1
|
Petrescu AM, Pirici ND, Ruxanda AI, Vasile L, Pîrșcoveanu M, Paitici Ș, Petrescu GS, Munteanu AC, Matei RA, Dumitrache D, Donoiu A, Mogoantă SȘ. Aggressive Male Breast Cancer-Clinical and Therapeutic Aspects Correlated with the Histopathological Examination: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2167. [PMID: 38138270 PMCID: PMC10744383 DOI: 10.3390/medicina59122167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Breast cancer is often seen as a disease that occurs in women, but it can also appear in men in a very small percentage, below 1%. Men have a minimal amount of breast tissue compared to women, which has the potential to become malignant in a similar way to women, although much less frequently. A patient presented with advanced local invasion due to the low amount of breast tissue, with the tumor quickly invading the adjacent structures. Histopathological and immunohistochemical examinations have an extremely important role in the pathology of breast cancer. Given that male breast cancer is rare and there are not enough surgeons specializing in breast surgery in our country, there is a lack of experience in the management and early diagnosis of this type of cancer, which will be highlighted in this article.
Collapse
Affiliation(s)
- Ana-Maria Petrescu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.-M.P.); (R.-A.M.)
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
| | - Nicolae-Daniel Pirici
- Department of Research Methodology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Anca-Ileana Ruxanda
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Liviu Vasile
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mircea Pîrșcoveanu
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ștefan Paitici
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Gabriel-Sebastian Petrescu
- Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Alexandru Claudiu Munteanu
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ramona-Andreea Matei
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.-M.P.); (R.-A.M.)
| | - Daniel Dumitrache
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
| | - Andreas Donoiu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.-M.P.); (R.-A.M.)
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
| | - Stelian-Ștefăniță Mogoantă
- 3rd General Surgery Clinic, Emergency County Hospital, 200642 Craiova, Romania; (A.-I.R.); (L.V.); (M.P.); (A.C.M.); (D.D.); (S.-Ș.M.)
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| |
Collapse
|
2
|
Accomasso F, Actis S, Minella C, Rosso R, Granaglia C, Ponzone R, Biglia N, Bounous VE. Clinical, Pathological, and Prognostic Features of Male Breast Cancer: A Multicenter Study. Curr Oncol 2023; 30:9860-9871. [PMID: 37999136 PMCID: PMC10670254 DOI: 10.3390/curroncol30110716] [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: 08/22/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Male breast cancer (BC) represents less than 1% of male tumors. Little is known about male BC characteristics, management, and survival, with many studies based on a small number of cases. Consequently, the treatment of male BC lacks specific guidelines. The aims of the study are to compare male and female breast cancer (FBC) in terms of cancer clinical and anatomopathological features and treatment approach, and to identify differences between male BC and FBC in terms of survival. Patients and methods: Data from 2006 to 2018 were retrospectively acquired. Amounts of 49 males and 680 postmenopausal females with primary non-metastatic BC who underwent breast surgery at Mauriziano Hospital or IRCCS Candiolo (TO-Italy) were included. The mean age at diagnosis for male BC was 68.6 years, and males presented a smaller tumor size than women (p < 0.05) at diagnosis. Most male BC patients received adjuvant endocrine therapy (AET) with tamoxifen (73.5%). AET drop-out rate due to side effects was 16.3% for males compared to 7.6% for women (p = 0.04). Comparing FBC and male BC, no differences have been identified in terms of DFS and OS, with a similar 10-year-relapse rate (12% male BC vs. 12.4% FBC). Propensity Score Matching by age, nodal status, pT, and molecular subtype had been performed and no differences in OS and DFS were seen between male BC and FBC. In conclusion, male BC and FBC have similar prognostic factors and survival outcomes. The drop-out rate of AET was higher in males, and side effects were the main reason for drug discontinuation.
Collapse
Affiliation(s)
- Francesca Accomasso
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (F.A.); (S.A.); (C.M.); (R.R.); (V.E.B.)
| | - Silvia Actis
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (F.A.); (S.A.); (C.M.); (R.R.); (V.E.B.)
| | - Carola Minella
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (F.A.); (S.A.); (C.M.); (R.R.); (V.E.B.)
| | - Roberta Rosso
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (F.A.); (S.A.); (C.M.); (R.R.); (V.E.B.)
| | - Claudia Granaglia
- Department of Surgical Sciences, University of Turin, 10124 Torino, Italy
| | | | - Nicoletta Biglia
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (F.A.); (S.A.); (C.M.); (R.R.); (V.E.B.)
| | - Valentina Elisabetta Bounous
- Gynecology and Obstetrics Unit, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, 10128 Turin, Italy; (F.A.); (S.A.); (C.M.); (R.R.); (V.E.B.)
| |
Collapse
|
3
|
Singh R, Cao L, Sarode AL, Kharouta M, Shenk R, Miller ME. Trends in surgery and survival for T1-T2 male breast cancer: A study from the National Cancer Database. Am J Surg 2023; 225:75-83. [PMID: 36208958 DOI: 10.1016/j.amjsurg.2022.09.043] [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: 04/17/2022] [Revised: 08/14/2022] [Accepted: 09/20/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Despite evidence that early-stage male breast cancer (MBC) can be treated the same as in females, we hypothesized that men undergo more extensive surgery. METHODS Patients with clinical T1-2 breast cancer were identified in the National Cancer Database 2004-2016. Trends in surgery type and overall survival were compared between sexes. RESULTS Of 9,782 males and 1,078,105 females, most were cN0 with AJCC stage I/II disease. Unilateral mastectomy was most common in men (67.1% vs. 24.1%, p < 0.001) and partial mastectomy in women (64.7% vs. 26.4%, p < 0.001), with no significant change over time. Over 1/3 of men received ALND in 2016. While overall survival was superior in females (HR 0.83, 95% CI 0.73-0.94, p = 0.003), partial mastectomy was associated with a 42% reduction in mortality risk for males (HR 0.58, 95% CI 0.4-0.8, p = 0.003). CONCLUSIONS De-escalation of surgery could be considered for MBC to improve survival and align with current standards of care.
Collapse
Affiliation(s)
- Rashi Singh
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Research in Surgical Outcomes and Effectiveness (UH-RISES), USA
| | - Lifen Cao
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Research in Surgical Outcomes and Effectiveness (UH-RISES), USA
| | - Anuja L Sarode
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Research in Surgical Outcomes and Effectiveness (UH-RISES), USA
| | - Michael Kharouta
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Robert Shenk
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Research in Surgical Outcomes and Effectiveness (UH-RISES), USA
| | - Megan E Miller
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Research in Surgical Outcomes and Effectiveness (UH-RISES), USA.
| |
Collapse
|
4
|
The role of postoperative radiation therapy in stage I–III male breast cancer: A population-based study from the surveillance, epidemiology, and End Results database. Breast 2022; 65:41-48. [PMID: 35810531 PMCID: PMC9272391 DOI: 10.1016/j.breast.2022.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background This study aimed to investigate the role of postoperative radiation therapy in a large population-based cohort of patients with stage I–III male breast cancer (MaBC). Methods Patients with stage I–III breast cancer treated with surgery were selected from the Surveillance, Epidemiology, and End Results cancer database from 2010 to 2015. Multivariate logistic regression identified the predictors of radiation therapy administration. Multivariate Cox regression model was used to evaluate the predictors of survival. Results We identified 1321 patients. Age, stage, positive regional nodes, surgical procedure, and HER2 status were strong predictors of radiation therapy administration. There was no difference between patients who received radiation therapy and those who did not (P = 0.46); however, after propensity score matching, it was associated with improved OS (P = 0.04). In the multivariate analysis of the unmatched cohort, the factors associated with better OS were administration of radiation therapy and chemotherapy. In the subset analysis of the unmatched cohort, postoperative radiation therapy was associated with improved OS in men undergoing breast-conserving surgery (BCS), with four or more node-positive or larger primary tumours (T3/T4). Furthermore, we found no benefit of radiation therapy, regardless of the type of axillary surgery in mastectomy (MS). In older MaBC patients with T1-2N1 who underwent MS, radiation therapy showed no significant effects, regardless of chemotherapy. Conclusion Postoperative radiation therapy could improve the survival of MaBC patients undergoing BCS, with four or more node-positive or larger primary tumours. Moreover, it should be carefully considered in patients undergoing MS and older T1-2N1 patients. Postoperative radiation therapy may improve survival of some male breast cancer patients. Patients undergoing breast-conserving surgery or with large tumours may benefit. Radiation therapy had no benefits in mastectomy regardless of axillary surgery type. Radiation therapy was not effective in older T1-2N1 patients with receiving mastectomy.
Collapse
|
5
|
Silva FHDS, Underwood A, Almeida CP, Ribeiro TS, Souza-Fagundes EM, Martins AS, Eliezeck M, Guatimosim S, Andrade LO, Rezende L, Gomes HW, Oliveira CA, Rodrigues RC, Borges IT, Cassali GD, Ferreira E, Del Puerto HL. Transcription factor SOX3 upregulated pro-apoptotic genes expression in human breast cancer. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2022; 39:212. [PMID: 36175695 DOI: 10.1007/s12032-022-01758-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sex-determining region Y-box 3 (SOX3) protein, a SOX transcriptions factors group, has been identified as a key regulator in several diseases, including cancer. Downregulation of transcriptions factors in invasive ductal carcinoma (IDC) can interfere in neoplasia development, increasing its aggressiveness. We investigated SOX3 protein expression and its correlation with apoptosis in the MDA-MB-231 cell line, as SOX3 and Pro-Caspase-3 immunoexpression in paraffin-embedded invasive ductal carcinoma tissue samples from patients (n = 27). Breast cancer cell line MDA-MD-231 transfected with pEF1-SOX3 + and pEF1-Empty vector followed by cytotoxicity assay (MTT), Annexin-V FITC PI for apoptosis percentage assessment by flow cytometry, qPCR for apoptotic-related gene expression, immunofluorescence, and immunohistochemistry to SOX3 immunolocalization in culture cells, and paraffin-embedded invasive ductal carcinoma tissue samples. RESULTS Apoptotic rate was higher in cells transfected with pEF1-SOX3 + (56%) than controls (10%). MDA-MB-231 transfected with pEF1-SOX3 + presented upregulation of pro-apoptotic mRNA from CASP3, CASP8, CASP9, and BAX genes, contrasting with downregulation antiapoptotic mRNA from BCL2, compared to non-transfected cells and cells transfected with pEF1-empty vector (p < 0.005). SOX3 protein nuclear expression was detected in 14% (4/27 cases) of ductal carcinoma cases, and pro-Caspase-3 expression was positive in 50% of the cases. CONCLUSION Data suggest that SOX3 transcription factor upregulates apoptosis in breast cancer cell line MDA-MB-231, and has a down nuclear expression in ductal carcinoma cases, and need to be investigated as a tumor suppressor protein, and its loss of expression and non-nuclear action turn the cells resistant to apoptosis. Further studies are necessary to understand how SOX3 protein regulates the promoter regions of genes involved in apoptosis.
Collapse
Affiliation(s)
- Felipe Henrique de Souza Silva
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627 - Campus UFMG, Belo Horizonte, MG, 31270-901, Brazil
| | - Adam Underwood
- Division of Mathematics and Sciences, Walsh University, North Canton, OH, USA
| | - Camila Pereira Almeida
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627 - Campus UFMG, Belo Horizonte, MG, 31270-901, Brazil
| | - Thais Salviana Ribeiro
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627 - Campus UFMG, Belo Horizonte, MG, 31270-901, Brazil
| | - Elaine M Souza-Fagundes
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Almir S Martins
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Marcos Eliezeck
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Silvia Guatimosim
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Luciana O Andrade
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Luisa Rezende
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Hipacia Werneck Gomes
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Cleida Aparecida Oliveira
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | | | - Isabella Terra Borges
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627 - Campus UFMG, Belo Horizonte, MG, 31270-901, Brazil
| | - Geovanni Dantas Cassali
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627 - Campus UFMG, Belo Horizonte, MG, 31270-901, Brazil
| | - Enio Ferreira
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627 - Campus UFMG, Belo Horizonte, MG, 31270-901, Brazil
| | - Helen Lima Del Puerto
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627 - Campus UFMG, Belo Horizonte, MG, 31270-901, Brazil.
| |
Collapse
|
6
|
Mátrai Z, Kelemen P, Kósa C, Maráz R, Paszt A, Pavlovics G, Sávolt Á, Simonka Z, Tóth D, Kásler M, Kaprin A, Krivorotko P, Vicko F, Pluta P, Kolacinska-Wow A, Murawa D, Jankau J, Ciesla S, Dyttert D, Sabol M, Zhygulin A, Avetisyan A, Bessonov A, Lázár G. Modern Breast Cancer Surgery 1st Central-Eastern European Professional Consensus Statement on Breast Cancer. Pathol Oncol Res 2022; 28:1610377. [PMID: 35783360 PMCID: PMC9240205 DOI: 10.3389/pore.2022.1610377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/29/2022] [Indexed: 12/16/2022]
Abstract
This text is based on the recommendations accepted by the 4th Hungarian Consensus Conference on Breast Cancer, modified on the basis of the international consultation and conference within the frames of the Central-Eastern European Academy of Oncology. The recommendations cover non-operative, intraoperative and postoperative diagnostics, determination of prognostic and predictive markers and the content of cytology and histology reports. Furthermore, they address some specific issues such as the current status of multigene molecular markers, the role of pathologists in clinical trials and prerequisites for their involvement, and some remarks about the future.
Collapse
Affiliation(s)
- Zoltán Mátrai
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Péter Kelemen
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Csaba Kósa
- Department of Surgery, University of Debrecen, Debrecen, Hungary
| | - Róbert Maráz
- Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
| | - Attila Paszt
- Department of Surgery, Faculty of Medicine, SZTE ÁOK, University of Szeged, Szeged, Hungary
| | | | - Ákos Sávolt
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Zsolt Simonka
- Department of Surgery, Faculty of Medicine, SZTE ÁOK, University of Szeged, Szeged, Hungary
| | - Dezső Tóth
- Department of Surgery, University of Debrecen, Debrecen, Hungary
| | - Miklós Kásler
- Minister of Human Capacities, Government of Hungary, Budapest, Hungary
| | - Andrey Kaprin
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Russian Academy of Sciences, Moscow, Russia
| | - Petr Krivorotko
- N.N.Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Ferenc Vicko
- Medical Faculty Novi Sad, Oncology Institute of Vojvodina Sremska Kamenica, University of Novi Sad, Novi Sad, Serbia
| | - Piotr Pluta
- Department of Surgical Oncology and Breast Diseases, Polish Mother’s Memorial Hospital–Research Institute in Lodz, Lodz, Poland
| | - Agnieszka Kolacinska-Wow
- Department of Head and Neck Cancer Surgery, Medical University of Lodz, Lodz, Poland
- Department of Surgical Oncology, Cancer Center, Medical University of Lodz, Lodz, Poland
| | - Dawid Murawa
- Clinic of Surgical Oncology, Poznan University of Medical Sciences, Poznan, Poland
- General and Oncological Surgery Clinic, Karol Marcinkowski University Hospital, Zielona Gora, Poland
| | - Jerzy Jankau
- Plastic Surgery Department, Medical University of Gdańsk/University Hospitals, Gdansk, Poland
| | - Slawomir Ciesla
- General and Oncological Surgery Clinic, Karol Marcinkowski University Hospital, Zielona Gora, Poland
| | - Daniel Dyttert
- Department of Surgical Oncology, St. Elisabeth Cancer Institute, Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Martin Sabol
- Department of Surgical Oncology, St. Elisabeth Cancer Institute, Medical Faculty, Comenius University, Bratislava, Slovakia
| | | | | | - Alexander Bessonov
- Breast Cancer Department of the LOKOD, N.N.Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - György Lázár
- Department of Surgery, Faculty of Medicine, SZTE ÁOK, University of Szeged, Szeged, Hungary
| |
Collapse
|
7
|
Grebić D, Pavić K, Kustić D, Čargonja P, Pirjavec A. The incidence and characteristics of male breast cancer. Chirurgia (Bucur) 2020. [DOI: 10.23736/s0394-9508.19.05051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
8
|
Liu J, Suresh A, Palettas M, Stephens J, Ganju A, Morgan E, Kassem M, Hou Y, Parwani A, Noonan A, Reinbolt R, VanDeusen J, Sardesai S, Williams N, Cherian M, Tozbikian G, Stover DG, Lustberg M, Li Z, Ramaswamy B, Wesolowski R. Features, Outcomes, and Management Strategies of Male Breast Cancer: A Single Institution Comparison to Well-Matched Female Controls. Eur J Breast Health 2020; 16:201-207. [PMID: 32656521 DOI: 10.5152/ejbh.2020.5536] [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: 02/24/2020] [Accepted: 04/19/2020] [Indexed: 01/21/2023]
Abstract
Objective The primary objective of this study was to delineate differences in management, overall and distant disease-free survival in males diagnosed with breast cancer and treated at The Ohio State University Comprehensive Cancer Center as compared to comprehensively matched female subjects. Secondary objectives included assessment of clinical and histopathologic features and recurrence score, as measured by Oncotype DX and the modified Magee equation #2. Materials and Methods This single institution retrospective study compared male and comprehensively matched female patients (1:2) with stage I-III breast cancer between 1994 and 2014. Recurrence risk was estimated using a modified Magee equation. Overall survival and distant disease-free survival were estimated and compared using Kaplan-Meier and Log-rank methods. Results Forty-five male breast cancer patients were included (stage I: 26.7%; stage II: 53.3%; stage III: 20.0%; hormone receptor positive: 97.8%; human epidermal growth factor receptor 2 negative: 84.4%) with a median age of 63.8 (43.0-79.4) years at diagnosis. Intermediate and low recurrence scores were most common in male and female patients respectively; mean score was similar between groups (20.3 vs. 19.8). The proportion of male breast cancer patients treated with adjuvant chemotherapy and post-mastectomy radiation was lower compared to female patients (42.2% vs. 65.3%, p=0.013; 22.7% vs. 44.4%, p=0.030, respectively). Overall survival and distant disease-free survival between male and female patients were similar. Conclusion Male breast cancer patient outcomes were similar compared to well-matched female patients suggesting that breast cancer specific factors are more prognostic than gender.
Collapse
Affiliation(s)
- Joseph Liu
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Anupama Suresh
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Marilly Palettas
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA
| | - Julie Stephens
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA
| | - Akaansha Ganju
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Evan Morgan
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Mahmoud Kassem
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Yanjun Hou
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Anil Parwani
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Anne Noonan
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Raquel Reinbolt
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Jeffrey VanDeusen
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Sagar Sardesai
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Nicole Williams
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Mathew Cherian
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Gary Tozbikian
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Daniel G Stover
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Maryam Lustberg
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Zaibo Li
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Bhuvaneswari Ramaswamy
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| | - Robert Wesolowski
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA.,Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
| |
Collapse
|
9
|
Male breast cancer: a closer look at patient and tumor characteristics and factors that affect survival using the National Cancer Database. Breast Cancer Res Treat 2020; 180:471-479. [PMID: 32040687 DOI: 10.1007/s10549-020-05556-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/31/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To comprehensively describe the tumor and clinical characteristics of breast cancer in a cohort of male patients and to assess the factors that affect survival. BACKGROUND Much of the standard care of male breast cancer is based on the diagnosis and treatment strategies of female breast cancer. However, important clinical differences between the two have been elucidated, which suggests the need for unique attention to male breast cancer. METHODS We evaluated the records of male patients who were diagnosed with breast cancer between 2004 and 2015 using the National Cancer Database (NCDB). Data obtained were demographic characteristics, clinical and tumor data, type of therapy, as well as survival data. We used descriptive statistics to characterize our study population. We then performed a survival and Cox proportional hazards analysis. RESULTS We identified 16,498 patients (median age: 63 years). Several treatment modalities were used, of which surgery was the most common (14,882 [90.4%]). The total follow-up time was 13 years (156 months). Five-year survival was 77.7% (95% CI 76.9-78.4) and 10-year survival was 60.7%. In a Cox proportional hazards model, mastectomy was associated with the greatest survival (hazard ratio [HR] 0.49; p < 0.001). CONCLUSION We report what is to our knowledge the largest national population-based cohort of male breast cancer patients. Importantly, our data suggests that similar to female patients, several treatment modalities are significantly associated with improved survival in male patients, particularly surgery. Increasing age, black race, government insurance, more comorbidities, and higher tumor stages are associated with decreased survival.
Collapse
|
10
|
Gan Q, Joseph CT, Guo M, Zhang M, Sun X, Gong Y. Utility of NKX3.1 Immunostaining in the Detection of Metastatic Prostatic Carcinoma on Fine-Needle Aspiration Smears. Am J Clin Pathol 2019; 152:495-501. [PMID: 31175351 DOI: 10.1093/ajcp/aqz063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES NK3 homeobox 1 (NKX3.1) has been increasingly used to diagnose metastatic prostatic carcinoma in histologic samples. However, its utility and reliability in cytologic direct smears have not been studied. METHODS A total of 59 fine-needle aspiration (FNA) cases with a definitive diagnosis of metastatic carcinoma from the prostate were included. The cases were grouped based on different Gleason score in their corresponding primary tumors and morphologic variants. For each case, tumor cells were immunostained with NKX3.1, prostate-specific antigen (PSA), and prostatic acid phosphatase (PAP) on cell-transferred smears. RESULTS NKX3.1 was strongly and diffusely positive in all 40 metastatic prostatic adenocarcinomas, including those with ductal features, but negative for the 19 small cell carcinoma (SmCC) cases. NKX3.1 had a better detection rate than PSA (13/50, 26%) and PAP (0/47, 0%). CONCLUSIONS NKX3.1 immunostaining on FNA smears is highly reliable for detecting metastatic prostatic carcinomas of conventional and ductal types but not for SmCC.
Collapse
Affiliation(s)
- Qiong Gan
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Cicily T Joseph
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Ming Guo
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Miao Zhang
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Xiaoping Sun
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Yun Gong
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston
| |
Collapse
|
11
|
Aldossary MY, Alquraish F, Alazhri J. A Case of Locally Advanced Breast Cancer in a 59-Year-Old Man Requiring a Modified Approach to Management. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:531-536. [PMID: 30992422 PMCID: PMC6485044 DOI: 10.12659/ajcr.915377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Patient: Male, 59 Final Diagnosis: Invasive ductal carcinoma Symptoms: Foul-smelling discharge • painful breast mass Medication: — Clinical Procedure: Modified radical mastectomy Specialty: Surgery
Collapse
Affiliation(s)
- Mohammed Yousef Aldossary
- Department of General Surgery, Surgical Oncology Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Fatimah Alquraish
- Department of General Surgery, King Abdulaziz Air Base Hospital, Dhahran, Saudi Arabia
| | - Jamila Alazhri
- Department of General Surgery, Surgical Oncology Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| |
Collapse
|
12
|
Wang X, Fan L, Yan W, Zhang Q, Bao S, Wang Y, Bao X, Liu L. Axillary lymph node metastasis as the first manifestation of male occult breast cancer: A Case Report. Medicine (Baltimore) 2018; 97:e13706. [PMID: 30558087 PMCID: PMC6320098 DOI: 10.1097/md.0000000000013706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONAL Occult breast cancer (OBC) is an extremely rare breast cancer and is defined by the presence of axillary metastasis without a primary tumor in the breasts or any abnormality on radiologic examination. PATIENT CONCERNS This case report presents a 49-year-old man who was diagnosed with male OBC, which first manifested as an axillary lymph node metastasis followed by the emergence of infraclavicular lymph node metastasis. Neither the breast nor other organs had any abnormality. DIAGNOSIS The pathological examination revealed metastatic adenocarcinoma. Immunohistochemical (IHC) staining results were positive for estrogen receptor (ER), progesterone receptor (PR), and gross cystic disease fluid protein-15 (GCDFP-15); and negative for human epidermal receptor-2 (Her-2) 1+, cytokeratin (CK) 7, CK20, and thyroid transcription factor-1 (TTF-1). INTERVENTIONS The patient underwent left axillary lymph node dissection but not a mastectomy. After the operation, the patient subsequently underwent chemotherapy, radiotherapy, and endocrinotherapy. OUTCOMES Currently, he has been followed-up for >4 years without any signs of recurrence. LESSONS Careful physical and imaging examinations combined with pathological analysis are essential in the diagnosis of male OBC. Early surgery remains the primary treatment.
Collapse
|
13
|
Wang W, Xu X, Tian B, Wang Y, Du L, Sun T, Shi Y, Zhao X, Jia Y, Xi Y, Jing J. Clinical features of patients with male breast cancer in Shanxi province of China from 2007 to 2016. J Investig Med 2018; 67:699-705. [PMID: 30368484 DOI: 10.1136/jim-2018-000823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2018] [Indexed: 01/11/2023]
Abstract
This study aims to understand the clinical features, treatment, and prognosis of patients with male breast cancer (MBC) in Shanxi province of China from 2007 to 2016. Data for 77 patients with MBC were collected for analysis. Immunohistochemistry, pathological results, and other data such as demographic characteristics (age, marital status, smoking history, drinking history, and family history of cancer) as well as clinical data were investigated by retrieving information from the patients' medical records. A total of 12,404 patients were diagnosed with breast cancer between 2007 and 2016, and 77 were patients with MBC among them. The median diagnosis age of patients with MBC was 62 years (range, 24-84 years). The most common complaint was a painless lump in the breast, accounting for 68.8% of the patients, and the main pathological type in MBC was infiltrating ductal carcinoma (66.2%). In terms of hormone receptors, 80.5% (62/77) of patients with MBC were estrogen receptor positive, 75.3% (58/77) of patients were progesterone receptor positive, and only 6.5% (5/77) of patients were HER2 overexpressing. The multivariant Cox proportional hazards regression analysis showed that M stage is an independent prognostic factor (p=0.018, HR=18.791, 95% CI 1.663 to 212.6). The epidemiological and clinical features of Chinese MBC are similar to that of other countries. As the Chinese public have limited knowledge of MBC, it is necessary to increase awareness among them about it. Further research with a large sample size is required for better understanding of the risks associated with MBC.
Collapse
Affiliation(s)
- Weigang Wang
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Xiaoqin Xu
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Baoguo Tian
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Yan Wang
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Lili Du
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Ting Sun
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Yanchun Shi
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Xianwen Zhao
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Yali Jia
- Department of Preventive Health Care, Shanxi Cancer Hospital, Shanxi, China
| | - Yanfeng Xi
- Department of Pathology, Shanxi Cancer Hospital, Shanxi, China
| | - Jiexian Jing
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| |
Collapse
|
14
|
Özkurt E, Tükenmez M, Yılmaz R, Cabioğlu N, Müslümanoğlu M, Dinççağ AS, İğci A, Özmen V. Favorable Long-Term Outcome in Male Breast Cancer. Eur J Breast Health 2018; 14:180-185. [PMID: 30123885 DOI: 10.5152/ejbh.2018.3946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 03/03/2018] [Indexed: 11/22/2022]
Abstract
Objective Male breast cancer (MBC) is a rare type of cancer in the breast cancer series and in the male population. Data is usually extrapolated from female breast cancer (FBC) studies. We aim to study the clinicopathological characteristics and outcome of MBC patients at our institution and we aim to emphasize the differences compared with FBC. Materials and Methods Between January 1993 and April 2016, 56 male patients who were diagnosed as breast cancer and underwent surgical operation were retrospectively analyzed. Patients were evaluated for demographical characteristics, surgery type, clinicopathological characteristics, adjuvant and neoadjuvant treatments, follow-up time, overall survival (OS), disease free survival (DFS), and disease specific survival (DSS). Results The ratio of MBC among all breast cancers at our institution is 1%. The median age was 64 (34-85). Surgical procedures were modified radical mastectomy (MRM) in 41 patients (77%), simple mastectomy in 11 patients (21%), and lumpectomy in 1 patient (2%). Two patients were Stage 0 (4%), 7 were Stage 1 (13%), 12 were Stage 2 (22.6%), and 32 were Stage 3 (60.4%). Molecular subtypes of the invasive tumors were luminal A in 40 (80%), luminal B in 6 (12%), HER-2 type in 1 (2%), and basal-like in 3 (6%). Median follow-up time was 77 (3-287) months. 5-year and 10-year OS, DFS, and DSS rates were 80.7%, 96%, 95.6% and 71.6%, 81.9%, 91.7% respectively. Conclusion MBC presents different clinicopathological and prognostic factors when compared to FBC. Our survival rates are higher than the average presented in available literature. Because of the high rate of hormone receptor positivity, hormonal therapy is the mainstay for the treatment of estrogen receptor (ER)+ male breast cancer.
Collapse
Affiliation(s)
- Enver Özkurt
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey.,Department of Breast Surgical Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, USA
| | - Mustafa Tükenmez
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Ravza Yılmaz
- Department of Radiology, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Ahmet Said Dinççağ
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Abdullah İğci
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| |
Collapse
|
15
|
Weir J, Zhao YD, Herman T, Algan Ö. Clinicopathologic Features and Radiation Therapy Utilization in Patients with Male Breast Cancer: A National Cancer Database Study. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2018; 12:1178223418770687. [PMID: 29881286 PMCID: PMC5987905 DOI: 10.1177/1178223418770687] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/09/2018] [Indexed: 01/30/2023]
Abstract
Male breast cancer (MBC) accounts for approximately 1% of all breast cancers,
limiting the data characterizing clinicopathologic features and treatment
outcomes in patients with MBC. This paucity of data has led to most of our
treatment guidance being extrapolated from patients with female breast cancer
(FBC). From 1998 to 2012, data were captured using the National Cancer Database
to identify patients with nonmetastatic MBC (n = 23 305) and FBC (n = 2 678
061). Tumor and clinicopathologic features were obtained and compared. Patients
with MBC were more likely to have invasive disease, T2-4 tumors, centrally
located tumors, positive lymph nodes, estrogen receptor–positive or progesterone
receptor–positive tumors, lymphovascular space invasion, and were less likely to
have Her2/neu-positive or triple-negative tumors. All of these differences were
statistically significant (P < .001). Treatment comparisons
showed that patients with MBC were more likely to undergo mastectomy and less
likely to undergo breast-conserving surgery with postoperative radiation
utilization found to be less in patients with MBC, both as part of
breast-conserving therapy (BCT) and for postmastectomy radiation treatment
(PMRT) (P < .001). Stage-by-stage comparisons showed that
median survival, 5-year, and 10-year overall survival (OS) rates are lower in
patients with MBC vs patients with FBC (P < .001). The
utilization of adjuvant radiation, both BCT and PMRT, was shown to improve 5-
and 10-year OS (P < .001). Male breast cancer
clinicopathologic features appear to be unfavorable in relation to FBC and
adjuvant radiation is shown beneficial in survival outcomes. Further
investigation is needed to help guide future utilization and treatment with
radiation, systemic, and endocrine manipulation in this small population of
patients with MBC.
Collapse
Affiliation(s)
- Joshua Weir
- Department of Radiation Oncology, Peggy and Charles Stephenson Oklahoma Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan Daniel Zhao
- Department of Biostatistics and Epidemiology, Peggy and Charles Stephenson Oklahoma Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Terence Herman
- Department of Radiation Oncology, Peggy and Charles Stephenson Oklahoma Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Özer Algan
- Department of Radiation Oncology, Peggy and Charles Stephenson Oklahoma Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
16
|
Wan BA, Ganesh V, Zhang L, Sousa P, Drost L, Lorentz J, Vesprini D, Lee J, Rakovitch E, Lu FI, Eisen A, Yee C, Lam H, Chow E. Treatment Outcomes in Male Breast Cancer: A Retrospective Analysis of 161 Patients. Clin Oncol (R Coll Radiol) 2018; 30:354-365. [PMID: 29496323 DOI: 10.1016/j.clon.2018.02.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/28/2017] [Accepted: 01/11/2018] [Indexed: 12/31/2022]
Abstract
AIMS Male breast cancer is a rare disease with limited evidence-based guidelines for treatment. This study aimed to identify demographic, pathological and clinical factors associated with its prognosis. MATERIALS AND METHODS A retrospective review of 161 male breast cancer patients diagnosed at a single institution from 1987 to June 2017 was conducted. Patient demographics, disease characteristics, treatment and outcome were extracted and included in competing-risk analysis and the univariate Cox proportional hazard model for univariate analysis. Factors with P < 0.10 were included in multivariable analysis. RESULTS The mean age at diagnosis was 67 years (standard deviation = 11.2) and the median follow-up duration was 5.3 years (range 0-25 years). There were 48 deaths, including 23 cancer-specific deaths. The actuarial median survival was 19.9 years. In multivariable analysis, factors associated with overall survival were size of tumours (hazard ratio 2.0; 95% confidence interval 1.4-2.7, P < 0.0001) and diagnosis of metastatic disease (hazard ratio 8.7; 95% confidence interval 1.9-40.6; P = 0.006). Of 138 patients without metastases at diagnoses, 11 had local-regional recurrence and 26 had distant metastases. In the multivariable model for local-regional recurrence, a more recent year of diagnosis was associated with reduced risk (hazard ratio 0.9, 95% confidence interval 0.8-1.0, P = 0.008), whereas more positive lymph nodes was associated with higher risk (hazard ratio 2.2, 95% confidence interval 1.2-4.0, P = 0.01). A higher risk of metastases was associated with more positive lymph nodes (hazard ratio 1.9; 95% confidence interval 1.1-3.3; P = 0.03) and tumour size (hazard ratio 1.8; 95% confidence interval 1.1-2.9; P = 0.01). A higher risk of any recurrence or metastases was associated with the number of positive nodes (hazard ratio 1.9; 95% confidence interval 1.2-3.0; P = 0.005) and tumour size (hazard ratio 1.6; 95% confidence interval 1.1-2.2; P = 0.01). CONCLUSION In general, tumour size and more positive lymph nodes were associated with worse prognosis. Larger powered studies are needed to identify prognostic factors with smaller effect sizes.
Collapse
Affiliation(s)
- B A Wan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - V Ganesh
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Zhang
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - P Sousa
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Drost
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Lorentz
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - D Vesprini
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Lee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - E Rakovitch
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - F-I Lu
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - A Eisen
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - C Yee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - H Lam
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - E Chow
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
17
|
Xu R, Li J, Zhang Y, Jing H, Zhu Y. Male occult breast cancer with axillary lymph node metastasis as the first manifestation: A case report and literature review. Medicine (Baltimore) 2017; 96:e9312. [PMID: 29390502 PMCID: PMC5758204 DOI: 10.1097/md.0000000000009312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
RATIONALE Occult breast cancer (OBC) is extremely rare in males with neither symptoms in the breast nor abnormalities upon imaging examination. PATIENT CONCERNS This current case report presents a young male patient who was diagnosed with male OBC first manifesting as axillary lymph node metastasis. The physical and imaging examination showed no primary lesions in either breasts or in other organs. DIAGNOSES The pathological results revealed infiltrating ductal carcinoma in the axillary lymph nodes. Immunohistochemical (IHC) staining was negative for estrogen receptor (ER), progesterone receptor (PR), cytokeratin (CK)20 and thyroid transcription factor-1 (TTF-1), positive for CK7, gross cystic disease fluid protein-15 (GCDFP-15), epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), and suspicious positive for human epidermal receptor-2 (Her-2). On basis of IHC markers, particularly such as CK7, CK20 and GCDFP-15, and eliminating other malignancies, male OBC was identified in spite of negativity for hormone receptors. INTERVENTIONS The patient underwent left axillary lymph node dissection (ALND) but not mastectomy. After the surgery, the patient subsequently underwent chemotherapy and radiotherapy. OUTCOMES The patient is currently being followed up without any signs of recurrence. LESSONS Carefully imaging examination and pathological analysis were particularly essential in the diagnosis of male OBC. The guidelines for managing male OBC default to those of female OBC and male breast cancer.
Collapse
MESH Headings
- Adult
- Axilla/diagnostic imaging
- Axilla/pathology
- Breast Neoplasms, Male/diagnostic imaging
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/therapy
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Humans
- Lymph Node Excision
- Lymphatic Metastasis
- Male
- Neoplasms, Unknown Primary/diagnostic imaging
- Neoplasms, Unknown Primary/pathology
- Neoplasms, Unknown Primary/therapy
Collapse
Affiliation(s)
- Ruixin Xu
- Medicine and Life Sciences College of Shandong Academy of Medical Sciences, University of Jinan
- Department of Radiation Oncology
| | | | | | - Hongbiao Jing
- Department of Pathology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Youzhe Zhu
- Medicine and Life Sciences College of Shandong Academy of Medical Sciences, University of Jinan
- Department of Radiation Oncology
| |
Collapse
|
18
|
Abstract
Endocrine therapy (ET) of hormone receptor (HR)-positive and human epidermal growth factor receptor 2-(HER2)-negative metastatic breast cancer (MBC) historically focused on estrogen deprivation and antagonism. The identification of several intracellular pathways promoting resistance to antiestrogen therapy led to the introduction of novel endocrine drug combinations that reformed treatment schema and expanded therapeutic options. There is no doubt that efforts to overcome or delay resistance to ET are fruiting, particularly with the introduction of cyclin-dependent kinase 4/6 inhibitors such as palbociclib and ribociclib, and mechanistic target of rapamycin inhibitors such as everolimus. Although still considered incurable by currently available treatment modalities, many patients with MBC nowadays enjoy several years of good quality life coupled with decent tumor control. The diversity of therapies and unusual pattern of side effects can be quite perplexing to the treating physician. The sequence of variable agents and management of side effects, in addition to the timing of initiation of cytotoxic chemotherapy, is among the challenges faced by oncologists. In this review, we shed a spotlight on mechanisms of resistance to ET, and provide a review of landmark studies that have recently reshaped the landscape of treatment options for patients with metastatic HR-positive, HER2-negative MBC. A suggested treatment strategy for newly diagnosed patients is also discussed herein.
Collapse
Affiliation(s)
- Mohamad Adham Salkeni
- Department of Medicine, West Virginia University Cancer Institute, Morgantown, WV 26506, USA
| | - Samantha June Hall
- Department of Medicine, West Virginia University Cancer Institute, Morgantown, WV 26506, USA
| |
Collapse
|
19
|
Emile G. Cancer du sein chez l’homme : ce qui différencie les hommes des femmes. PSYCHO-ONCOLOGIE 2017. [DOI: 10.1007/s11839-017-0636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
20
|
Martinez Vila C, Fernández-Morales LA, Oliveres H, Marín M, Ribera P, Pardo JC, Dalmau E, Segui MA. Fulvestrant plus LHRH analogues in male with synchronous breast and prostate cancer. Ann Oncol 2017; 28:2027-2028. [PMID: 28444131 DOI: 10.1093/annonc/mdx198] [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
Affiliation(s)
- C Martinez Vila
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | | | - H Oliveres
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - M Marín
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - P Ribera
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - J C Pardo
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - E Dalmau
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - M A Segui
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| |
Collapse
|
21
|
Zhao M, Jing Q, Wang Y, Luo F. Male Occult Breast Cancer First Manifesting as a Supraclavicular Lymph Node Metastasis: A Case Report. INT J GERONTOL 2017. [DOI: 10.1016/j.ijge.2016.09.004] [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
|
22
|
Metastatic Breast Carcinoma to the Superior Oblique in a Male. Ophthalmol Ther 2017; 6:355-359. [PMID: 28550385 PMCID: PMC5693831 DOI: 10.1007/s40123-017-0093-7] [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: 05/01/2017] [Indexed: 11/03/2022] Open
Abstract
We describe a case of breast cancer metastatic to the superior oblique, in a male. The patient was a 66-year-old Caucasian male with a history of stage IIIB rectal adenocarcinoma and stage IIA left breast carcinoma diagnosed 12 years and 5 years prior, respectively, who presented with headaches and intermittent diplopia. He underwent left total mastectomy with sentinel lymph node biopsy 6 years prior, which showed ER/PR+, HER2/neu-, moderately-differentiated, infiltrating ductal carcinoma with 3/14 positive nodes. He completed adjuvant doxorubicin/cyclophosphamide and oral tamoxifen, and prior routine surveillance imaging had found no evidence of recurrent disease. MRI of the orbit revealed a 0.7 × 1.4 × 1.9 cm mass in the superomedial right orbit in the region of the superior oblique. Transcaruncular orbitotomy with biopsy of the superior oblique revealed metastatic breast carcinoma. Unfortunately, he developed new metastases. Post-operatively, he continues to have good vision with minimal diplopia.
Collapse
|
23
|
Giunta G, Rossi M, Toia F, Rinaldi G, Cordova A. Male breast cancer: Modified radical mastectomy or breast conservation surgery? A case report and review of the literature. Int J Surg Case Rep 2016; 30:89-92. [PMID: 28006719 PMCID: PMC5192241 DOI: 10.1016/j.ijscr.2016.11.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/17/2016] [Accepted: 11/17/2016] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Male breast cancer (MBC) is a rare disease that accounts for <1% of breast cancer cases. The most common treatment is modified radical mastectomy (MRM). Recently, breast conservative surgery (BCS) is getting popular for MBC treatment. We report a case and reviewed the literature to investigate whether emerging BCS can be considered as an alternative of a more radical surgery. PRESENTATION OF CASE A 46 y.o. patient, presented with a painless left breast lump over a period of six months. The patient underwent a quadrantectomy at another institution. Pathology revealed an intraductal carcinoma in close proximity to the margins of excision. Adjuvant hormonal therapy was proposed to the patient, who refused and was referred to our Institution. We performed a MRM and a sentinel lymph node biopsy (SLNB). A contralateral breast liposuction and an adenectomy were also performed. The patient underwent also a nipple-areolar complex reconstruction. The patient didn't receive adjuvant therapy. DISCUSSION Both oncological safety and satisfactory cosmetic outcomes are the goals of MBC treatment. No specific guidelines for MBC treatment have been proposed. MRM is currently the surgical gold standard of MBC (approximately 70% of all cases). Some authors reported that male BCS associated with radiation therapy is a feasible alternative MRM. Taking into account data from the literature and considering the previous surgery, in the case we report, we offered a MRM, SLNB and a contralateral breast symmetrization. CONCLUSION MRM with SLNB and reconstruction of male breast asymmetry should be still considered as the treatment of choice of MBC.
Collapse
Affiliation(s)
- Gabriele Giunta
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy.
| | - Matteo Rossi
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Francesca Toia
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Gaetana Rinaldi
- Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Adriana Cordova
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| |
Collapse
|
24
|
Javidiparsijani S, Rosen LE, Gattuso P. Male Breast Carcinoma: A Clinical and Pathological Review. Int J Surg Pathol 2016; 25:200-205. [PMID: 27831530 DOI: 10.1177/1066896916675953] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Male breast carcinomas (MBCs) are rare neoplasms that account for 0.1% of all male cancers. Still, there are 2000 new cases of MCB diagnosed annually in the United States. Because of its rarity, data regarding the etiology, risk factors, diagnosis, management, and prognosis of MBC are limited. MBC shares some similarities with female breast carcinoma (FBC). This review will address the important clinical, histopathological, immunohistochemical and molecular features, genetics, management, and prognosis of MBC.
Collapse
|
25
|
Gallan AJ, Antic T. Benign müllerian glandular inclusions in men undergoing pelvic lymph node dissection. Hum Pathol 2016; 57:136-139. [DOI: 10.1016/j.humpath.2016.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 06/09/2016] [Accepted: 07/02/2016] [Indexed: 11/15/2022]
|
26
|
Serarslan A, Gursel B, Okumus NO, Meydan D, Sullu Y, Gonullu G. Male Breast Cancer: 20 Years Experience of a Tertiary Hospital from the Middle Black Sea Region of Turkey. Asian Pac J Cancer Prev 2016; 16:6673-9. [PMID: 26434893 DOI: 10.7314/apjcp.2015.16.15.6673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Male breast cancer is a rare neoplasm, and its treatments are based on those of female breast cancer. This study aimed to analyze 20 years of male breast cancer clinical characteristics and treatment results from the Middle Black Sea Region of Turkey. MATERIALS AND METHODS A retrospective analysis of 16 male breast cancer patients treated in our tertiary hospital between 1994 and 2014 was performed. Epidemiologic data, tumor characteristics, and treatments were recorded and compared with 466 female breast cancer ((premenopausal; n=230)+(postmenopausal n=236)) patients. The 5-year disease-free and overall survival rates were calculated. RESULTS Male breast cancer constituted 0.1% of all malignant neoplasms in both sexes, 0.2% of all malignant neoplasms in males, and 0.7% of all breast cancers. The mean patient age in this study was 59.8±9.5 (39-74) years. The mean time between first symptom and diagnosis was 32.4±5.3 (3-60) months. Histology revealed infiltrative ductal carcinoma in 81.3% of patients. The most common detected molecular subtype was luminal A, in 12 (75%) patients. Estrogen receptor rate (93.8%) in male breast cancer patients was significantly higher than that in female breast cancer (70.8% in all females, p=0.003; 68.2% in postmenopausal females, p=0.002) patients. Most of the tumors (56.3%) were grade 2. Tumor stage was T4 in 50% of males. The majority (56.3%) of the patients were stage III at diagnosis. Surgery, chemotherapy, radiotherapy and endocrine-therapy were applied to 62.5%, 62.5%, 81.2% and 73.3%, respectively. Loco-regional failure did not occur in any of the cases. All recurrences were metastastic. The 5-year disease-free and overall survival rates in male breast cancer patients were 58% and 68%, respectively. CONCLUSIONS Tumors found in male breast cancer patients were similar in size to tumors found in females, but they advanced to T4 stage more rapidly because of the lack of breast parenchymal tissues. The rate of estrogen receptor expression tended to be higher in male breast cancer patients than in female breast cancer patients. Metastasis is the most important problem in initially non-metastatic male breast cancer patients.
Collapse
Affiliation(s)
- Alparslan Serarslan
- Department of Radiation Oncology, Faculty of Medicine, Ondokuz Mayis University , Samsun, Turkey E-mail :
| | | | | | | | | | | |
Collapse
|
27
|
Affiliation(s)
- Iraj Khalkhali
- LA BioMed at Harbor-UCLA Medical Center, Torrance, California
| | | |
Collapse
|
28
|
da Silva TL. Male breast cancer: Medical and psychological management in comparison to female breast cancer. A review. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.ctrc.2016.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
29
|
Fathalla AES, Hafez MNAE. Breast Cancer in Males (BCM), Does It Really Differ? National Cancer Institute Experience (NCI), Cairo University, Egypt. JOURNAL OF CANCER THERAPY 2016; 07:344-351. [DOI: 10.4236/jct.2016.75037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
|
30
|
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.
Collapse
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
| |
Collapse
|
31
|
Invasive Ductal Carcinoma in a 46,XY Partial Androgen Insensitivity Syndrome Patient on Hormone Therapy. J Pediatr Adolesc Gynecol 2015; 28:e95-7. [PMID: 26024935 DOI: 10.1016/j.jpag.2014.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 08/07/2014] [Accepted: 08/08/2014] [Indexed: 01/23/2023]
Abstract
BACKGROUND The hormonal management of patients with androgen insensitivity can be challenging. CASE An illustrative case is presented of a newborn with ambiguous genitalia who was raised female. She was diagnosed as 46,XY Disorder of Sexual Development with partial androgen insensitivity. To induce puberty, conjugated equine estrogens were administered beginning at age 12. At age 13, she instead began taking combined oral contraceptives for maternal concerns about height and continued taking them for social reasons. Invasive ductal carcinoma was diagnosed at age 27, and the patient was treated with chemotherapy, radiation therapy, bilateral mastectomies, and endocrine therapy. SUMMARY AND CONCLUSION The current literature is reviewed, and hormonal management and other risks for breast cancer are discussed.
Collapse
|
32
|
Motofei IG, Rowland DL, Popa F, Bratucu E, Straja D, Manea M, Georgescu SR, Paunica S, Bratucu M, Balalau C, Constantin VD. A Pilot Study on Tamoxifen Sexual Side Effects and Hand Preference in Male Breast Cancer. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1589-1594. [PMID: 26108899 DOI: 10.1007/s10508-015-0530-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 03/09/2015] [Accepted: 03/12/2015] [Indexed: 06/04/2023]
Abstract
Recent clinical and imaging studies suggest that sex hormones modulate sexuality according to a psychophysiologic process of lateralization of the brain, with androgens playing a greater role in sexual functioning of left hemibrain/right handedness and estrogens possibly for right hemibrain/left handedness. Based on this perspective, the current study attempted to specify the relationship between hand preference, estrogens, and sexual function in subjects with male breast cancer, taking into account the sexual side effects of tamoxifen as the agent for inhibiting estrogen action. Twenty-eight Romanian men-17 right-handed and 11 left-handed-undergoing treatment with tamoxifen for male breast cancer participated in this study. These men were assessed both prior to and during tamoxifen treatment using the International Index of Erectile Function, a standardized instrument used for the evaluation of various aspects of sexual functioning, including erectile function (EF), orgasmic function (OF), sexual desire (SD), and overall functioning (OF). A main effect for handedness was found on EF, OF, SD, and OS scales, with right-handed men showing higher functioning than left-handed men. Regarding interaction effects, the left-handed group of men showed greater decreased sexual functioning during tamoxifen (on three subscales: OF, SD, OS) compared to right-handed men. Further research should be conducted in order to support and refine this potential lateralized process of sexual neuromodulation within the brain.
Collapse
Affiliation(s)
- Ion G Motofei
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Cazangiilor Street, No. 10, Sect. 3, 03306, Bucharest, Romania,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Timoteo ARDS, Albuquerque BM, Moura PCP, Ramos CCDO, Agnez-Lima LF, Walsh T, King MC, Lajus TBP. Identification of a new BRCA2 large genomic deletion associated with high risk male breast cancer. Hered Cancer Clin Pract 2015; 13:2. [PMID: 25632310 PMCID: PMC4308828 DOI: 10.1186/s13053-014-0022-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/15/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Male breast cancer (MBC) is an uncommon disease that has been the focus of limited research. It is estimated that approximately 10% of men with breast cancer have a genetic predisposition, with BRCA2 being the most prevalent genetic mutation. Here we describe the case of MBC in a 64-year-old man who presented on physical examination a nodule in his left breast and declared to have an extensive family history of cancer. METHODS AND RESULTS The patient was firstly diagnosed with an invasive ductal carcinoma (IDC) with histological grade III, nuclear grade 3, pT4N2Mx and positive for hormonal receptors and HER2. Exome sequencing was performed by massive parallel sequencing which had detected a novel BRCA2 germline mutation that is a large genomic deletion of 3,492 nucleotides including BRCA2 exon 14, and this deletion is out of frame and is predicted to lead to a stop codon in exon 15 at codon 2,496. CONCLUSION Large rearrangements in BRCA1 and BRCA2 occur in a small percentage (<1%) of patients tested for hereditary breast and ovarian cancer. This is the first report of the mutation del3492 in BRCA2 exon 14, which leads to a truncated protein and therefore is clinically relevant. Mutation segregation analysis should be further done in the Brazilian population. Herein we highlight the importance of next-generation sequencing in the detection of large genomic deletions.
Collapse
Affiliation(s)
| | | | | | | | | | - Tom Walsh
- />University of Washington, Department of Medicine and Genome Sciences, Health Sciences K-160, Seattle, USA
| | - Mary-Claire King
- />University of Washington, Department of Medicine and Genome Sciences, Health Sciences K-160, Seattle, USA
| | | |
Collapse
|
34
|
Tewes M, Kasimir-Bauer S, Welt A, Schuler M, Kimmig R, Aktas B. Detection of disseminated tumor cells in bone marrow and circulating tumor cells in blood of patients with early-stage male breast cancer. J Cancer Res Clin Oncol 2014; 141:87-92. [DOI: 10.1007/s00432-014-1784-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/17/2014] [Indexed: 10/24/2022]
|
35
|
Tariq KB, Al-Saffar F, Ibrahim S, Pham D, Farhangi A, Rana F, Zaiden R. Male Breast Cancer and Hyperestrogenemia: A Thirteen-Year Review. World J Oncol 2014; 5:55-61. [PMID: 29147378 PMCID: PMC5649874 DOI: 10.14740/wjon803w] [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] [Accepted: 04/12/2014] [Indexed: 11/11/2022] Open
Abstract
Background Male breast cancer (MBC) is a very rare malignancy and accounts for 0.1% of all male cancers. MBC has not been studied as extensively as its female counterpart. Certain clinical and pathological risk factors like smoking history, age at onset, family history of cancer, obesity, ethnicity, estrogen/progesterone receptor status and BRCA gene mutation status have all been studied well in the female breast cancer (FBC) patients and the clinical trial evidence from these studies is then extrapolated to treat and manage patients with MBC. One such area of interest is high levels of estrogen and its relationship with MBC. In our retrospect research study we aim to find an association between MBC and high levels of circulating estrogen at the time of diagnosis. Methods A 13-year retrospective review of the male breast cases at University of Florida College of Medicine's Tumor Registry was conducted. Data regarding certain clinic-pathological risk factors and MBC were collected and reviewed. Main surrogate indicators for elevated estrogen were examined, namely, low HDL (< 40 mg/dL), low albumin (< 4 g/dL) and high BMI (> 25). Presence of any one of these surrogates was seen as an indirect marker for high estrogen level. For cancer staging, the American Joint Committee on Cancer (AJCC) staging system was used. Stages 0-2 were grouped together as they are less extensive compared to stages 3-4 (also grouped together) which represent extensive disease. Univariate analysis was conducted using STATA 13 to do Fischer's exact test as cross-tables showed cell counts of five or less. The main comparison was that between extensive MBC (stages 3-4) and non-extensive breast cancer (stages 0-2). Results Between January 2000 and November 2013, we found a total of 2,129 cases of breast cancer patients at our institute. Out of these 2,113 (99.24%) were female and 16 (0.75%) were men. Four MBC patients were excluded because their complete charts could not be found in the medical records department. Six (50%) patients had one indicator, four (33%) patients had two indicators and one (8.3%) patient had all three. Eleven (91.6%) patients had precursors suggestive of hyperestrogenemia. Only one (8.33%) patient did not have any surrogate marker indicator of high estrogen levels. Two (16%) were black and 10 (83.33%) were white. Mean age was 61.75. Five (41%) had a first degree relative with a malignancy. Laterality was nine (75%) in the left breast, three (35%) in right breast. Eight (66.6%) found a mass on physical exam. Five (41.6%) had a positive smoking history. One patient had no data in the chart. Remaining all 11 (91.6%) had non-TNBC. One patient did not have complete documentation. Five (41.6%) had mastectomy, six (50%) received RT, four (33.3%) received chemotherapy and another four received hormone therapy. In terms of stage, four (33.3%) had stage 4, two (16.6%) stage 3B, two (16.6%) stage 2B, two (16.6%) stage 2A, one (8.33%) had stage 1C and one had stage 0. HDL data were available in seven (58.3%) with mean of 37, albumin in 10 (83.3%) with mean of 3.61, BMI in 11 (91.66%) patients with a mean of 33.30. Within subgroups, two patients were black and 10 white. Both black patients had LE disease (stage 0-2). Of the white patients, four (40%) had limited disease while six (60%) had extensive breast cancer. Family history assumed a similar distribution as three (60%) of patients with negative family history for cancer had limited disease and two (40%) had extensive one, same numbers applied for family-history-positive population. Three (60%) of patients with limited disease smoker and two (40%) did not. As for laterality, a total of nine patients had left-sided breast cancer, of whom five had had limited disease and four fell into the extensive disease category. The hormonal status for most patients were HER/NEU negative (seven out of 10 patients, two patients did not have this information on file), ER positive (11 out of 12) and PR positive (8 out of 12). Estrogen status: Low HDL was seen in three out of seven patients, low albumin in four out of 10 and obese BMI in nine out of 11. Finally, 11 out of 12 patients had at least one indicator of high estrogen. No significant change in prevalence of these markers was seen when comparing patients with limited and extensive disease. Conclusion None of the aforementioned variables assumed statistical significance between the two subgroups. Results, however, show that as a whole, 11 out of the 12 patients had at least one indicator of high estrogen. Our results point in the direction that elevated estrogen is probably associated with MBC. Further meta-analysis of similar studies can be helpful to explain the dynamics of this association. Our statistical analysis was limited due to the small sample size, which is due to the extreme rarity of the disease.
Collapse
Affiliation(s)
- Khurram Bilal Tariq
- Department of Internal Medicine, University of Florida, College of Medicine, 653 West 8th Street, Box L 18, Jacksonville, FL 32209, USA
| | - Farah Al-Saffar
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Saif Ibrahim
- Department of Internal Medicine, University of Florida, College of Medicine, 653 West 8th Street, Box L 18, Jacksonville, FL 32209, USA
| | - Dat Pham
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Arezo Farhangi
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Fauzia Rana
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Robert Zaiden
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| |
Collapse
|