microRNA cancer expression profile for MBC. Forty-nine miRNAs showed greater expression, while 26 were found to be down-regulated in MBC, compared to normal tissue. The lower expression of miR-125b correlated significantly with tumors> 2 cm, suggesting that its down-regulation may be implicated in mechanisms to more aggressive tumors. Conclusions: These results suggest that MBC has a unique expression profile compared to normal breast tissue and expression profile of female breast cancer. Differentially expressed miRNAs provide insights of this uncommon but highly aggressive pathology.
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Affiliation(s)
- Maria J Merino
- Translational Surgical Pathology Section, Laboratory of Pathology. Center for Cancer Research, National Cancer Institute, National Institutes of Health
| | - Sara Gil
- Translational Surgical Pathology Section, Laboratory of Pathology. Center for Cancer Research, National Cancer Institute, National Institutes of Health
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Vermeulen MA, Slaets L, Cardoso F, Giordano SH, Tryfonidis K, van Diest PJ, Dijkstra NH, Schröder CP, van Asperen CJ, Linderholm B, Benstead K, Foekens R, Martens JW, Bartlett JM, van Deurzen CH. Pathological characterisation of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Eur J Cancer 2017; 82:219-227. [DOI: 10.1016/j.ejca.2017.01.034] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 02/08/2023]
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Saha D, Tannenbaum S, Zhu Q. Treatment of Male Breast Cancer by Dual Human Epidermal Growth Factor Receptor 2 (HER2) Blockade and Response Prediction Using Novel Optical Tomography Imaging: A Case Report. Cureus 2017; 9:e1481. [PMID: 28944120 PMCID: PMC5602378 DOI: 10.7759/cureus.1481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Male breast cancer, although rare, is on the rise. Prospective clinical trials are unlikely and current management mirrors that of post-menopausal women. Neoadjuvant chemotherapy is widely used and pathologic complete response (pCR) predicts long-term survival. The addition of dual HER2 (human epidermal growth factor receptor 2) blockade has shown the highest pCR rates; however, there is no published data of this approach in men. Also, newer monitoring tools are necessary during a neoadjuvant therapy to help personalize treatment. Here, we describe the case of a 64-year-old man with Stage IIB (tumor size 2 to 5 cm with involvement of axillary lymph nodes), high-grade estrogen receptor, progesterone receptor, and HER2-positive invasive ductal carcinoma with a germline breast cancer susceptibility gene 1 (BRCA1) mutation who was treated in a neoadjuvant fashion with dual HER2 blockade and platinum-based chemotherapy regimen. A novel predictive tool, ultrasound-localized diffuse optical tomography, was used to monitor his progress during treatment.
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Affiliation(s)
- Debasmita Saha
- Neag Comprehensive Cancer Center, University of Connecticut Health Center
| | - Susan Tannenbaum
- Neag Comprehensive Cancer Center, University of Connecticut Health Center
| | - Quing Zhu
- Biomedical Engineering and Radiology, Washington University, St Louis, Mo
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Katiyar R, Patne SCU, Kumar S, Khanna R. Invasive Papillary Carcinoma of the Male Breast Misdiagnosed as Fibroadenoma on FNAB. J Clin Diagn Res 2017; 11:ED06-ED07. [PMID: 28384872 DOI: 10.7860/jcdr/2017/24832.9211] [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: 10/16/2016] [Accepted: 11/28/2016] [Indexed: 11/24/2022]
Abstract
Male breast cancers constitute less than 1% of all the breast cancers. Papillary carcinoma is a very rare tumour of the male breast. Due to rarity, Fine Needle Aspiration Biopsy (FNAB) findings of papillary carcinoma in male breast are seldom reported. A 55-year-old male presented with a lump in the left breast of two years' duration. FNAB was reported as fibroadenoma. Histopathological examination of the excised breast lump revealed invasive papillary carcinoma. Immunohistochemistry showed expression of pancytokeratin, oestrogen receptor, and progesterone receptor. Negative immunostaining was seen for HER2, p53, 34βE12, and CD34. Ki-67 proliferative index was 5%. We have discussed cytological findings of invasive papillary carcinoma and its differential diagnoses. Cytopathologists must be aware of cytologic findings of invasive papillary carcinoma of the male breast.
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Affiliation(s)
- Richa Katiyar
- Service Senior Resident, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, Uttar Pradesh, India
| | - Shashikant C U Patne
- Assistant Professor, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, Uttar Pradesh, India
| | - Sandip Kumar
- Assistant Professor, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, Uttar Pradesh, India
| | - Rahul Khanna
- Professor, Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University , Varanasi, Uttar Pradesh, India
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Banys-Paluchowski M, Burandt E, Banys J, Geist S, Sauter G, Krawczyk N, Paluchowski P. Male papillary breast cancer treated by wide resection and latissimus dorsi flap reconstruction: A case report and review of the literature. World J Clin Oncol 2016; 7:420-424. [PMID: 27777885 PMCID: PMC5056334 DOI: 10.5306/wjco.v7.i5.420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/16/2016] [Accepted: 09/18/2016] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors (both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical (non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; pT3 (10 cm), pN0 (0/15), M0, R0; OncotypeDX Recurrence Score indicated low risk (RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.
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Chau A, Jafarian N, Rosa M. Male Breast: Clinical and Imaging Evaluations of Benign and Malignant Entities with Histologic Correlation. Am J Med 2016; 129:776-91. [PMID: 26844632 DOI: 10.1016/j.amjmed.2016.01.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 11/17/2022]
Abstract
Breast cancer is an uncommon disease in men. As a result, the diagnosis may not initially be considered. Understanding the common benign and malignant entities affecting the male breast is critical for timely and accurate diagnosis in the primary care setting. Most patients present with a palpable breast mass or pain. The usual etiology is gynecomastia, the most common breast condition in males, but breast cancer must always be excluded through careful imaging evaluation when physical examination findings are suspicious or inconclusive. Imaging of the male breast generally relies on mammography and ultrasound, with mammography employed as the initial imaging modality of choice and ultrasound when a mass is detected or suspected. Here we describe the normal male breast anatomy and present an evaluation algorithm for the male patient with breast signs or symptoms. The most common benign and malignant entities are described.
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Affiliation(s)
- Alec Chau
- Breast Imaging Section, Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, Fla; Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa.
| | - Neda Jafarian
- Diagnostic Radiology, Oregon Health & Science University, Portland
| | - Marilin Rosa
- Department of Anatomic Pathology and Women's Oncology, Moffitt Cancer Center, Tampa, Fla; Department of Oncologic Sciences & Pathology, College of Medicine, University of South Florida, Tampa
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Yalaza M, İnan A, Bozer M. Male Breast Cancer. THE JOURNAL OF BREAST HEALTH 2016; 12:1-8. [PMID: 28331724 DOI: 10.5152/tjbh.2015.2711] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/03/2015] [Indexed: 12/24/2022]
Abstract
Male breast cancer (MBC) is a rare disease, accounting for less than 1% of all breast cancer diagnoses worldwide. Although breast carcinomas share certain characteristics in both genders, there are notable differences. Most studies on men with breast cancer are very small. Thus, most data on male breast cancer are derived from studies on females. However, when a number of these small studies are grouped together, we can learn more from them. This review emphasizes the incidence, etiology, clinical features, diagnosis, treatment, pathology, survival, and prognostic factors related to MBC.
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Affiliation(s)
- Metin Yalaza
- Clinic of Surgical Oncology, Konya Training and Research Hospital, Konya, Turkey
| | - Aydın İnan
- Department of General Surgery, Turgut Özal University Faculty of Medicine, Ankara, Turkey
| | - Mikdat Bozer
- Department of General Surgery, Division of Surgical Oncology, Fatih University Faculty of Medicine, İstanbul, Turkey
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38
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Uslukaya Ö, Gümüş M, Gümüş H, Bozdağ Z, Türkoğlu A. The Management and Outcomes of Male Breast Cancer. THE JOURNAL OF BREAST HEALTH 2016; 12:165-170. [PMID: 28331756 DOI: 10.5152/tjbh.2016.3073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 05/23/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Due to a lack of sufficient data, the treatment protocols for male breast cancer are usually the same as those used for female breast cancer. The aim of the current study was to present our clinical experience with male breast cancer. MATERIALS AND METHODS The records of 37 patients who were treated for male breast cancer in our hospital between 2004 and 2014 were reviewed retrospectively. The data of patients were recorded and analyzed. RESULTS The mean age of the patients was 63.03±12.36 years. Thirty-three patients (89.2%) had invasive ductal carcinoma, two (5.4%) had ductal carcinoma in situ, and two had invasive lobular carcinoma (5.4%). The most common molecular subtype was luminal A (17 cases, 45.9%). Twenty-nine patients with male breast cancer underwent mastectomy and two underwent breast conserving surgery. Axillary lymph node dissection was performed in 25 patients. The most common surgical procedure was modified radical mastectomy. Distant metastases were present in 17 (45.9%) patients. Overall, the 5-year survival was 60%. The 5-year survival was 100% for those with stage 0-I disease, 87% for stage II, and 42% for stage III. The 3-year survival was 14% for stage IV. CONCLUSION Patients with male breast cancer presented at an older age, a later stage, and with earlier metastasis. Early metastasis and death increases with increasing stage. Poor prognosis correlates with late admission. Data from different centers should be compiled and reviewed in order to determine a specific treatment protocol for male breast cancer; each paper published reveals new data.
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Affiliation(s)
- Ömer Uslukaya
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Metehan Gümüş
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Hatice Gümüş
- Department of Radiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Zübeyir Bozdağ
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Ahmet Türkoğlu
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
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Abstract
Bilateral synchronous breast cancer is extremely rare. A 75-year-old man presented with a right breast mass, which ulcerated and a lump in the left breast. Right breast examination revealed a breast ulcer 7×10cm with everted edges and complete nipple destruction. The left breast showed a hard lump measuring 4×5cm in the nipple-areolar area, unattached to skin, or underlying structure. There was no palpable axillary lymph node bilaterally. A wedge biopsy of right breast ulcer and excision of the left breast lump confirmed bilateral invasive ductal carcinoma - Grade 2 tumor in both breasts. He had bilateral simple mastectomy and chemotherapy; defaulted for 18 months during treatment, and re-presented with bilateral tumor recurrence. The importance of this case report is to create more awareness that breast cancer can occur in males just as in females, though the incidence is rare in males. Early presentation and compliance with treatment modality provide a better outcome.
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Affiliation(s)
- Nnamdi J Nwashilli
- Department of Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. E-mail.
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40
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Flow cytometric DNA hypertetraploidy tends to be more frequent in male than in female breast cancers. Virchows Arch 2014; 466:185-9. [PMID: 25471639 DOI: 10.1007/s00428-014-1694-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
Abstract
The aim of the study was to explore possible differences in DNA flow cytometric characteristics, particularly differences in distribution of DNA indices of aneuploid clones, between male and female breast cancers. We retrospectively analyzed 31 male breast cancers. Clinicopathological and DNA flow cytometric characteristics of male breast cancers (patient age, tumor size, histological type, histological grade, axillary lymph node status, hormone receptor expression, ploidy, and S-phase fraction) were compared with that of the control group of matched female breast cancers. Hormone receptors and HER-2/neu were investigated immunohistochemically with additional chromogenic in situ hybridization (CISH) analysis of HER-2/neu 2+ cases. Ploidy and S-phase fraction were determined by DNA flow cytometry. Comparison with clinicopathological features was made using χ (2) and t test. Aneuploidy was found in 78% of the cases, with the predomination of hypotetraploid clones (39%), followed by tetraploid (23%) and hypertetraploid clones (16%). We found higher frequency of hypertetraploidy in male breast cancers (16 and 6%, respectively) than in the control group of matched female breast cancers. Clinicopathological features of hypertetraploid male breast cancers did not differ from that of non-hypertetraploid cancers. Higher frequency of hypertetraploidy among male breast cancers might indicate different cytogenetical evolutionary pathway between male and female breast cancer.
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Zhou R, Yu L, Zhou S, Bi R, Shui R, Yu B, Lu H, Cai X, Yang W. Male breast carcinoma: a clinicopathological and immunohistochemical characterization study. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:6852-6861. [PMID: 25400768 PMCID: PMC4230132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 09/13/2014] [Indexed: 06/04/2023]
Abstract
Male breast carcinoma is a relatively rare disease. This study retrospectively investigated the clinicopathological features of 73 cases of male breast carcinoma in Chinese population, and classified the molecular subtype based on surrogate immunohistochemical definitions. The expression of GCDFP15, MGB, AR and FOXP1 were evaluated. Invasive carcinoma of no special type was the most common histological type in the study group (71.2%, 52/73). The luminal A and B subtypes were the major types of male breast carcinoma (60.9%, 34.8% respectively). AR and FOXP1 are expressed in 84.2% (48/57) and 71.9% (41/57) of the studied cases. Carcinoma of the luminal A subtype expressed GCDFP15 (73.5%, 25/34) and MGB (58.8%, 20/34) more frequently than cases of the luminal B subtypes (34.8%, 8/23 and 43.5%, 10/23, respectively; P = 0.004, P = 0.255, respectively). In conclusion, invasive carcinoma of no special type was the most common histological type in male breast carcinoma among Chinese population. Our study revealed that the luminal A and B subtypes were the major types of male breast carcinoma. AR and FOXP1 are highly expressed in male breast cancer. The luminal A subtype tends to express GCDFP15 and MGB more frequently than the luminal B subtype.
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Affiliation(s)
- Ruoji Zhou
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Lin Yu
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Shuling Zhou
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Rui Bi
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Ruohong Shui
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Baohua Yu
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Hongfen Lu
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Xu Cai
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer CenterShanghai 200032, P.R. China
- Department of Oncology, Shanghai Medical College, Fudan UniversityShanghai 200032, P.R. China
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Pure invasive micropapillary carcinoma of the male breast: report of a rare case with C-MYC amplification. Pathol Res Pract 2014; 210:1164-6. [PMID: 25042382 DOI: 10.1016/j.prp.2014.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 05/02/2014] [Accepted: 06/10/2014] [Indexed: 12/25/2022]
Abstract
Male breast cancer is rare. The most common histological subtypes include invasive carcinoma "of no special type" and papillary carcinoma. Other variants, including pure micropapillary carcinoma, have been described as well but are extremely rare. Pure micropapillary carcinoma has been recently characterized by a C-MYC gene amplification in women. We report here, occurring in a 73-year-old man, the first case of pure micropapillary carcinoma with amplification of the C-MYC gene.
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Rubio Hernández MC, Díaz Prado YI, Pérez SR, Díaz RR, Aleaga ZG. Synchronous bilateral breast cancer in a male. Ecancermedicalscience 2013; 7:377. [PMID: 24319497 PMCID: PMC3848462 DOI: 10.3332/ecancer.2013.377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Indexed: 11/06/2022] Open
Abstract
Male breast cancer, which represents only 1% of all breast cancers, is occasionally associated with a family history of breast cancer. Sporadic male breast cancers presenting with another primary breast cancer are extremely rare. In this article, we report on a 70-year-old male patient with bilateral multifocal and synchronous breast cancer and without a family history of breast cancer.
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Affiliation(s)
- María Caridad Rubio Hernández
- Mastology Department, Cuban National Institute of Oncology and Radiobiology, 29 y F Vedado, Plaza, La Habana 10400, Cuba
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Madhukar M, Chetlen A. Multimodality imaging of benign and malignant male breast disease. Clin Radiol 2013; 68:e698-706. [DOI: 10.1016/j.crad.2013.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022]
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45
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Lattin GE, Jesinger RA, Mattu R, Glassman LM. From the radiologic pathology archives: diseases of the male breast: radiologic-pathologic correlation. Radiographics 2013; 33:461-89. [PMID: 23479708 DOI: 10.1148/rg.332125208] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Male breast disease includes a variety of benign and malignant conditions, many of which are hormonally influenced. Gynecomastia and skin lesions account for the majority of conditions in symptomatic men with a palpable abnormality, and these conditions should be accurately recognized. Imaging patterns of gynecomastia include nodular, dendritic, and diffuse patterns. Histopathologically, the nodular and dendritic patterns correlate with the florid and quiescent (fibrotic) phases of gynecomastia, respectively. The diffuse pattern may have features of both phases and is associated with exposure to exogenous estrogen. Benign-appearing palpable masses in male patients should be approached cautiously, given the overlapping morphologic features of benign and malignant tumors. In addition to gynecomastia, other benign male breast tumors include lipoma, pseudoangiomatous stromal hyperplasia, granular cell tumor, fibromatosis, myofibroblastoma, schwannoma, and hemangioma. Male breast cancer accounts for 1% of all breast carcinomas. Invasive ductal carcinoma accounts for the majority of cases in adult males and typically appears as a subareolar mass without calcifications that is eccentric to the nipple. Other epithelial and mesenchymal tumors that may occur, albeit not as commonly as in women, include papillary carcinoma, invasive lobular carcinoma, adenoid cystic carcinoma, liposarcoma, dermatofibrosarcoma, pleomorphic hyalinizing angiectatic tumor, basal cell carcinoma of the nipple, hematopoietic malignancies, and secondary tumors. Knowledge of the natural history, clinical characteristics, and imaging features of tumors that occur in the male breast will help narrow the radiologic differential diagnosis and optimize treatment.
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Affiliation(s)
- Grant E Lattin
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA.
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Ni YB, Mujtaba S, Shao MM, Lacambra M, Tsang JYS, Chan SK, Tse GM. Columnar cell-like changes in the male breast. J Clin Pathol 2013; 67:45-8. [DOI: 10.1136/jclinpath-2013-201631] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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47
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Ninkovic S, Azanjac G, Knezevic M, Radovanovic D, Canovic D, Nedovic J, Mitrovic S. Lobular Breast Cancer in a Male Patient with a Previous History of Irradiation Due to Hodgkin's Disease. ACTA ACUST UNITED AC 2013; 7:315-8. [PMID: 23904835 DOI: 10.1159/000341391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Male breast cancer is rare and represents less than 1% of all breast cancers. Considering the fact that the male breast most often does not consist of lobules and acini, lobular carcinoma of the male breast is exceptionally rare. CASE REPORT In this paper we present a unique case of alveolar variant of lobular male breast cancer in a 56-year-old patient. CONCLUSION According to our knowledge this is the first presentation of an alveolar variant of lobular male breast cancer that appeared 14 years after chemo- and radiotherapy for the treatment of Hodgkin's disease.
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Affiliation(s)
- Srdjan Ninkovic
- Faculty of Medicine, University of Kragujevac, Serbia ; Clinical Centre Kragujevac, Serbia
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48
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Ly D, Forman D, Ferlay J, Brinton LA, Cook MB. An international comparison of male and female breast cancer incidence rates. Int J Cancer 2013; 132:1918-26. [PMID: 22987302 PMCID: PMC3553266 DOI: 10.1002/ijc.27841] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 08/27/2012] [Indexed: 11/11/2022]
Abstract
Global international trends in female breast cancer incidence have been described previously but no comparable analysis of male breast cancer incidence rates has been conducted. We obtained male and female case and population data using Cancer Incidence in Five Continents (CI5). We calculated age-adjusted, sex-specific incidence rates and female-to-male incidence rate ratios (FMIRRs) and compared trends of such for the period 1988-2002. This analysis included 8,681 male breast cancer cases and 1.14 million female breast cancer cases. The highest male incidence rate was observed in Israel at 1.24 per 100,000 man-years, and the highest female incidence rate was observed in the United States at 90.7 per 100,000 woman-years. The lowest incidence rates for males (0.16) and females (18.0) were observed in Thailand. In general, male breast cancer incidence trends were variable; a minority of countries displayed evidence for an increase. In contrast, female incidence rates have been increasing in a majority of countries. The Pearson correlation coefficient (r) for male and female breast cancer incidence rates by country during 1988-2002 was 0.69. Male breast cancer rates were generally less than 1 per 100,000 man-years, in contrast to the much higher rates of female breast cancer, providing for an overall FMIRR of 122. The differences in both incidence rates and time trends between males and females may reflect sex differences in underlying risk factors, pathogenesis, and/or overdiagnosis. Conversely, the high correlation between male and female breast cancer incidences may indicate that both sexes share some common risk factors for breast cancer.
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Affiliation(s)
- Diana Ly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20852-7234, USA
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Ruddy KJ, Winer EP. Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship. Ann Oncol 2013; 24:1434-43. [PMID: 23425944 DOI: 10.1093/annonc/mdt025] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The causes, optimal treatments, and medical/psychosocial sequelae of breast cancer in men are poorly understood. DESIGN A systematic review of the English language literature was conducted to identify studies relevant to male breast cancer between 1987 and 2012 and including at least 20 patients. Searches were carried out on PubMed using the title terms 'male breast cancer' or 'male breast carcinoma'. RESULTS Relevant published data regarding risk factors, biological characteristics, presentation and prognosis, appropriate evaluation and treatment, and survivorship issues in male breast cancer patients are presented. BRCA2 mutations, age, conditions that alter the estrogen/androgen ratio, and radiation are proven risk factors. Disease biology is distinct in men, but diagnostic approaches and treatments for men are generally extrapolated from those in women due to inadequate research in men. Survivorship issues in men may include sexual and hormonal side-effects of endocrine therapies as well as unique psychosocial impacts of the disease. CONCLUSION Further research is needed to address gaps in knowledge pertaining to care of male breast cancer patients and survivors.
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Affiliation(s)
- K J Ruddy
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
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Vaysse C, Sroussi J, Mallon P, Feron JG, Rivain AL, Ngo C, Belichard C, Lasry S, Pierga JY, Couturaud B, Fitoussi A, Laki F, Fourchotte V, Alran S, Kirova Y, Vincent-Salomon A, Sastre-Garau X, Sigal-Zafrani B, Rouzier R, Reyal F. Prediction of axillary lymph node status in male breast carcinoma. Ann Oncol 2013; 24:370-376. [PMID: 23051951 DOI: 10.1093/annonc/mds283] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND To evaluate whether predictive factors of axillary lymph node metastasis in female breast cancer (BC) are similar in male BC. PATIENTS AND METHODS From January 1994 to May 2011, we recorded 80 non-metastatic male BC treated at Institut Curie (IC). We analysed the calibration and discrimination performance of two nomograms [IC, Memorian Sloan-Kettering Cancer Center (MSKCC)] originally designed to predict axillary lymph node metastases in female BC. RESULTS About 55% and 24% of the tumours were pT1 and pT4, respectively. Nearly 46% demonstrated axillary lymph node metastasis. About 99% were oestrogen receptor positive and 94% HER2 negative. Lymph node status was the only significant prognostic factor of overall survival (P = 0.012). The area under curve (AUC) of IC and MSKCC nomograms were 0.66 (95% CI 0.54-0.79) and 0.64 (95% CI 0.52-0.76), respectively. The calibration of these two models was inadequate. CONCLUSIONS Multi-variate models designed to predict axillary lymph node metastases for female BC were not effective in our male BC series. Our results may be explained by (i) small sample size (ii) different biological determinants influencing axillary metastasis in male BC compared with female BC.
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