Clinical Indications for Mammography in Men and Correlation With Breast Cancer

Gender-Specific Genetic Predisposition to Breast Cancer: BRCA Genes and Beyond

Among neoplastic diseases, breast cancer (BC) is one of the most influenced by gender. Despite common misconceptions associating BC as a women-only disease, BC can also occur in men. Additionally, transgender individuals may also experience BC. Genetic risk factors play a relevant role in BC predisposition, with important implications in precision prevention and treatment. The genetic architecture of BC susceptibility is similar in women and men, with high-, moderate-, and low-penetrance risk variants; however, some sex-specific features have emerged. Inherited high-penetrance pathogenic variants (PVs) in BRCA1 and BRCA2 genes are the strongest BC genetic risk factor. BRCA1 and BRCA2 PVs are more commonly associated with increased risk of female and male BC, respectively. Notably, BRCA-associated BCs are characterized by sex-specific pathologic features. Recently, next-generation sequencing technologies have helped to provide more insights on the role of moderate-penetrance BC risk variants, particularly in PALB2, CHEK2, and ATM genes, while international collaborative genome-wide association studies have contributed evidence on common low-penetrance BC risk variants, on their combined effect in polygenic models, and on their role as risk modulators in BRCA1/2 PV carriers. Overall, all these studies suggested that the genetic basis of male BC, although similar, may differ from female BC. Evaluating the genetic component of male BC as a distinct entity from female BC is the first step to improve both personalized risk assessment and therapeutic choices of patients of both sexes in order to reach gender equality in BC care. In this review, we summarize the latest research in the field of BC genetic predisposition with a particular focus on similarities and differences in male and female BC, and we also discuss the implications, challenges, and open issues that surround the establishment of a gender-oriented clinical management for BC.

Vaccines in Breast Cancer: Challenges and Breakthroughs

Breast cancer is a problem for women's health globally. Early detection techniques come in a variety of forms ranging from local to systemic and from non-invasive to invasive. The treatment of cancer has always been challenging despite the availability of a wide range of therapeutics. This is either due to the variable behaviour and heterogeneity of the proliferating cells and/or the individual's response towards the treatment applied. However, advancements in cancer biology and scientific technology have changed the course of the cancer treatment approach. This current review briefly encompasses the diagnostics, the latest and most recent breakthrough strategies and challenges, and the limitations in fighting breast cancer, emphasising the development of breast cancer vaccines. It also includes the filed/granted patents referring to the same aspects.

Female-Type Presentation of Male Breast Cancer in Mammography and Its Clinical Implications

Introduction Male breast cancer is rare, accounting for about 1% of total breast cancer cases. In contrast to gynecomastia, which has a painful, soft, movable mass concentric to the nipple, the traditional presentation is a painless, hard, eccentric retro-areolar mass. However, when cancer occurs concurrently with significant gynecomastia, the mammographic pattern simulates female-type breast cancer, whereby there is a variable location and pattern of cancer. This study addresses the clinical and radiologic implications of this combination of gynecomastia and co-existing breast cancer. This combined presentation has not been highlighted thus far. Materials and method Following institutional approval, a retrospective study of male breast cancer was conducted over a 10-year period (2011-2021) in a single institution. Age, clinical presentation, risk factors, comorbidities, imaging results, and comprehensive pathology reports were all obtained from the picture archiving and communication system (PACS). Patients who did not have an initial imaging examination were eliminated from the study. Results There were 17 cases in all that were investigated. Nine of the men exhibited a classic presentation appearance, whereas eight had gynecomastia. The mean age was 58 years. The female-type presentation included multicentric cancers away from the nipple, diffuse parenchymal involvement, leukemia/lymphoma, and positive axillary lymphadenopathy without intramammary lesion, some of which had delayed investigation due to clinical suspicion of gynecomastia or breast swelling. All of the radiologic diagnoses were accurate. The pathology report in all except two cases was hormone receptor-positive and human epidermal growth factor receptor 2 (HER2) negative. Conclusion Female-type presentation of male breast cancer is highlighted to prevent false clinical impressions and delayed radiologic investigation and treatment. Mammography readily identifies such cancers and should be requested at the initial clinical presentation of males with significant gynecomastia or risk factor.