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Nicosia L, Mariano L, Bozzini AC, Pesapane F, Bagnardi V, Frassoni S, Oriecuia C, Dominelli V, Latronico A, Palma S, Venturini M, Fontana F, Priolo F, Abiuso I, Sangalli C, Cassano E. Radiological Features of Male Breast Neoplasms: How to Improve the Management of a Rare Disease. Diagnostics (Basel) 2024; 14:104. [PMID: 38201413 PMCID: PMC10795707 DOI: 10.3390/diagnostics14010104] [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: 12/08/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
The primary aim of our study was to assess the main mammographic and ultrasonographic features of invasive male breast malignancies. The secondary aim was to evaluate whether a specific radiological presentation would be associated with a worse receptor profile. Radiological images (mammography and/or ultrasound) of all patients who underwent surgery for male invasive breast cancer in our institution between 2008 and 2023 were retrospectively analyzed by two breast radiologists in consensus. All significant features of radiological presentation known in the literature were re-evaluated. Fifty-six patients were selected. The mean age at surgery of patients was 69 years (range: 35-81); in 82% of cases (46 patients), the histologic outcome was invasive ductal carcinoma. A total of 28 out of 56 (50%) patients had preoperative mammography; in 9/28 cases (32%), we found a mass with microcalcifications on mammography. The mass presented high density in 25 out of 28 patients (89%); the mass showed irregular margins in 15/28 (54%) cases. A total of 46 out of 56 patients had preoperative ultrasounds. The lesion showed a solid mass in 41/46 (89%) cases. In 5/46 patients (11%), the lesion was a mass with a mixed (partly liquid-partly solid) structure. We did not find any statistically significant correlation between major types of radiological presentation and tumor receptor arrangement. Knowledge of the main radiologic presentation patterns of malignant male breast neoplasm can help better manage this type of disease, which is rare but whose incidence is increasing.
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Affiliation(s)
- Luca Nicosia
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
| | - Luciano Mariano
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
| | - Anna Carla Bozzini
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
| | - Filippo Pesapane
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy; (V.B.); (S.F.)
| | - Samuele Frassoni
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy; (V.B.); (S.F.)
| | - Chiara Oriecuia
- Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy;
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
| | - Valeria Dominelli
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
| | - Antuono Latronico
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
| | - Simone Palma
- Department of Bioimaging, Radiation Oncology and Hematology, UOC of Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCSS, Largo A. Gemelli 8, 00168 Rome, Italy;
| | - Massimo Venturini
- Department of Diagnostic and Interventional Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (M.V.); (F.F.)
| | - Federico Fontana
- Department of Diagnostic and Interventional Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (M.V.); (F.F.)
| | - Francesca Priolo
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
| | - Ida Abiuso
- Radiology Department, Università degli Studi di Torino, 10129 Turin, Italy;
| | - Claudia Sangalli
- Data Management, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Enrico Cassano
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.M.); (A.C.B.); (F.P.); (V.D.); (A.L.); (F.P.); (E.C.)
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Male Breast Cancer with Radiological and Histopathological Findings. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 54:375-379. [PMID: 33312039 PMCID: PMC7729722 DOI: 10.14744/semb.2020.01643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/21/2020] [Indexed: 01/21/2023]
Abstract
Objectives We aimed to remind and emphasize the importance of male breast cancer with radiological and histopathological results of the patients diagnosed in our institution. Methods Men who had proven breast cancer by histopathological analysis between February 2010-April 2018 were reviewed retrospectively. The mammographic, ultrasonographic, magnetic resonance and positron-emission-tomography imaging features and histopathological results of the masses were noted. Results Twenty-five men were included in this study. Mean age of the patients was 62.9 (min:42; max: 82) with a mean size of lesions was 26.4 mm (min:10 mm; max: 70 mm). All the lesions were presented as a palpable mass. According to imaging features of the five patients who had mammography, all the four patients were presented as a mass but one patient as asymmetrical density. According to imaging features of the 20 patients who had an ultrasound, 16 (80%) lesions were presented as hypoechoic solid masses with irregular margins, while four (20%) were presented as complex-cystic masses with irregular margins. All the patients were diagnosed as invasive ductal cancer with luminal subtype by histopathological analysis. Conclusion Even at young ages, the palpable lesion may be the only symptom of male breast cancer. Male breast cancer is generally presented as retroareolar mass and detected in advanced stages, probably due to low awareness and lack of screening programme. Invasive ductal cancer is the most common type of male breast cancer with the luminal subtype.
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Streng M, Ignatov A, Reinisch M, Costa SD, Eggemann H. A comparison of tumour size measurements with palpation, ultrasound and mammography in male breast cancer: first results of the prospective register study. J Cancer Res Clin Oncol 2017; 144:381-387. [PMID: 29204896 DOI: 10.1007/s00432-017-2554-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 11/27/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Precise presurgical diagnosis of tumour size is essential for adequate treatment of male breast cancer (MBC). This study is aimed to compare the accuracy of clinical measurement (CE), ultrasound (US) and mammography (MG) for preoperative estimation of tumour size. METHODS This study was conducted as a prospective, multicentre register study. One hundred and twenty-nine male patients with invasive breast cancer were included. CE, US and MG were performed in 107, 110 and 75 patients, respectively, and the estimated tumour size was compared with the histopathological (HP) tumour size. RESULTS All methods tended to underestimate the HP tumour size. None of the methods were significantly more accurate than the others in determining the maximal tumour diameter. The sensitivity within 5 mm tolerance for US was 65.5%, which was better than for MG (61.3%) and CE (56.6%). In the group of patients with pT2 tumours, MG showed significantly better accuracy than US. The measurements obtained with each method were significantly correlated with the HP measurements. The highest correlation coefficient was observed for MG (0.788), followed by US (0.741) and CE (0.671). CONCLUSIONS Our data demonstrate that MG and US have similar accuracy with regard to tumour size estimation. US assessment showed the highest sensitivity in determining tumour size, followed by MG and CE. However, MG demonstrated a significant advantage for estimating the real tumour size for pT2 tumours compared to US or CE.
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Affiliation(s)
- Martin Streng
- Department of Obstetrics and Gynecology, University of Magdeburg, Magdeburg, Germany
| | - Atanas Ignatov
- Department of Obstetrics and Gynecology, University of Magdeburg, Magdeburg, Germany
| | | | - Serban-Dan Costa
- Department of Obstetrics and Gynecology, University of Magdeburg, Magdeburg, Germany
| | - Holm Eggemann
- Department of Obstetrics and Gynecology, University of Magdeburg, Magdeburg, Germany.
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Kanthan R, Fried I, Rueckl T, Senger JL, Kanthan SC. Expression of cell cycle proteins in male breast carcinoma. World J Surg Oncol 2010; 8:10. [PMID: 20152033 PMCID: PMC2829567 DOI: 10.1186/1477-7819-8-10] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 02/12/2010] [Indexed: 11/18/2022] Open
Abstract
Introduction Male breast cancer (MBC) is a rare, yet potentially aggressive disease. Although literature regarding female breast cancer (FBC) is extensive, little is known about the etiopathogenesis of male breast cancer. Studies from our laboratory show that MBCs have a distinct immunophenotypic profile, suggesting that the etiopathogenesis of MBC is different from FBCs. The aim of this study was to evaluate and correlate the immunohistochemical expression of cell cycle proteins in male breast carcinoma to significant clinico-biological endpoints. Methods 75 cases of MBC were identified using the records of the Saskatchewan Cancer Agency over 26 years (1970-1996). Cases were reviewed and analyzed for the immunohistochemical expression of PCNA, Ki67, p27, p16, p57, p21, cyclin-D1 and c-myc and correlated to clinico-biological endpoints of tumor size, node status, stage of the disease, and disease free survival (DFS). Results Decreased DFS was observed in the majority of tumors that overexpressed PCNA (98%, p = 0.004). The overexpression of PCNA was inversely correlated to the expression of Ki67 which was predominantly negative (78.3%). Cyclin D1 was overexpressed in 83.7% of cases. Cyclin D1 positive tumors were smaller than 2 cm (55.6%, p = 0.005), had a low incidence of lymph node metastasis (38.2%, p = 0.04) and were associated with increased DFS of >150 months (p = 0.04). Overexpression of c-myc (90%) was linked with a higher incidence of node negativity (58.3%, p = 0.006) and increased DFS (p = 0.04). p27 over expression was associated with decreased lymph node metastasis (p = 0.04). P21 and p57 positive tumors were related to decreased DFS (p = 0.04). Though p16 was overexpressed in 76.6%, this did not reach statistical significance with DFS (p = 0.06) or nodal status (p = 0.07). Conclusion Aberrant cell cycle protein expression supports our view that these are important pathways involved in the etiopathogenesis of MBC. Tumors with overexpression of Cyclin D1 and c-myc had better outcomes, in contrast to tumors with overexpression of p21, p57, and PCNA with significantly worse outcomes. P27 appears to be a predictive marker for lymph nodal status. Such observation strongly suggests that dysregulation of cell cycle proteins may play a unique role in the initiation and progression of disease in male breast cancer. Such findings open up new avenues for the treatment of MBC as a suitable candidate for novel CDK-based anticancer therapies in the future.
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Affiliation(s)
- Rani Kanthan
- Department of Pathology and Laboratory Sciences, Royal University Hospital, Saskatoon, SK, Canada.
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