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Li Y, Guo Y, Chen F, Cui Y, Chen X, Shi G. Male breast cancer differs from female breast cancer in molecular features that affect prognoses and drug responses. Transl Oncol 2024; 45:101980. [PMID: 38701649 PMCID: PMC11088352 DOI: 10.1016/j.tranon.2024.101980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/13/2024] [Accepted: 04/26/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Male breast cancer (MBC) is a rare malignancy with a worse prognosis than female breast cancer (FBC). Current MBC treatment strategies are based on those for FBC. However, molecular differences between MBC and FBC with respect to prognosis and drug responses remain unclear. METHODS After controlling for confounding factors with propensity score matching (PSM), differences between MBC and FBC were comprehensively analyzed using many types of data: survival, immune microenvironments, sex hormone responses, drug sensitivity, transcriptomes, genomes, epigenomes, and proteomes. RESULTS Overall survival (OS) and cancer-specific survival (CSS) were both worse for MBC than for FBC. Differentially expressed mRNAs were enriched in numerous cancer-related functions and pathways, with SPAG16 and STOX1 being as the most important prognosis-related mRNAs for MBC. Competing endogenous RNA (ceRNA) and transcription factor (TF)-mRNA regulatory networks contain potential prognostic genes. Nine genes had higher mutation frequencies in MBC than in FBC. MBC shows a comparatively poor response to immunotherapy, with five proteins that promote breast cancer progression being highly expressed in MBC. MBC may be more responsive than FBC to estrogen. We detected six United States Food and Drug Administration (FDA)-approved therapeutic target genes as being differentially expressed between MBC and FBC. CONCLUSION The poor prognosis of MBC compared to FBC is due to numerous molecular differences and resulting drug responses.
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Affiliation(s)
- Yangyang Li
- Department of Breast Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province 150081, China
| | - Yan Guo
- Department of Breast Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province 150081, China; Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi Province 030013, China
| | - Fengzhi Chen
- Department of Breast Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province 150081, China
| | - Yuqing Cui
- Department of Breast Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province 150081, China
| | - Xuesong Chen
- Department of Oncology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province 150001, China; NHC Key Laboratory of Cell Transplantation, Harbin Medical University, Harbin, Heilongjiang Province 150001, China.
| | - Guangyue Shi
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province 150081, China.
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Lissidini G, Nicosia L, Sargenti M, Cucchi MC, Fabi A, Falco G, Gardani M, Grilz G, Maugeri I, Murgo R, Neri A, Pellini F, Sensi C, Scomersi S, Taffurelli M, Bagnardi V, Oriecuia C, Pagan E, Sangalli C, Dessena M, Veronesi P, Galimberti V. Male breast cancer: a multicenter study to provide a guide for proper management. Breast Cancer Res Treat 2024:10.1007/s10549-024-07380-0. [PMID: 38896332 DOI: 10.1007/s10549-024-07380-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/14/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION To offer an extensive retrospective experience on the management of male breast cancer. METHODS A multicenter retrospective observational cohort study was conducted, including male patients diagnosed with breast cancer (invasive or in situ) in 12 Italian breast units from January 1975 to December 2019. Patients aged 18 years or older were assessed for eligibility. Exclusion criteria were metastatic cancer at diagnosis, previous cancer(s), received neoadjuvant treatment, incomplete data on (neo) adjuvant treatment(s), and/or follow-up data. Data on radiological examinations, demographic characteristics, risk factors, histological features, receptor status, treatments, and follow-up were collected. RESULTS In a series of 671 male patients with breast cancer assessed for eligibility, 403 (28 in situ and 375 invasive neoplasms) were included in the study. All included patients underwent surgery. The median age at surgery was 63.8 years (IQR 56.1-72.1). In 68% of cases, patients underwent echography, and in 55.1%, a mammography. Most patients were ER and PR positive (63.8%), HER2 negative (80.4%), with high (≥ 20%) Ki67 values (61.3%), and luminal B subtype (51.1%). The 10-year overall survival was 73.6% (95% CI 67.0-79.1) for invasive breast cancer and 90% (95% CI 65.6-97.4) for in situ breast cancer. In patients with invasive breast cancer, at univariable analysis, having a G3 tumor (vs. G1), pT2/3/4 (vs. pT1), pN2/3 (vs. pN0), luminal B subtype with Ki67 ≥ 20% (vs. Luminal A), were significantly associated with a higher risk of death. In multivariable analyses, pT2/3/4 (vs. pT1) remained significantly associated with a higher risk of death (HR 3.14, 95% CI 1.83-5.39), and having a HER2 positive or a triple-negative subtype (vs. Luminal A) was also significantly associated with a higher risk of mortality (HR 4.76, 95% CI 1.26-18.1). CONCLUSION Male breast cancer is a rare disease, the better understanding of which is necessary for a more effective diagnostic and therapeutic approach.
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Affiliation(s)
- Germana Lissidini
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Luca Nicosia
- Division of Breast Radiology, IRCSS, IEO European Institute of Oncology, 20141, Milan, Italy.
| | - Manuela Sargenti
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | | | - Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS Rome, Rome, Italy
| | | | - Marco Gardani
- Department of Surgery, Breast Unit Piacenza, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Greta Grilz
- Breast Surgery Unit Chirurgia Senologica Breast Unit Ospedale Cottolengo, Turin, Italy
| | - Ilaria Maugeri
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori Di Milano, Milan, Italy
| | - Roberto Murgo
- Breast Surgery Unit, IRCCS Ospedale Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Alessandro Neri
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Francesca Pellini
- Complex Operative Unit (UOC) Breast Surgery, Breast Unit, Oncology Department Azienda Ospedaliera, Universitaria Integrata (AOUI) Verona, Verona, Italy
| | | | - Serena Scomersi
- Division of General Surgery, Breast Unit, Hospital of Cattinara, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Mario Taffurelli
- Breast and General Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Chiara Oriecuia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Claudia Sangalli
- Clinical Trial Office, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Massimo Dessena
- Breast Surgery Unit, Azienda Ospedaliero-Universitaria Di Cagliari, Cagliari, Italy
| | - Paolo Veronesi
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Viviana Galimberti
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy
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Frevert ML, Dannehl D, Jansen L, Hermann S, Schäffler H, Huwer S, Janni W, Juhasz-Böss I, Hartkopf AD, Taran FA. Feasibility of targeted therapies in the adjuvant setting of early breast cancer in men: real-world data from a population-based registry. Arch Gynecol Obstet 2024; 309:2811-2819. [PMID: 38472501 PMCID: PMC11147886 DOI: 10.1007/s00404-024-07405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/28/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Following the positive iDFS and OS results of the phase III clinical trials monarchE, NATALEE and OlympiA, new oral anticancer agents (the CDK4/6 inhibitors abemaciclib, ribociclib as well as the PARP inhibitor olaparib) have recently been introduced into the treatment of high-risk early breast cancer (eBC). However, only few male patients were included in these trials (0.4%, 0.6% and 0.3%, respectively). The objective of this real-world analysis was to determine the proportion of male patients with eBC fulfilling the clinical high-risk criteria of above-mentioned trials. PATIENTS AND METHODS We conducted a data inquiry and analysis with the Cancer Registry of Baden-Württemberg of men with breast cancer diagnosed between January 1, 2015 and December 31, 2021. Men with eBC were identified and the number of patients at clinical high-risk according to the inclusion criteria of monarchE, NATALEE and OlympiA was assessed. RESULTS Of 397 men with eBC, 354 (89.1%) had a HR + /Her2- and 4 (1.0%) a triple-negative subtype. 84 patients (21.2%) met the clinical high-risk criteria according to the monarchE, 189 (47.6%) those according to the NATALEE and 50 (12.6%) those according to the OlympiA trial. CONCLUSION In a large real-world sample, more men with eBC are at clinical high risk according to the inclusion criteria of monarchE, NATALEE and OlympiA than would be expected in women. This is most likely due to more advanced stages at initial diagnosis in men. To evaluate whether CDK4/6 and PARP inhibitors improve prognosis also in men should be the topic of future real- world analyses.
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Affiliation(s)
- M L Frevert
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - D Dannehl
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - L Jansen
- Epidemiological Cancer Registry of Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Hermann
- Epidemiological Cancer Registry of Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Schäffler
- Department of Obstetrics and Gynecology, University Clinic Ulm, Faculty of Medicine, University of Ulm, Ulm, Germany
| | - S Huwer
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - W Janni
- Department of Obstetrics and Gynecology, University Clinic Ulm, Faculty of Medicine, University of Ulm, Ulm, Germany
| | - I Juhasz-Böss
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - A D Hartkopf
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - F-A Taran
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Evans A, Dunn J, Donnelly PK. Mammographic surveillance after breast cancer. Br J Radiol 2024; 97:882-885. [PMID: 38450420 PMCID: PMC11075979 DOI: 10.1093/bjr/tqae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/28/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024] Open
Abstract
Early detection of local recurrence has been shown to improve survival. What is unclear is how frequently mammography should be performed, how long surveillance should continue and how the answers to these questions vary with tumour pathology, patients age, and surgery type. Many of these questions are not directly answerable from the current literature. While some of these questions will be answered by the Mammo-50 study, evidence from local recurrence rates, tumour biology, and the lead time of mammography can be used to guide policy. Young age is the strongest predictor of local recurrence and given the short lead time of screening in women under 50, these women require annual mammography. Women over 50 with HER-2 positive and triple negative breast cancer have higher rates of local recurrence after breast conserving surgery than women with luminal cancers. Women with HER-2 positive and triple negative breast cancer also have a higher rate of recurrence in years 1-3 post surgery. Annual mammography in year 1-4 would appear justified. Women over 50 with luminal cancers have low rates of local recurrence and no early peak. Recurrence growth will be low due to tumour biology and hormone therapy. Biennial mammography after year 2 would seem appropriate. Women over 50 following mastectomy have no early peak in contralateral cancers so the frequency should be determined by the lead time of screening. This would suggest 2 yearly mammography for women aged 50-60 while 3 yearly mammography may suffice for women over 60.
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Affiliation(s)
- Andy Evans
- Breast Unit, Royal Derby Hospital, Uttoxeter Road, Derby DE22 8NE
| | - Janet Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL
| | - Peter Kevin Donnelly
- Torbay and South Devon NHS Foundation Trust, Torbay Hospital, Lowes Bridge, Torquay, TQ2 7AA
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Thomas M, Al Kashroom H, Reddy S, Zaccarini D, Willer K. Male Breast Cancer: Imaging Considerations for Diagnosis and Surveillance. J Clin Med Res 2024; 16:197-207. [PMID: 38855781 PMCID: PMC11161189 DOI: 10.14740/jocmr5169] [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: 04/05/2024] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Male breast cancer accounts for less than 1% of all breast cancer cases. The important risk factors for the development of male breast cancer are family history, genetic mutations, obesity, liver disease, alcoholism, exogenous estrogen administration, and radiation exposure to the chest area. Despite its rarity, numerous studies have investigated the data on imaging considerations (mammogram, ultrasound, and magnetic resonance imaging (MRI)), but have addressed only certain aspects of male breast cancer. A comprehensive approach on the imaging characteristics, timing of imaging, prognostication based on imaging characteristics, and follow-up strategies in male breast cancer are still lacking. The purpose of this review article was to provide a comprehensive overview of the imaging findings, optimal timing to obtain imaging, and the appropriate follow-up strategies in male breast cancer survivors. This article also describes how imaging modalities can aid in determining prognosis. By addressing this knowledge gap, the article provides valuable insights for clinicians managing this uncommon yet clinically significant disease.
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Affiliation(s)
- Mathew Thomas
- Department of Internal Medicine, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Hatem Al Kashroom
- Department of Radiology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Shilpa Reddy
- Department of Pathology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Daniel Zaccarini
- Department of Pathology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Katherine Willer
- Department of Radiology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
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Al Assaad M, Michaud O, Semaan A, Sigouros M, Tranquille M, Phan A, Levine MF, Gundem G, Medina-Martínez JS, Papaemmanuil E, Manohar J, Wilkes D, Sboner A, Hoda SAF, Elemento O, Mosquera JM. Whole-Genome Sequencing Analysis of Male Breast Cancer Unveils Novel Structural Events and Potential Therapeutic Targets. Mod Pathol 2024; 37:100452. [PMID: 38369186 DOI: 10.1016/j.modpat.2024.100452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/17/2024] [Accepted: 02/08/2024] [Indexed: 02/20/2024]
Abstract
The molecular characterization of male breast cancer (MaBC) has received limited attention in research, mostly because of its low incidence rate, accounting for only 0.5% to 1% of all reported cases of breast cancer each year. Managing MaBC presents significant challenges, with most treatment protocols being adapted from those developed for female breast cancer. Utilizing whole-genome sequencing (WGS) and state-of-the-art analyses, the genomic features of 10 MaBC cases (n = 10) were delineated and correlated with clinical and histopathologic characteristics. Using fluorescence in situ hybridization, an additional cohort of 18 patients was interrogated to supplement WGS findings. The genomic landscape of MaBC uncovered significant genetic alterations that could influence diagnosis and treatment. We found common somatic mutations in key driver genes, such as FAT1, GATA3, SMARCA4, and ARID2. Our study also mapped out structural variants that impact cancer-associated genes, such as ARID1A, ESR1, GATA3, NTRK1, and NF1. Using a WGS-based classifier, homologous recombination deficiency (HRD) was identified in 2 cases, both presenting with deleterious variants in BRCA2. Noteworthy was the observation of FGFR1 amplification in 21% of cases. Altogether, we identified at least 1 potential therapeutic target in 8 of the 10 cases, including high tumor mutational burden, FGFR1 amplification, and HRD. Our study is the first WGS characterization of MaBC, which uncovered potentially relevant variants, including structural events in cancer genes, HRD signatures, and germline pathogenic mutations. Our results demonstrate unique genetic markers and potential treatment targets in MaBC, thereby underlining the necessity of tailoring treatment strategies for this understudied patient population. These WGS-based findings add to the growing knowledge of MaBC genomics and highlight the need to expand research on this type of cancer.
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Affiliation(s)
- Majd Al Assaad
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York; Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Olivier Michaud
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York; Département de Pathologie, Université Laval, Quebec City, Quebec, Canada
| | - Alissa Semaan
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Michael Sigouros
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Marvel Tranquille
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Andy Phan
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | | | | | | | | | - Jyothi Manohar
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - David Wilkes
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Andrea Sboner
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York; Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Syed A F Hoda
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Olivier Elemento
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York; Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York; Institute for Computational Biomedicine, Weill Cornell Medicine, New York, New York
| | - Juan Miguel Mosquera
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York; Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York; New York Genome Center, New York, New York.
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Ye M, Qiu L, Jin Y, Huang Y. Stakeholders' experiences and perceptions of male breast cancer:A qualitative evidence synthesis. Breast 2024; 74:103694. [PMID: 38417232 PMCID: PMC10904996 DOI: 10.1016/j.breast.2024.103694] [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: 09/12/2023] [Revised: 12/06/2023] [Accepted: 02/19/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The experiences, physical and mental health and needs of women with breast cancer have been studied in some detail, but there is a lack of discussion of the experiences of stakeholder groups such as men with breast cancer, partners and carers and healthcare professionals. The aim of this study was to explore and understand the experiences and perceptions of male breast cancer stakeholders from diagnosis through to survivorship. METHODS We conducted a thematic review of qualitative studies included in a large published scoping review on male breast cancer (reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews extension). To be included in a qualitative evidence review, studies had to use qualitative methods for data collection and analysis to capture the perspectives of men with breast cancer, partners or caregivers, and healthcare workers. Key characteristics and findings were extracted and a conceptual coding framework was summarized using thematic analysis. RESULTS Out of a total of 310 studies in the research literature (published research articles and gray literature), 15 studies met the inclusion criteria. These studies reported on the experiences of men with breast cancer, partners or caregivers, and healthcare workers, with participant numbers ranging from 2 to 31. A total of 17 descriptive themes (study outcomes) were identified. From these, four high-level analytic themes emerged: (1) Predicament; (2) Emotion; (3) Support; (4) Coping. CONCLUSIONS The gender stigma that exists at the patient, healthcare system, and family-society levels largely influences the experiences of the male breast cancer stakeholder population. To address gender inequalities in breast cancer care, healthcare organizations and society at large should remain equally attentive to the needs of male and female breast cancer patients. These needs include reducing healthcare and social stigma, providing gender-specific information and emotional support, and access to support groups.
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Affiliation(s)
- Maodie Ye
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Lin Qiu
- Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China
| | - Yongmei Jin
- Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China.
| | - Yingying Huang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
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8
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Lei H, Hua B, Mao Y, Cui W, Mao C, Yang S, Li J. Clinical characteristics and prognostic factors of male breast cancer in China. Front Oncol 2024; 14:1362826. [PMID: 38525418 PMCID: PMC10957788 DOI: 10.3389/fonc.2024.1362826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose This study aimed to explore the clinical characteristics of male breast cancer (MBC) patients and the factors influencing their prognosis. Methods We conducted a retrospective case series analysis of 117 MBC cases who were treated at Zhejiang Cancer Hospital from 2009 to 2022. Cox proportional hazard model was used to identify prognostic factors of MBC. Nomogram was constructed based on these factors, which was further evaluated by C-index and calibration curves. Results A total of 115 MBC cases were finally included in our analyses, with median diagnosis age of 59 years. Of these cases, 80.0% were estrogen receptor (ER) positive, 79.2% were progesterone receptor (PR) positive, 48.7% were human epidermal growth factor receptor 2 (HER2) negative, and 42.6% had Ki67 levels higher than 15%. 108 (93.9%) cases underwent radical mastectomy, while only 3 (2.6%) received breast-conserving surgery. The Logrank test suggested that lymphocyte-to-monocyte ratio (LMR) was negatively associated with both overall survival (OS) and disease-free survival (DFS) of MBC, while platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were only positively associated with OS (all P-values < 0.05). Multivariate regression analysis showed that age (HR 1.08, 95% CI 1.03-1.13) was significant prognostic factors for OS. Meanwhile, age (HR 1.06, 95% CI 1.02-1.10), histological differentiation grade (poorly differentiated/undifferentiated vs. well-differentiated: HR 2.55, 95% CI 1.05-6.17), and TNM stage (IV vs. I: HR 31.59, 95% CI 6.01-165.93) were also significant prognostic factors for DFS. Nomograms were developed for DFS, with C-indexes of 0.782, indicating good predictive performance. Conclusion Increased age, bigger tumor size, higher TNM stage, and lower histological differentiation grade were associated with poor MBC prognosis, and LMR, PLR, and NLR might be potential predictors for MBC prognosis.
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Affiliation(s)
- Han Lei
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Baojie Hua
- Department of Epidemiology, Zhejiang Chinese Medical University School of Public Health, Hangzhou, China
| | - Yingying Mao
- Department of Epidemiology, Zhejiang Chinese Medical University School of Public Health, Hangzhou, China
| | - Wei Cui
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Caiping Mao
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Shaoxue Yang
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Jiayu Li
- Department of Epidemiology, Zhejiang Chinese Medical University School of Public Health, Hangzhou, China
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9
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Dillon J, Bernik S, Zeizafoun N, Balija T. Benign phyllodes tumour in a transgender woman receiving hormonal therapy. BMJ Case Rep 2024; 17:e258616. [PMID: 38453219 PMCID: PMC10921526 DOI: 10.1136/bcr-2023-258616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
We present a case of a transwoman taking hormonal feminisation therapy for over 20 years, who underwent surgical excision of a benign phyllodes tumour of the breast. Hormones progesterone and oestrogen act on breast epithelium to increase proliferation. For ciswomen, endogenous and exogenous oestrogen exposure over a lifetime is associated with increased risk for certain benign and malignant breast pathologies. Transwomen taking hormonal therapy may also be at an increased risk of breast disease.
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Affiliation(s)
| | - Stephanie Bernik
- Breast Surgery, The Mount Sinai Hospital, New York, New York, USA
| | | | - Tara Balija
- Breast Surgery, The Mount Sinai Hospital, New York, New York, USA
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10
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Pleasant V. A Public Health Emergency: Breast Cancer Among Black Communities in the United States. Obstet Gynecol Clin North Am 2024; 51:69-103. [PMID: 38267132 DOI: 10.1016/j.ogc.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
While Black people have a similar incidence of breast cancer compared to White people, they have a 40% increased death rate. Black people are more likely to be diagnosed with aggressive subtypes such as triple-negative breast cancer. However, despite biological factors, systemic racism and social determinants of health create delays in care and barriers to treatment. While genetic testing holds incredible promise for Black people, uptake remains low and results may be challenging to interpret. There is a need for more robust, multidisciplinary, and antiracist interventions to reverse breast cancer-related racial disparities.
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Affiliation(s)
- Versha Pleasant
- Department of Obstetrics and Gynecology, Cancer Genetics & Breast Health Clinic, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
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Shang Q, Feng K, Wei Y, Wang K, Yang C, Zhao S, Liu J, Meng X, Li Y, Du C, Wang J, Qiao G, Li J, Wang X, Wang X. Evaluation of Male Breast Cancer and the Application of Sentinel Lymph Node Biopsy: A Multicenter Retrospective Study. Oncologist 2023; 28:e1170-e1178. [PMID: 37399228 PMCID: PMC10712710 DOI: 10.1093/oncolo/oyad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/27/2023] [Indexed: 07/05/2023] Open
Abstract
Sentinel lymph node biopsy (SLNB) is currently used as a routine treatment for patients with breast cancer. However, it may not be applicable for patients with male breast cancer (MBC), because they have notably different clinicopathological features from those occurring in females. There is a lack of evidence of SLNB application and safe exemption from axillary lymph node dissection (ALND) in patients with MBC. This study aimed to evaluate the application of SLNB to provide information for the standardized treatment of patients with MBC. The MBC patient records from 4 institutions ranging from January 2001 to November 2020 were retrospectively reviewed. There were 220 patients with MBC with a median age of 60 (range 24-88) years and an average tumor size of 2.3 cm (range 0.5 cm-6.5 cm). Sixty-six percent of patients underwent SLNB, and 39% of them showed positive results. A total of 157 patients underwent ALND, while only half of them had positive nodes, causing unnecessary complications. For patients in the clinical early stage, we found that the SLNB showed a noninferiority to the ALND treatment in DFS (P = .18) and OS (P = .055). In conclusion, there are certain obstacles to the broad application of SLNB due to the lower proportion of patients with clinically negative lymph nodes. However, it is undeniable that SLNB can safely and effectively exempt patients with MBC at early stage with clinically negative nodes from ALND to reduce subsequent complications. It is still an ideal criterion for the axillary staging of patients with MBC.
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Affiliation(s)
- Qingyao Shang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Kexin Feng
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Ya Wei
- Department of Breast Surgery, Anyang Cancer Hospital, Henan, People’s Republic of China
| | - Kaipeng Wang
- Department of Medical Record, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Chenxuan Yang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Shuangtao Zhao
- Department of Thoracic Surgery, Beijing Tuberculosis and Thoracic Tumor Research Institute/Beijing Chest Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jiaxiang Liu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Xiangzhi Meng
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yalun Li
- Department of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People’s Republic of China
| | - Chuang Du
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Jing Wang
- Department of Breast Surgery, Anyang Cancer Hospital, Henan, People’s Republic of China
| | - Guangdong Qiao
- Department of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People’s Republic of China
| | - Jingruo Li
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Xin Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Xiang Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Mada SR, Zay HH, Bies JJ, Massebo E, Didia C. A Rare Case of Remittent Male Invasive Ductal Carcinoma With New Metastasis After Incomplete Adjuvant Therapy. Cureus 2023; 15:e50400. [PMID: 38213367 PMCID: PMC10783793 DOI: 10.7759/cureus.50400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
Breast cancer is a rare disease in men with many barriers to effective management such as limited research and treatment modalities. While the current standard of care utilizes mastectomy and axillary dissection with chemotherapy, clinicians must follow the female-staged breast cancer protocol, as there is no established regimen for men. In this case presentation, we report a 43-year-old male with a prior history of ER-positive invasive ductal carcinoma (IDC) who presented with a recurrent breast lesion. The patient had previously undergone left breast mastectomy with sentinel node biopsy with negative margins. The patient declined adjuvant chemotherapy and tamoxifen therapy after the initial dissection. Three years after the primary dissection, the patient presents with a breast lesion and metastasis to bilateral axillary lymph nodes, lungs, and spine. The diagnosis was supported by a right axillary biopsy which revealed an ER-positive and PR-positive lesion. We want to shed light on the importance of complete and thorough treatment of primary IDC in men while highlighting the implications of incomplete treatment. We hope that this clinical case will serve as a guide for physicians in promoting adjuvant treatments after primary tumor removal in male IDC.
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Affiliation(s)
- Sanjana R Mada
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Hein H Zay
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Jared J Bies
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Eyoab Massebo
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Claudia Didia
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
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Sartoretti E, Largiadèr S, Sartoretti T, Laures S, Walter MA, Monti E, Füchsel I, Dettling M, Pfister S, Dubsky P, Ort A, Sartoretti-Schefer S, Meissnitzer M, Hergan K, Forstner R, Matoori S, Bech- Hohenberger R, Froehlich JM, Plümecke T, Harder D, Koh DM, Gutzeit A. Understanding the needs of women undergoing breast ultrasound: Are male radiologists still needed? PLoS One 2023; 18:e0291007. [PMID: 37939048 PMCID: PMC10631629 DOI: 10.1371/journal.pone.0291007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/21/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION A trend towards less male radiologists specializing in breast ultrasound was observed. A common notion in the field of breast radiology is, that female patients feel more comfortable being treated by female radiologists. The aim of the study was to understand and report the needs of women undergoing breast ultrasound with regards to the sex of the radiologist performing the investigation. METHODS Informed consent was obtained from all patients prior to inclusion in a prospective bi-center quality study. At center 1 (72 patients), the women were examined exclusively by female radiologists, at center 2 (100 patients) only by male radiologists. After the examination the patients were asked about their experiences and their wishes for the future. RESULTS Overall, women made no distinction between female and male radiologists; 25% of them wanted a female radiologist and 1.2% wanted a male radiologist. The majority (74%) stated that it made no difference whether a female or male radiologist performed the examination. The majority of women in group 2, who were investigated exclusively by male radiologists, stated that they had no preferences with regard to the sex of the radiologist (93%); 5% of the women wished to be investigated solely by a female radiologist and 2% exclusively by a male radiologist. DISCUSSION The majority of women undergoing breast ultrasound are unconcerned about the radiologist's sex. It would appear that women examined by male radiologists are less selective about the sex of the examining radiologist. TRIAL REGISTRATION Written informed consent was obtained from all patients. All patient data were anonymized. The physicians had no access to any further personal data. National regulations did not require dedicated ethics approval with anonymized lists or retrospective questionnaires.
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Affiliation(s)
- Elisabeth Sartoretti
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Selina Largiadèr
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Thomas Sartoretti
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Simin Laures
- Institute of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Martin Alexander Walter
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Institute of Radiology and Nuclear Medicine, Hirslanden Klinik St. Anna, Lucerne, Switzerland
| | - Eva Monti
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Ina Füchsel
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Mira Dettling
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Stephan Pfister
- Institute of Radiology and Nuclear Medicine, Hirslanden Klinik St. Anna, Lucerne, Switzerland
| | - Peter Dubsky
- St. Anna Breast Center, Hirslanden Klinik St. Anna, Lucerne, Switzerland
| | - Alexander Ort
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Matthias Meissnitzer
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Klaus Hergan
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Rosemarie Forstner
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Simon Matoori
- Faculté de Pharmacie, Université de Montréal, Montréal, Canada
| | | | - John M. Froehlich
- Institute of Radiology and Nuclear Medicine, Hirslanden Klinik St. Anna, Lucerne, Switzerland
| | - Tino Plümecke
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Dorothee Harder
- Department of Radiology, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Dow Mu Koh
- Department of Radiology, Royal Marsden Hospital, Surrey, United Kingdom
| | - Andreas Gutzeit
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Institute of Radiology and Nuclear Medicine, Hirslanden Klinik St. Anna, Lucerne, Switzerland
- St. Anna Breast Center, Hirslanden Klinik St. Anna, Lucerne, Switzerland
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
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14
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Phillips L, Lundholm C, Almqvist C, Skarin Nordenvall A, Nordenskjöld A. Risk of Urological Cancer Among Boys and Men Born with Hypospadias: A Swedish Population-based Study. EUR UROL SUPPL 2023; 57:51-59. [PMID: 38020521 PMCID: PMC10658418 DOI: 10.1016/j.euros.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Hypospadias is a common genital malformation among boys. Studies indicate that hypospadias is associated with a higher risk of testicular cancer. Other forms of urological cancer may be linked to hypospadias via a mutual aetiology, hormonal dysfunction, or hypospadias complications, but this has not yet been studied. Objective To investigate the association between hypospadias and testicular cancer and the risk of other urological cancers among individuals born with hypospadias. Design setting and participants The study used a population-based male cohort born in Sweden in 1964-2018. Exposure was hypospadias diagnosis in national registers. Outcomes were defined using the Swedish Cancer Register. An extended cohort born from 1940 was used to study cancers among older men. Biological brothers and fathers were linked to investigate familial coaggregation. Outcome measurements and statistical analysis Associations were assessed using Cox proportional-hazards regression analysis, with results presented as hazard ratios. Results and limitations We found that hypospadias was associated with a higher risk of testicular cancer (hazard ratio 2.04, 95% confidence interval 1.42-2.92), especially for proximal hypospadias, but did not observe any clear familial coaggregation of hypospadias and testicular cancer. Hypospadias was associated with Wilms' tumour in childhood. We also found an association between hypospadias and bladder and urethral cancers, but not prostate cancer. The number of cases with hypospadias was small and the results for cancers among older men may be impacted by limitations in register coverage. Conclusions Our study supports the hypothesis of a higher risk of testicular cancer for men with hypospadias, especially with proximal phenotypes. Hypospadias may also be associated with a higher risk of lower urinary tract cancers, although this requires further investigation in older cohorts. Patient summary Boys and men in whom the opening of the urethra is not at the end of the penis (called hypospadias) at birth are at higher risk of developing testicular cancer, although their overall risk is still low. They may also have a higher risk of developing other forms of cancer in the urinary tract.
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Affiliation(s)
- Lottie Phillips
- Department of Women’s and Children’s Health and Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Lundholm
- Deparment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Deparment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Skarin Nordenvall
- Deparment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Nordenskjöld
- Department of Women’s and Children’s Health and Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Surgery, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
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15
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Oliveira MJ, Costa S, Magalhães A, Garrido L, Peleteiro B, Fougo JL, Castedo S. A comprehensive study on surveillance outcomes of a male population followed at a hereditary breast cancer high-risk consultation at a Portuguese tertiary hospital. J Cancer Res Clin Oncol 2023; 149:11145-11156. [PMID: 37347260 PMCID: PMC10465621 DOI: 10.1007/s00432-023-04994-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/15/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION Men born with pathogenic/likely pathogenic variants in genes associated with the Hereditary Breast and Ovarian Cancer Syndrome have a higher risk to develop breast cancer and other cancers (such as prostate cancer) and should undergo adequate surveillance protocols in highly specialized Centers. METHODS A retrospective study was conducted to assess these genetic variants' epidemiological and phenotypical manifestations in male carriers, as well as the efficacy of the surveillance protocol and compliance toward it through a survey. During follow-up, a genetic panel for testing was implemented, the starting age for surveillance was delayed, and the six-month screening interval was extended to annual. RESULTS A total of 104 men from a tertiary hospital's High-Risk Consultation were included, 102 with positive genetic testing for BRCA1 (n = 31), BRCA2 (n = 55), both BRCA2 and another gene (n = 5), CDH1 (n = 2), CHEK2 (n = 4), NF1 (n = 1), RAD51C (n = 4), and an additional two men with no actionable genetic variant identified. The follow-up period ranged from 1 to 13 years, and only one man developed cancer. Survey responses from 48 men in active surveillance showed that more than half recognizes their carrier status and consequent surveillance impact on their life, including the risk of transmission to offspring, fear of future cancer, meaningful distress, and feeling of injustice. Biannual surveillance was not actively detecting more cancer disease cases, confirming the adequacy of the currently implemented protocol CONCLUSION: With support of Genetics to fulfill the current gaps in high-risk management, the proposed redefinition of surveillance protocol would adapt it to the population needs and concerns.
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Affiliation(s)
- Maria João Oliveira
- Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Susy Costa
- Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- Surgery Department, Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - André Magalhães
- Surgery Department, Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Luzia Garrido
- Medical Genetics Service and Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Bárbara Peleteiro
- Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- Surgery Department, Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
- Institute of Public Health, EPI Unit, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translation Research in Population Health, University of Porto, Porto, Portugal
| | - José Luís Fougo
- Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- Surgery Department, Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sérgio Castedo
- Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- Medical Genetics Service, Centro Hospitalar Universitário de São João, Porto, Portugal
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
- i3S - Institute for Research and Inovation in Health, Porto, Portugal
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Sun Q, Liu XY, Zhang Q, Jiang H. Non-retroareolar male mucinous breast cancer without gynecomastia development in an elderly man: A case report. World J Clin Cases 2023; 11:5954-5961. [PMID: 37727495 PMCID: PMC10506025 DOI: 10.12998/wjcc.v11.i25.5954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/30/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Male breast cancer (MBC) is an extremely rare condition and accounts for less than 1% of all breast cancers, and malignant tumors occur in less than 1% of the affected men. Mucinous breast cancer is extremely rare and accounts for 2% of all invasive breast cancers. Generally, MBC is accompanied by a retroareolar mass. CASE SUMMARY Herein, we report a case of male mucinous breast carcinoma (MMBC) without gynecomastia development and with mass localization outside the common retroareolar region, wherein the mass was a painless nodule in the right breast of a 64-year-old man. We also discuss the clinical and pathological characteristics of this unusual tumor. The excised breast specimen showed pure mucinous carcinoma. The patient had strong expression of estrogen and progesterone receptors, a low Ki-67 proliferation index of the tumor cells, and negative pathological axillary lymph nodes. The patient underwent modified radical mastectomy and axillary lymph node dissection, followed by tamoxifen hormone therapy. CONCLUSION To the best of our knowledge, this is the first case report of MMBC in the non-retroareolar region of the nipple without gynecomastia development. Mucinous tumors are easily missed during diagnosis, and the incidence of axillary lymph node metastases of chest mucinous tumors has increased.
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Affiliation(s)
- Qiang Sun
- Department of Breast Surgery, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi 117000, Liaoning Province, China
| | - Xu-Yan Liu
- Department of Pathology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi 117000, Liaoning Province, China
| | - Qi Zhang
- Department of Breast Surgery, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi 117000, Liaoning Province, China
| | - Hai Jiang
- Department of Breast Surgery, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi 117000, Liaoning Province, China
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do Nascimento JHF, da Silva CN, Gusmão-Cunha A, Neto MMS, de Andrade AB. Effects of the COVID-19 pandemic on delays in diagnosis-to-treatment initiation for breast cancer in Brazil: a nationwide study. Ecancermedicalscience 2023; 17:1570. [PMID: 37533939 PMCID: PMC10393311 DOI: 10.3332/ecancer.2023.1570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Indexed: 08/04/2023] Open
Abstract
Background Short period from diagnosis to breast cancer (BC) treatment initiation remains challenging for the public health system in Brazil, which may have been further affected by the coronavirus disease-2019 (COVID-19) pandemic. This study assessed BC diagnosis-to-treatment intervals (DTi) in Brazil and the possible effects of the COVID-19 outbreak on delays. Methods The Painel de Monitoramento de Tratamento Oncológico database was queried to obtain the number of Brazilian patients with a BC confirmed diagnosis and initiating cancer treatment in the pre-COVID-19 (2013-2019) and during the COVID-19 (2020-2021) periods, adopting a 60-day limit as timely treatment. A p-value of <0.05 was considered significant. Results A total of 315,951 cases were included (females: 99.3% and males: 0.7%), of which 251,667 and 64,284 records were computed before and during the COVID-19 years, respectively. Most patients failed to perform the first cancer treatment within 60 days (>60: 51.8%). We observed an upward trend in the number of BC treatments provided in the pre-COVID-19 years (r2 = 0.9575; p < 0.05), but the volume of treatments exhibited an average reduction of 24.6% yearly during the COVID-19 pandemic. The average DTi in days was 122.4, 122.5 and 122.3 in the total period studied, before and during the COVID-19 outbreak, respectively. The arrival of COVID-19 in Brazil increased the chances of treatment delay (OR = 1.043; p < 0.05) and inverted the proportion of early/advanced stages at BC diagnosis (55.8%/44.2%-48.4%/51.6%). Conclusion COVID-19 has imposed changes in BC care in Brazil, reducing the number of treatments provided by the Brazilian public health system, increasing the chances of delayed treatment initiation despite no differences in DTi averages being identified, and raising the proportion of advanced-stage diagnoses.
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Affiliation(s)
| | - Cleonice Nascimento da Silva
- Life Sciences Department, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Brazil
- https://orcid.org/0000-0002-8356-6426
| | - André Gusmão-Cunha
- Life Sciences Department, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Brazil
- Anesthesiology and Surgery Department, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Brazil
- https://orcid.org/0000-0001-7762-168X
| | - Marinho Marques Silva Neto
- Life Sciences Department, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Brazil
- https://orcid.org/0000-0002-9728-7268
| | - André Bouzas de Andrade
- Life Sciences Department, Universidade do Estado da Bahia (UNEB), Salvador 41150-000, Brazil
- Hospital Santa Izabel (HSI), Bahia Cancer Institute, Salvador 40050-410, Brazil
- https://orcid.org/0000-0002-4010-0415
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18
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Kour A, Sharma S, Sambyal V, Guleria K, Singh NR, Uppal MS, Manjari M, Sudan M. Copy number variations in male breast cancer. J Cancer Res Ther 2023; 19:1415-1418. [PMID: 37787318 DOI: 10.4103/jcrt.jcrt_208_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Common copy number variations often contain cancer-related genes and are likely to play a role in carcinogenesis. Different mechanisms of tumorigenesis are suggested in female and male breast cancer because of different molecular profiles. The cytogenetic analysis of GTG-banded chromosomes was performed in six male patients with infiltrating ductal carcinoma and six healthy male controls matched for age. Single-nucleotide polymorphism (SNP) array analysis was performed in male breast cancer (MBC) patients. Cytogenetic analysis found aberrations previously implicated in cancer. SNP array analysis in patients revealed a gain of Xp11.23, 8p23.2, Yq11.221, Yq11.3 (AZF region), 12p11.21, 18q12.1, and 17q21.3; a loss of Yq11.222 and 7q11.21; and a loss of heterozygosity of 4p16.3, 6p12.3, 6p22.2-p21.31, 7p14.2-14.1, 18q11.2-q12.1, 20p11.23-11.1, 20q11.21-11.23, 1q25.2-q25.3, 2q11.1-q11.2, 5q23.1-23.2, 11p15.4-15.3, and 22q13.1-13.31. Some of these variations, especially those of the Y-chromosome, have not been reported earlier. Chromosomal loci identified by SNP array harbor genes were reported to be associated with cancer progression and metastasis, indicating their involvement in MBC also.
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Affiliation(s)
- Akeen Kour
- Department of Human Genetics, Human Cytogenetics Laboratory, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Sarika Sharma
- Department of Human Genetics, Human Cytogenetics Laboratory, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Vasudha Sambyal
- Department of Human Genetics, Human Cytogenetics Laboratory, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Kamlesh Guleria
- Department of Human Genetics, Human Cytogenetics Laboratory, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Neeti R Singh
- Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Manjit S Uppal
- Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Mridu Manjari
- Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Meena Sudan
- Department of Radiotherapy, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
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19
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Clinicopathological features, genetic alterations, and BRCA1 promoter methylation in Japanese male patients with breast cancer. Breast Cancer Res Treat 2023; 197:593-602. [PMID: 36494460 PMCID: PMC9883318 DOI: 10.1007/s10549-022-06822-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Male breast cancer (MBC) is a rare cancer accounting for only 1% of all male cancers and is, therefore, poorly studied. We aimed to characterize the subtypes of MBC in Japanese patients based on genetic profiling, the presence of tumor-infiltrating cells, and the expression of immunohistochemical markers. METHODS This retrospective study included 103 patients with MBC diagnosed between January 2009 and December 2019 at various hospitals in Japan. Clinicopathological patient characteristics were obtained from medical records, and formalin-fixed paraffin-embedded tissue specimens were analyzed for histological markers, mutations of 126 genes, BRCA1 methylation, and stromal tumor-infiltrating lymphocytes. RESULTS The median patient age was 71 (range 31-92) years. T1-stage tumors were the most frequent (47.6%), and most were node negative (77.7%). The majority of tumors were positive for estrogen receptor (98.1%), progesterone receptor (95.1%), and androgen receptor (96.1%), and BRCA2 was the most frequently mutated gene (12.6%). The most common treatment was surgery (99.0%), either total mastectomy (91.1%) or partial mastectomy (7.0%). Survival analysis showed a 5-year recurrence-free survival rate of 64.4% (95% confidence interval [CI] 46.7-88.8) and a 5-year overall survival rate of 54.3% (95% CI 24.1-100.0). CONCLUSION Japanese MBC is characterized by a high rate of hormonal receptor positivity and BRCA2 somatic mutation. Due to the observed clinicopathological differences in MBC between the Western countries and Japan, further prospective studies are needed to evaluate the most suitable treatment strategies.
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Xin Y, Wang F, Ren D, Zhao F, Zhao J. Male Breast Cancer: Three Case Reports and a Literature Review. Anticancer Agents Med Chem 2023; 23:2161-2169. [PMID: 37605409 DOI: 10.2174/1871520623666230821124008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/01/2023] [Accepted: 07/24/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Male breast cancer (MBC) accounts for 0.5%-1% of all breast cancers diagnosed worldwide. However, its biological characteristics can be distinguished from that of female breast cancer (FBC). CASE REPRESENTATION The diagnostic and treatment approaches for MBC are mainly similar to that of FBC due to the lack of male breast cancer-related studies, clinical trials, and literature. An increasing number of retrospective and prospective studies have been conducted to clarify the individualized care for MBC. Herein, we report three cases of advanced MBC to describe the diagnostic approaches, treatment process, and survival prognosis. CONCLUSION MBC patients had older age, later stage at first diagnosis, higher expression of hormone receptors, and poor prognosis. A literature review was conducted to determine the incidence, risk factors, disease features, diagnosis, treatment, survival, and management of MBC.
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Affiliation(s)
- Yuanfang Xin
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Fengmei Wang
- Pathology Department of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Dengfeng Ren
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Fuxing Zhao
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
| | - Jiuda Zhao
- Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China
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21
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Scagliotti MF, Boietti BR, Knoblovits P. Prevalence of men's health history in male breast cancer patients. ENDOCRINOLOGIA, DIABETES Y NUTRICION 2022:S2530-0180(22)00242-6. [PMID: 36509663 DOI: 10.1016/j.endien.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/08/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Male breast carcinoma (MBC) is an uncommon disease, accounting for less than 0.5% of cancer diagnoses in men. Data on the prevalence thereof in Argentina are unknown. PRIMARY OBJECTIVE To estimate the prevalence of a men's health history associated with MBC as well as the anthropometric and clinical characteristics of the study population. METHODS This cross-sectional study included all men according to original biological sex over 18 years of age with a history of breast cancer who sought care at the Hospital Italiano de Buenos Aires [Italian Hospital of Buenos Aires] between January 2010 and December 2018. RESULTS We included 57 men with breast cancer. Their median age was 71 years. Of them, 53.06% had obesity and 24.53% had diabetes. With respect to men's health history, 5.56% (2/36) had infertility, 29.17% (14/48) had gynaecomastia and 60.71% (17/28) had sexual dysfunction. Some 63% (7/11) had androgen deficiency based on laboratory diagnosis; of them, 45.45% (5/11) had high gonadotropins. CONCLUSION We identified similarities with the literature as to the prevalence of obesity, diabetes and infertility in patients with MBC. The prevalence of testosterone deficiency was higher than reported for men of the same age. Many of these factors support the need to examine the role of endogenous hormones. Further research is required to help physicians care for and counsel men at higher risk of this disease.
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Affiliation(s)
- Maria Florencia Scagliotti
- Servicio de Endocrinología y Metabolismo, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Bruno Rafael Boietti
- Área de Investigación Medicina Interna, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Pablo Knoblovits
- Servicio de Endocrinología y Metabolismo, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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22
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Prognostic relevance of mixed histological subtypes in invasive breast carcinoma: a retrospective analysis. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04443-x. [DOI: 10.1007/s00432-022-04443-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
Abstract
Purpose
The prognostic and therapeutic power of special histological subtypes in breast cancer in pure form or in combination with other histological subtypes is still not established, and diagnostic guidelines are cautious regarding prognostic power based on the histological subtype alone. Therapy decisions are guided in most cases independently of the histological subtype and are directed by biomarkers and tumor stage. In this study, we analyzed a comprehensive large retrospective breast cancer cohort with a special focus on histological subtype (other than ductal non-special type or lobular carcinoma) and correlated pure or mixed histological forms with pathological tumor stage and overall disease-free survival.
Materials and methods
A total of 827 breast cancer cases with pure or mixed special histological types were retrospectively analyzed. Survival information was available in 645 of 827 cases.
Results
A total of 293 cases had pure forms, and 534 cases had mixed histological subtypes. The most common pure special types were mucinous (23.9%), micropapillary (21.2%), high-grade metaplastic (13%), male breast cancer (8.2%), cribriform (6.8%), metastases (6.1%), apocrine and papillary (each 5.46%), NST with medullary and clear cell pattern (up to 3.4%) and high-grade neuroendocrine carcinomas (2.7%). Mixed forms were most frequently encountered in NST carcinomas with micropapillary components (41.8%), followed by mucinous (9.93%) and cribriform (6.74%) mixed patterns. In univariate analysis, no pure form had prognostic relevance compared with any mixed form with the basic pure element. Pooling pure histological subtypes with tumor stage and age in a linear random-effects model, the cribriform subtype had the most favorable prognosis, while male breast cancer showed the poorest outcome (p < 0.001). All other frequent pure forms had intermediate prognostic power (p < 0.001).
Conclusion
Our results show that the analyzed special histological breast cancer subtypes (other than ductal and lobular carcinomas) do not carry prognostic information alone, either in pure form or in any combination with other subtypes. Prognostic groups including special subtypes, however, can strongly stratify breast cancer if tumor stage, age and biomarkers are included in the prognostic measurements.
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23
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Lerttiendamrong B, Vongsaisuwon M. First report of bilateral synchronous male accessory breast cancer. BMJ Case Rep 2022; 15:e250927. [PMID: 35985745 PMCID: PMC9396125 DOI: 10.1136/bcr-2022-250927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Accessory breast occurs due to the persistence of milk line in the non-thoracic region. Malignant transformation in male accessory breast is very rare, with 16 reports documented across the world. No bilateral synchronous accessory male breast cancer has been reported. We present the first case reported globally of a man in his 70s with a complaint of left axillary lump and chronic rash for 3 years. About 1 year ago, additional reddish rash was detected in the right axilla. Initial skin biopsy from a private hospital confirmed mammary carcinoma with skin invasion. Subsequent left breast mastectomy with left axillary lymph node dissection and right wide excision was performed. Final pathological result was grade 2 invasive ductal carcinoma in the left accessory breast and Paget's disease in the contralateral axilla. Postoperative treatment of adjuvant paclitaxel and trastuzumab was prescribed, which was followed by adjuvant radiation therapy.
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Affiliation(s)
| | - Mawin Vongsaisuwon
- Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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24
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Liu PH, Wei JCC, Wang YH, Yeh MH. Female breast cancer incidence predisposing risk factors identification using nationwide big data: a matched nested case-control study in Taiwan. BMC Cancer 2022; 22:849. [PMID: 35927682 PMCID: PMC9351234 DOI: 10.1186/s12885-022-09913-6] [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: 02/19/2022] [Accepted: 07/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background Breast cancer is an umbrella term referring to a group of biologically and molecularly heterogeneous diseases originating from the breast. Globally, incidences of breast cancer has been increasing dramatically over the past decades. Analyses of multiple clinical “big data” can aid us in clarifying the means of preventing the disease. In addition, predisposing risk factors will be the most important issues if we can confirm their relevance. This study aims to provide an overview of the predisposing factors that contribute to a higher possibility of developing breast cancer and emphasize the signs that we ought to pay more attention to. Methods This is a matched nested case-control study. The cohort focused on identifying the eligible risk factors in breast cancer development by data screening (2000-2013) from the Taiwan National Health Insurance Research Database (NHIRD) under approved protocol. A total of 486,069 females were enrolled from a nationwide sampled database, and 3281 females was elligible as breast cancer cohort, 478,574 females who had never diagnosed with breast cancer from 2000 to 2013 were eligible as non-breast cancer controls, and matched to breast cancer cases according to age using a 1:6 ratio. Results We analyzed 3281 breast cancer cases and 19,686 non-breast cancer controls after an age-matched procedure. The significant predisposing factors associated with breast cancer development including obesity, hyperlipidemia, thyroid cancer and liver cancer. As for patients under the age of 55, gastric cancer does seem to have an impact on the development of breast cancer; compared with their counterparts over the age of 55, endometrial cancer appears to exhibit an evocative effect. Conclusions In this nationwide matched nested case-control study, we identified obesity, hyperlipidemia, previous cancers of the thyroid, stomach and liver as risk factors associated with breast cancer. However, the retrospective nature and limited case numbers of certain cancers still difficult to provide robust evidence. Further prospective studies are necessitated to corroborate this finding in order to nip the disease in the bud. Trial registration The studies involving human participants were reviewed and approved by the China Medical University Hospital [CMUH104-REC2-115(AR-4)]. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09913-6.
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Affiliation(s)
- Ping-Hung Liu
- Division of General Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, 81342, Taiwan.,Department of Breast and Thyroid Surgery, Chung Shan Medical University Hospital, Taichung, 404332, Taiwan
| | - James Cheng-Chung Wei
- Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, 404332, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, 404332, Taiwan
| | - Ming-Hsin Yeh
- Department of Breast and Thyroid Surgery, Chung Shan Medical University Hospital, Taichung, 404332, Taiwan.
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25
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Li J, Chen C, Nie J, Wang L, Zhang Z, Li Y. Changes in the disease burden of breast cancer along with attributable risk factors in China from 1990 to 2019 and its projections: An analysis of the global burden of disease study 2019. Cancer Med 2022; 12:1888-1902. [PMID: 35785526 PMCID: PMC9883426 DOI: 10.1002/cam4.5006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND To investigate the secular trends in breast cancer burden with attributable risk factors, and make projections over time, which would contribute to the control and prevention of breast cancer. METHODS We extracted detailed data on breast cancer incident cases and age-standardized incidence rate (ASIR), deaths and age-standardized mortality rate (ASMR), disability-adjusted life-years (DALYs), and age-standardized DALYs rate (ASDR), as well as the attributable risk factors in China from the Global Burden of Diseases Study 2019. The estimated annual percentage change (EAPC) was calculated to quantify the changing trends. The national DALYs attributable to Socio-demographic Index (SDI) values were also presented. Projections to 2030 were estimated using the Bayesian age-period-cohort model. RESULTS From 1990 to 2019, the number of breast cancer incident cases increased fourfold to 375,484, with deaths and DALYs over doubling to 96.306 and 2,957,454, respectively. The ASIR (EAPC = 2.84; 95% CI, 2.74-2.95) and ASMR (EAPC = 0.06; 95% CI, 0.00-0.12) increased, while the ASDR decreased with the EAPC of -0.13 (95% CI, -0.19 to -0.06) at the same period. The ASDR varied across provincial regions, which appeared to be in a wave-like upcurve with SDI values increasing. High body mass index became the first contribution to breast cancer DALYs for females in 2019, and alcohol use for males. Breast Cancer incident cases and deaths would increase to 587.7 and 125.6 thousand in 2030, of which there will be 577.1 and 122.7 thousand for females, and 10.6 and 2.9 thousand for males, respectively. CONCLUSION Breast cancer remains a major public health problem in China. The absolute burden has been increasing over time, and varied across sex and regions. To control the potential risk factors and develop specific strategies will help to reduce the disease burden.
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Affiliation(s)
- Jie Li
- Dongying People's HospitalDongyingPeople's Republic of China
| | - Cui Chen
- Dongying People's HospitalDongyingPeople's Republic of China
| | - Jinjin Nie
- Dongying People's HospitalDongyingPeople's Republic of China
| | - Lili Wang
- Dongying Center for Disease Control and PreventionDongyingPeople's Republic of China
| | - Zhen Zhang
- Dongying Center for Disease Control and PreventionDongyingPeople's Republic of China
| | - Yuli Li
- Dongying People's HospitalDongyingPeople's Republic of China
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An Update on the General Features of Breast Cancer in Male Patients—A Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12071554. [PMID: 35885460 PMCID: PMC9323942 DOI: 10.3390/diagnostics12071554] [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: 05/23/2022] [Revised: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022] Open
Abstract
Male breast cancers are uncommon, as men account for less than 1 percent of all breast carcinomas. Among the predisposing risk factors for male breast cancer, the following appear to be significant: (a) breast/chest radiation exposure, (b) estrogen use, diseases associated with hyper-estrogenism, such as cirrhosis or Klinefelter syndrome, and (c) family health history. Furthermore, there are clear familial tendencies, with a higher incidence among men who have a large number of female relatives with breast cancer and (d) major inheritance susceptibility. Moreover, in families with BRCA mutations, there is an increased risk of male breast cancer, although the risk appears to be greater with inherited BRCA2 mutations than with inherited BRCA1 mutations. Due to diagnostic delays, male breast cancer is more likely to present at an advanced stage. A core biopsy or a fine needle aspiration must be performed to confirm suspicious findings. Infiltrating ductal cancer is the most prevalent form of male breast cancer, while invasive lobular carcinoma is extremely uncommon. Male breast cancer is almost always positive for hormone receptors. A worse prognosis is associated with a more advanced stage at diagnosis for men with breast cancer. Randomized controlled trials which recruit both female and male patients should be developed in order to gain more consistent data on the optimal clinical approach.
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27
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Profile of Male Breast Cancer in Makkah Region of Saudi Arabia: A 4-Year Retrospective Analysis of Radiology and Histopathology. Int J Breast Cancer 2022; 2022:8831011. [PMID: 35784659 PMCID: PMC9242822 DOI: 10.1155/2022/8831011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 05/08/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mammography is a method widely used for the diagnosis of breast disorders in women and may help detect breast cancer in its early stages. Male breast cancer often remains undiagnosed or is poorly controlled until serious complications arise; therefore, the use of screening methods is needed to help with early diagnosis. Methods From a total of 1,667 registered mammography cases screened, 17 male breast disease cases were included in this study. Mammography and ultrasound data were analyzed by Statistical Package of Social Sciences v.22 (SPSS). Diagnosis was made following biopsy in suspicious cases, and histopathological and immunological findings of all such patients were obtained for final diagnosis. Results The mean age of the patients was 35 years (range, 14-70 years); 17.6% of the cases were aged 37 yrs, and 2 cases were aged 51 and 52 yrs. Of the 17 cases, 11 had breast lesions, and skin thickening was observed in only 1 case. The different patterns of lesions detected were asymmetry of the parenchyma, mastitis, and hamartoma (n = 1 each), malignant lesions (n = 2), and gynecomastia (n = 6). According to the BI-RADS categorization, 8 cases were benign, one case was probably benign, and 2 cases were likely malignant. In the 2 cases with malignant lesions, pathological diagnosis was made after hematoxylin and eosin and immunocytochemistry examination as invasive ductal carcinoma (IDC) of no special type (NST), grade II and grade III. Conclusions Most breast lesions in this study population were benign, while IDC was the most common malignancy encountered. Mammography is currently the most accurate and cost-effective method for detecting breast lesions. The findings of our study may help increase awareness of male breast cancer and encourage Saudi men at risk to perform self-breast exam and undergo routine breast screening.
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Rutherford CL, Goodman D, Lannigan A. A systematic literature review of the management, oncological outcomes and psychosocial implications of male breast cancer. Eur J Surg Oncol 2022; 48:2104-2111. [PMID: 35725681 DOI: 10.1016/j.ejso.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/09/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although male breast cancer (MBC) is a rare disease, accounting for <1% of all breast cancers, it has significant oncological, survival and psychosocial implications for patients. The aim of this study is to assess the latest literature in the diagnosis, management, oncological outcomes, and psychosocial impact of MBC. METHODS A systematic literature review was conducted using the PRISMA guidelines (Moher et al., 2009) [1] to explore the management of MBC, with particular focus on investigative imaging, surgical management, oncological outcomes, survival, genetic screening and psychosocial effects. Electronic databases were searched for randomised control trials, cohort studies and case series involving more than 10 patients. Imaging and surgical techniques, local and distant disease recurrence, survival, genetic screening and psychosocial implications in the setting of MBC were assessed. RESULTS The search criteria identified 199 articles, of which 59 met the inclusion criteria. This included 39,529 patients, with a mean age of 64.5 years (55-71), and a mean follow-up of 66.3 months (26.2-115). Mastectomy remains the most frequently used surgical technique, with an average of 89.6%. Loco-regional and distant recurrence rate was 10.1% and 21.4% respectively. Disease-free survival (DFS) at 5 and 10 years was 66.8% and 54.5% respectively. Disease-specific survival (DSS) at 5 and 10 years was 87.1% and 67.1% respectively. Overall survival (OS) at 5 and 10 years was 72.7% and 50.7% respectively. Genetic screening was conducted in 38.6% of patients of which 4.8% and 15.8% were found to be BRCA1 and BRCA2 carriers respectively. Psychosocial studies were conducted mainly using questionnaire and interview-based methodology focusing primarily on awareness of breast cancer in men, support available and impact on gender identity. CONCLUSIONS This review demonstrates that men present with later stage disease with subsequent impact on survival outcomes. There remains a paucity of high-level evidence and prospective studies are required. There is a need for increasing awareness amongst the public and health care professionals in order to improve outcomes and reduce stigma associated with MBC.
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Affiliation(s)
| | - D Goodman
- National University of Ireland Galway, Ireland
| | - A Lannigan
- University Hospital Wishaw, United Kingdom
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29
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Scagliotti MF, Boietti BR, Knoblovits P. Prevalencia de antecedentes andrológicos en pacientes con cáncer de mama masculino. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Herring B, Lewis-Smith H, Paraskeva N, Harcourt D. Exploring the experiences and psychosocial support needs of informal carers of men with breast cancer: a qualitative study. Support Care Cancer 2022; 30:6669-6676. [PMID: 35508668 PMCID: PMC9067554 DOI: 10.1007/s00520-022-07095-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/25/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE The provision of practical and emotional support for men who have been diagnosed with breast cancer in the UK falls primarily on their partners, close family members or friends. However, informal carers' experiences are omitted from the research literature. Therefore, the present study aimed to explore the care-giving experiences of informal carers (ICs) of men with breast cancer in the UK and identify psychosocial support needs and preferences. METHODS Semi-structured interviews, conducted on the telephone or via online video calls, explored ICs' experiences of providing support, the psychosocial issues they faced and the impact of the illness on themselves and their relationship with the patient. They were also asked about any support previously offered to them, in addition to their support preferences. Twelve ICs participated (11 females, 1 male), and 9 were spouses. Interview transcripts were analysed with reflexive thematic analysis using NVIVO software. RESULTS Four key themes were identified: "The impact of caring", "Lack of awareness", "Isolated and alone" and "Making a difference". CONCLUSIONS The physical, emotional, financial and social impact of providing emotional and practical care and support for a man diagnosed with breast cancer can be considerable. ICs may experience significant levels of distress and often feel isolated. Greater awareness and more research is needed to better understand the psychosocial impact and support needs for ICs of men with breast cancer. There is an evident necessity to address their information needs and offer sources of support throughout the cancer journey.
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Affiliation(s)
- Beth Herring
- Centre for Appearance Research, Faculty of Health & Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK.
| | - Helena Lewis-Smith
- Centre for Appearance Research, Faculty of Health & Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
| | - Nicole Paraskeva
- Centre for Appearance Research, Faculty of Health & Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
| | - Diana Harcourt
- Centre for Appearance Research, Faculty of Health & Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
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Pollap A, Świt P. Recent Advances in Sandwich SERS Immunosensors for Cancer Detection. Int J Mol Sci 2022; 23:ijms23094740. [PMID: 35563131 PMCID: PMC9105793 DOI: 10.3390/ijms23094740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/18/2022] [Accepted: 04/22/2022] [Indexed: 12/04/2022] Open
Abstract
Cancer has been one of the most prevalent diseases around the world for many years. Its biomarkers are biological molecules found in the blood or other body fluids of people with cancer diseases. These biomarkers play a crucial role not only in the diagnosis of cancer diseases, but also in risk assessment, selection of treatment methods, and tracking its progress. Therefore, highly sensitive and selective detection and determination of cancer biomarkers are essential from the perspective of oncological diagnostics and planning the treatment process. Immunosensors are special types of biosensors that are based on the recognition of an analyte (antigen) by an antibody. Sandwich immunosensors apply two antibodies: a capture antibody and a detection antibody, with the antigen ‘sandwiched’ between them. Immunosensors’ advantages include not only high sensitivity and selectivity, but also flexible application and reusability. Surface-enhanced Raman spectroscopy, known also as the sensitive and selective method, uses the enhancement of light scattering by analyte molecules adsorbed on a nanostructured surface. The combination of immunosensors with the SERS technique further improves their analytical parameters. In this article, we followed the recent achievements in the field of sandwich SERS immunosensors for cancer biomarker detection and/or determination.
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Affiliation(s)
| | - Paweł Świt
- Institute of Chemistry, Faculty of Science and Technology, University of Silesia in Katowice, 9 Szkolna Street, 40-006 Katowice, Poland
- Correspondence:
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32
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Zhanghuang C, Wang J, Yao Z, Li L, Xie Y, Tang H, Zhang K, Wu C, Yang Z, Yan B. Development and Validation of a Nomogram to Predict Cancer-Specific Survival in Elderly Patients With Papillary Renal Cell Carcinoma. Front Public Health 2022; 10:874427. [PMID: 35444972 PMCID: PMC9015096 DOI: 10.3389/fpubh.2022.874427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/14/2022] [Indexed: 12/29/2022] Open
Abstract
Objective Papillary renal cell carcinoma (pRCC) is the second most common type of renal cell carcinoma and an important disease affecting older patients. We aimed to establish a nomogram to predict cancer-specific survival (CSS) in elderly patients with pRCC. Methods Patient information was downloaded from the Surveillance, Epidemiology, and End Results (SEER) project, and we included all elderly patients with pRCC from 2004 to 2018. All patients were randomly divided into a training cohort and a validation cohort. Univariate and multivariate Cox proportional risk regression models were used to identify patient independent risk factors. We constructed a nomogram based on a multivariate Cox regression model to predict CSS for 1-, 3-, and 5- years in elderly patients with pRCC. A series of validation methods were used to validate the accuracy and reliability of the model, including consistency index (C-index), calibration curve, and area under the Subject operating curve (AUC). Results A total of 13,105 elderly patients with pRCC were enrolled. Univariate and multivariate Cox regression analysis suggested that age, tumor size, histological grade, TNM stage, surgery, radiotherapy and chemotherapy were independent risk factors for survival. We constructed a nomogram to predict patients' CSS. The training and validation cohort's C-index were 0.853 (95%CI: 0.859–0.847) and 0.855 (95%CI: 0.865–0.845), respectively, suggesting that the model had good discrimination ability. The AUC showed the same results. The calibration curve also indicates that the model has good accuracy. Conclusions In this study, we constructed a nomogram to predict the CSS of elderly pRCC patients, which has good accuracy and reliability and can help doctors and patients make clinical decisions.
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Affiliation(s)
- Chenghao Zhanghuang
- Department of Urology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China.,Department of Urology, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Jinkui Wang
- Department of Urology, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Zhigang Yao
- Department of Urology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Li Li
- Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Yucheng Xie
- Department of Pathology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Haoyu Tang
- Department of Urology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Kun Zhang
- Department of Urology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Chengchuang Wu
- Department of Urology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Zhen Yang
- Department of Oncology, Yunnan Children Solid Tumor Treatment Center, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Bing Yan
- Department of Urology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China.,Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
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Dondi F, Albano D, Giubbini R, Bertagna F. 18F-FDG PET/CT for the evaluation of male breast cancer: a systematic review. Nucl Med Commun 2022; 43:123-128. [PMID: 34783719 DOI: 10.1097/mnm.0000000000001508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the last years, some studies on the usefulness of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) for the evaluation of male breast cancer (MBC) have been produced. The aim of this review is to analyze the usefulness of 18F-FDG PET/CT and its diagnostic performances for the assessment of MBC. METHODS A wide literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane library databases was made to find relevant published articles on the role of 18F-FDG PET/CT for the evaluation of MBC. Moreover, quality assessment including the risk of bias and applicability concerns was carried out using QUADAS-2 evaluation. RESULTS The comprehensive computer literature search revealed 3178 articles. On reviewing the titles and abstracts, 3170 articles were excluded because the reported data were not within the field of interest and finally eight studies were included in the review, for a total of 176 male patients. The studies considered revealed high diagnostic accuracy of 18F-FDG PET/CT for the evaluation of MBC both at staging and restaging of disease. Moreover, its added values compared to conventional imaging are starting to emerge and insight into its controversial prognostic importance is growing. CONCLUSION Despite some limitations affecting our review, 18F-FDG PET/CT seems to be a valuable tool to assess MBC. Further research studies are required to better underline the role of hybrid imaging with 18F-FDG for the evaluation of MBC, especially in comparison with female breast cancer.
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Affiliation(s)
- Francesco Dondi
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
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Hanna M, Solly M. Invasive Breast Carcinoma: Rare Clinical Presentation in a Male Patient. Cureus 2021; 13:e20547. [PMID: 35103127 PMCID: PMC8769931 DOI: 10.7759/cureus.20547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/25/2022] Open
Abstract
A 74-year-old male presented for evaluation of a right breast mass that the patient had self-detected a few weeks prior. This gentleman had an extensive family history of cancer, with a father (70 years old) and daughter (31 years old) with breast cancer, a sister with rectal cancer (70 years old), and a son and daughter with a pathogenic variant of the breast cancer (BRCA) gene. As with women, the frequency of malignancy increases with age. Many similar risk factors are noted to overlap between male and female presentations. Men tend to have similar profiles and presentations as postmenopausal women. The vast majority are diagnosed early, and less than 5% present with metastatic disease. This case report highlights the imaging presentation of this rare diagnosis and reviews its etiology and pathophysiology.
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Fang W, Huang Y, Han X, Peng J, Zheng M. Characteristics of metastasis and survival between male and female breast cancer with different molecular subtypes: A population-based observational study. Cancer Med 2021; 11:764-777. [PMID: 34898007 PMCID: PMC8817100 DOI: 10.1002/cam4.4469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/22/2022] Open
Abstract
Objective Male breast cancer (BC) is a rare disease, having different clinicopathological features and survival outcomes from female patients. The aim of this research was to, combine with molecular subtypes, analyze the metastatic patterns, and prognosis between male and female patients, and to determine whether the gender was the independent prognostic factor for BC. Methods Data used in this study were acquired from the SEER database from 2010 to 2016. The clinicopathology features and metastatic patterns were compared by the Chi‐square test and Fisher's exact test. Kaplan–Meier method was performed to compare overall survival (OS) and factors correlated with OS were determined by Cox regression models. Competing risk models were used to ascertain factors related to breast cancer‐specific death (BCSD). Results Compared with female BC, the incidence of regional LN (HR 1.849, 95% CI 1.674–2.043, p < 0.001) and distant metastasis (HR 1.421, 95%CI: 1.157–1.744, p < 0.001) was higher in male BC. For regional LN metastasis, hormone receptor (HoR)−/HER2+ subtype occupied the majority in both male (55.56%) and female (36.86%) groups. For distant metastasis, HoR−/HER2− subtype (21.26%), and HoR−/HER2+ (7.67%) were in major in male and female group separately. Male patients shared similar combinations of metastases with female groups as for single‐site, bi‐site, and tri‐site metastasis. Gender was an independent prognostic factor for OS (p < 0.001) but not for BCSD(p = 0.620). In subgroup of patients with HoR+/HER2−(OS: p = 0.003; BCSD: p = 0.606), HoR+/HER2+(OS: p = 0.003; BCSD: p = 0.277), regional LN positive(OS: p = 0.005; BCSD: p = 0.379), or bone metastasis (OS: p = 0.030; BCSD: p = 0.862), the male cohort had poorer OS but similar BCSD with female cohort. Conclusions Compared with female patients, male BC had different metastasis patterns and prognostic outcomes, and the affection of breast subtypes on metastasis and survivorship was also different. More attention needs to be paid for specific molecular subtype and more personalized therapeutic strategies should be customized while treating male patients.
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Affiliation(s)
- Wentong Fang
- Department of Pharmacy, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yue Huang
- Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Xu Han
- Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Jinghui Peng
- Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Mingjie Zheng
- Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
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Salih AM, Hammood ZD, Kakamad FH, Othman S, Ali RK, Latif S. Paget's disease of the breast in male with underlying invasive ductal carcinoma: A case report with review of literature. Ann Med Surg (Lond) 2021; 72:103035. [PMID: 34820122 PMCID: PMC8599100 DOI: 10.1016/j.amsu.2021.103035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/14/2022] Open
Abstract
Introduction Paget's disease of the breast is a rare cutaneous eczema-like condition that occurs in the nipple-areolar complex of the breast. The current study aims to report a rare case of Paget's disease of the breast associated with invasive ductal carcinoma in a male breast. Case report A 54-year-old male presented with ulceration of the left nipple-areolar complex that has been progressing over the last 6 months. On examination; there was a palpable axillary lymph node. On ultrasound, a small hypoechoic heterogenous mass was seen beneath the areola (8*4 mm) with surrounding vascularity, and a few axillary lymph nodes with normal morphology and cortical thickness. The mammography revealed some points of calcification arranged in clusters. The patient underwent left side mastectomy and sentinel lymph node biopsy. The result of histopathological examination showed left side unifocal invasive ductal carcinoma. Discussion There are two main theories that explain the histogenesis of Paget's disease of the breast with and without underlying malignancy: epidermotropic theory, which suggests an epidermal infiltration of the nipple with Paget cells, and transformative theory, which proposes a malignant transformation of normal glandular cells of the epidermis. Conclusion The clinical presentation of Paget's disease of the breast is characteristic and should always warn the surgeon of the possibility of underlying malignancy. Paget's disease of the breast (or nipple) is a very rare cutaneous entity. Paget's disease of the male breast is an extremely rare clinicopathologic condition. Breast cancer in male is likewise very rare.
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Affiliation(s)
- Abdulwahid M Salih
- Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Iraq.,Smart Health Tower, Madam Mittarand Str., Sulaimani, Iraq
| | | | - Fahmi H Kakamad
- Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Iraq.,Smart Health Tower, Madam Mittarand Str., Sulaimani, Iraq.,Kscien Organization, Hamdi Street, Azadi Mall, Sulaimani, Iraq
| | - Snur Othman
- Kscien Organization, Hamdi Street, Azadi Mall, Sulaimani, Iraq
| | - Razhan K Ali
- Department of Cardiothoracic Surgery, Shar Hospital, Sulaimani, Iraq
| | - Shaban Latif
- Smart Health Tower, Madam Mittarand Str., Sulaimani, Iraq
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Tari DU, Morelli L, Guida A, Pinto F. Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management. Diagnostics (Basel) 2021; 11:diagnostics11122199. [PMID: 34943439 PMCID: PMC8700459 DOI: 10.3390/diagnostics11122199] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 12/12/2022] Open
Abstract
Ductal carcinoma in situ (DCIS) of male breast is a rare lesion, often associated with invasive carcinoma. When the in situ component is present in pure form, histological grade is usually low or intermediate. Imaging is difficult as gynaecomastia is often present and can mask underlying findings. We report a rare case of pure high-grade DCIS in a young male patient, with associated intraductal papilloma and atypical ductal hyperplasia. Digital breast tomosynthesis (DBT) showed an area of architectural distortion at the union of outer quadrants of the left breast without gynaecomastia. Triple assessment suggested performing a nipple-sparing mastectomy, which revealed the presence of a focal area of high-grade DCIS of 2 mm. DCIS, even of high grade, is difficult to detect with mammography and even more rare, especially when associated with other proliferative lesions. DBT with 2D synthetic reconstruction is useful as the imaging step of a triple assessment and it should be performed in both symptomatic and asymptomatic high-risk men to differentiate between malignant and benign lesions. We propose a diagnostic model to early detect breast cancer in men, optimizing resources according to efficiency, effectiveness and economy, and look forward to radiomics as a powerful tool to help radiologists.
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Affiliation(s)
- Daniele Ugo Tari
- Department of Diagnostic Senology, District 12, Palazzo della Salute, Caserta LHA, 81100 Caserta, Italy
- Correspondence: ; Tel.: +39-3493659922
| | - Luigi Morelli
- Department of Pathological Anatomy A. di Tuoro, Caserta LHA, 81031 Aversa, Italy;
| | - Antonella Guida
- Head Office, District 12, Palazzo della Salute, Caserta LHA, 81100 Caserta, Italy;
| | - Fabio Pinto
- Department of Radiology, A. Guerriero Hospital, Caserta LHA, 81025 Marcianise, Italy;
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The impact of G protein-coupled oestrogen receptor 1 on male breast cancer: a retrospective analysis. Contemp Oncol (Pozn) 2021; 25:204-212. [PMID: 34729041 PMCID: PMC8547179 DOI: 10.5114/wo.2021.110010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction The G protein-coupled oestrogen receptor 1 (GPER-1) is a potential prognostic marker in breast cancer. However, its role in male breast cancer (MBC) is still unknown. This study evaluates the expression of GPER-1 in MBC samples and correlates these data with clinical and pathological parameters including patients' survival. Material and methods For this retrospective analysis of a prospectively maintained cohort of patients with MBC, we examined 161 specimens for GPER-1 expression using immunohistochemistry. An immunoreactive score (IRS) was calculated based on staining intensity and the percentage of positive tumour cells. Then, we correlated GPER-1 IRS with clinical and pathological parameters, and overall and relapse-free survival. Results About 40% of MBC samples were positive for GPER-1 expression (IRS ≥ 4). There was no significant correlation with clinicopathological parameters, such as hormone receptor status or grading. However, a statistical trend was observed for tumour size (≥ 2 cm, p = 0.093). Kaplan-Meier survival analysis revealed no significant correlation with relapse-free survival. However, there was a significant correlation with overall survival, but when we adjusted the log-rank p-value to compensate for the cut-off point optimization method, it rose above 0.1. Additionally, GPER-1-positive patients were older at diagnosis. When adjusted for age by multivariable Cox regression analysis, the significance of GPER-1 status for survival was further reduced. Conclusions We found no significant prognostic value of GPER-1 in this MBC cohort as anticipated from studies on female BC. Future studies with higher sample size are needed to further verify a potential sex-specific role of GPER-1.
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Pizzato M, Carioli G, Bertuccio P, Malvezzi M, Levi F, Boffetta P, Negri E, La Vecchia C. Trends in male breast cancer mortality: a global overview. Eur J Cancer Prev 2021; 30:472-479. [PMID: 33470692 DOI: 10.1097/cej.0000000000000651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Recent trends in male breast cancer have been inadequately studied. We updated mortality trends in selected countries and regions worldwide using most recent available data and we predicted figures for 2020. METHODS We extracted official death certification data for male breast cancer and population estimates from the WHO and the Pan American Health Organization databases, from 2000 to 2017. We computed age-standardized (world population) death rates for selected countries and regions worldwide. We used joinpoint regression analysis to identify significant changes in trends and to predict death numbers and rates for 2020. RESULTS In 2015-2017, Central-Eastern Europe had a rate of 2.85/1 000 000, and Russia of 2.22, ranking among the highest. North-Western and Southern Europe, the European Union as a whole and the USA showed rates ranging between 1.5 and 2.0. Lower rates were observed in most Latin American countries, with values below 1.35/1 000 000, in Australia, 1.22, and Japan, 0.58. Between 2000-2004 and 2015-2017, age-adjusted death rates decreased between 10 and 40% in North-Western Europe, Russia, and the USA, and between 1.5 and 25% in the other areas under study, except Latin America (+0.8%). Except for Central-Eastern Europe, predicted rates for 2020 were favourable. CONCLUSION Advancements in management are likely the main drivers of the favourable trends in male breast cancer death rates over the last decades. Delayed diagnosis and limited access to effective care explain the higher mortality in some areas.
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Affiliation(s)
| | - Greta Carioli
- Department of Clinical Sciences and Community Health
| | - Paola Bertuccio
- Department of Biomedical and Clinical Sciences L. Sacco, Università degli Studi di Milano, Milan, Italy
| | | | - Fabio Levi
- Department of Epidemiology and Health Services Research, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| | - Eva Negri
- Department of Biomedical and Clinical Sciences L. Sacco, Università degli Studi di Milano, Milan, Italy
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Stahl KA, Wong W, Olecki EJ, McLaughlin C, Perez-Holguin R, Lewcun JA, Dodge D, Shen C. Benefits of Trimodality Therapy Compared with Systemic Therapy Alone in Male Patients with Stage IV Breast Cancer. Ann Surg Oncol 2021; 29:1005-1017. [PMID: 34480282 DOI: 10.1245/s10434-021-10729-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Male breast cancer (MBC) represents <1% of all breast cancer (BC) diagnoses. Recent publications in female stage IV BC have shown that surgical intervention has a survival benefit. This study aims to determine the impact of surgical intervention in men with stage IV BC and known estrogen (ER) and progesterone receptor (PR) status. METHODS The National Cancer Database was used to identify 539 stage IV MBC patients with known ER/PR status from 2004 to 2017. Chi-square tests examined subgroup differences between the treatment modalities received. Overall survival (OS) was assessed using the Kaplan-Meier method. Multivariate Cox proportional hazard models examined factors associated with survival. RESULTS The Kaplan-Meier estimation showed that ER-positive (ER+) and PR-positive (PR+) patients who received surgery, systemic therapy, and radiation (Trimodality) or systemic therapy and surgery (ST+Surg) had improved survival compared with systemic therapy alone (ST) [ER+, p < 0.003; PR+, p < 0.033]. For ER+ patients, the 5-year OS rates by treatment were: Trimodality, 40%; ST+Surg, 27%; and ST, 20%. For PR+ patients, the 5-year OS rates were: Trimodality, 39%; ST+Surg, 24%; and ST, 20%. The Cox proportional hazard model revealed a survival advantage in patients who received Trimodality compared with ST (hazard ratio 0.622; p < 0.002). The timing of systemic therapy in relation to surgery was not found to be significant. CONCLUSIONS Trimodality therapy has a survival benefit in stage IV MBC patients with known ER+ status than in male patients who receive systemic therapy alone.
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Affiliation(s)
- Kelly A Stahl
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - William Wong
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Elizabeth J Olecki
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Christopher McLaughlin
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Rolfy Perez-Holguin
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Joseph A Lewcun
- Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Daleela Dodge
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Chan Shen
- Division of Outcomes Research and Quality, Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA. .,Division of Health Services and Behavioral Research, Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
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Yadav SK, Silwal S, Yadav S, Krishnamoorthy G, Chisti MM. A Systematic Comparison of Overall Survival Between Men and Women With Triple Negative Breast Cancer. Clin Breast Cancer 2021; 22:161-169. [PMID: 34419351 DOI: 10.1016/j.clbc.2021.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/03/2021] [Accepted: 07/02/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Triple-negative breast cancer (TNBC) in men is very rare. The clinical characteristics, prognostic factors, and overall survival of men with TNBC have not been characterized. METHODS The study population consisted of men and women with a diagnosis of stage I-III TNBC between 2010 and 2016 in the National Cancer Database. Baseline demographic and tumor characteristics between men and women were compared using Pearson's Chi-Square test for categorical variables and Mann-Whitney U test for continuous variables. Kaplan-Meier and multivariate Cox proportional hazards regression model was used to compare survival and identify prognostic factors. RESULTS A total of 311 men and 95,406 women with TNBC were included in the final analysis. The 3-year and 5-year overall survival was 74.8% and 68.8% in men, while it was 83.2% and 74.8% in women, respectively. In multivariate analysis, men were found to have a significantly worse overall survival compared to women (HR, 1.49, 95% CI, 1.19-1.86, P= .01). Older age at diagnosis, higher TNM stage, undergoing mastectomy and not undergoing chemotherapy or radiation were identified as independent negative prognostic factors in men with TNBC. CONCLUSION In one of the largest studies of men with TNBC, men were noted to have a poorer overall survival compared to women, despite adjusting for usual prognostic factors. Further research into differences in tumor biology, treatment patterns and compliance with therapy between men and women are needed to understand the underlying etiologies for the survival difference in TNBC.
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Affiliation(s)
| | - Swechchha Silwal
- Department of Internal Medicine/Transitional Year, Detroit Medical Center Sinai Grace Hospital, Detroit, MI
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Pan H, Zhang K, Wang M, Ling L, Wang S, Zhou W. The effect of chemotherapy on survival in patients with nonmetastatic male breast cancer: A population-based observational study. Cancer 2021; 126 Suppl 16:3830-3836. [PMID: 32710661 DOI: 10.1002/cncr.32829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Male breast cancer is a rare malignant disease, accounting for <1% of all breast cancers. The treatment of male breast cancer is mainly extrapolated from the enormous literature and clinical experience in women. The objective of the current study was to assess the relationship between adjuvant chemotherapy and survival in a large population-based cohort of patients with early-stage male breast cancer. METHODS Men with invasive stage I to stage III breast cancer were identified in the Surveillance, Epidemiology, and End Results cancer database from 1990 to 2014. The effect of chemotherapy on survival was determined using multivariable Cox regression. RESULTS Of 2713 male patients enrolled, 1817 (66.9%) did not receive chemotherapy. Age, T classification, N classification, tumor grade, and progesterone receptor (PR) status were found to be strong predictors of chemotherapy administration. Chemotherapy was associated with a significant 26% reduction in all-cause mortality (P < .001) and a marginally significant 21% reduction in breast cancer-specific mortality (P = .085). For men with PR-negative breast cancer, use of chemotherapy was associated with improved breast cancer-specific survival (hazards ratio [HR], 0.50; 95% confidence interval [95% CI], 0.28-0.91 [P = .023]) and overall survival (HR, 0.54; 95% CI, 0.37-0.77 [P = .001]). However, chemotherapy did not improve the breast cancer-specific survival for all men with PR-positive tumors (P = .959); it was associated with improved overall survival (HR, 0.78; 95% CI, 0.66-0.92 [P = .004]) for men with PR-positive stage II and stage III breast cancer. CONCLUSIONS Chemotherapy should be considered for men with PR-negative, nonmetastatic breast cancer and PR-positive, stage II and stage III breast cancer.
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Affiliation(s)
- Hong Pan
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Kai Zhang
- Pancreatic Center, Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.,Pancreas Institute of Nanjing Medical University, Nanjing, China
| | - Ming Wang
- Department of Plastic and Burn Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lijun Ling
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Shui Wang
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Wenbin Zhou
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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Management and outcomes of men diagnosed with primary breast cancer. Breast Cancer Res Treat 2021; 188:561-569. [PMID: 33830393 DOI: 10.1007/s10549-021-06174-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/03/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Fewer than 1% of all breast cancers occur in men. As a result, a distinct lack of data exists regarding the management and outcomes in this cohort. METHODS Any male patient with pathologically confirmed breast cancer diagnosed between August 2000 and October 2017 at either Massachusetts General Hospital or Brigham and Women's Hospital/Dana-Farber Cancer Institute and their affiliate satellite locations were included. Primary chart review was used to assess clinical and pathologic characteristics. Patient and treatment variables were reported via descriptive statistics. Local-regional failure (LRF), overall survival (OS), breast cancer-specific survival (BCSS), and disease-free survival (DFS) were estimated using the Kaplan-Meier method. RESULTS 100 patients were included in this study. Median follow-up was 112 months (range 1-220 months). Approximately 1/3 of patients experienced at least a 3-month delay to presentation. 83 patients ultimately underwent mastectomy as definitive surgical treatment. 46 patients received adjuvant radiation therapy, and 37 patients received chemotherapy. Of 82 hormone receptor-positive patients with invasive cancer, 94% (n = 77) received endocrine therapy. Of the fifty-eight patients who underwent genetic testing, 15 (26%) tested positive. The 5-year OS, BCSS, DFS, and LRF rates were 91.5%, 96.2%, 86%, and 4.8%, respectively. Delay to presentation was not associated with worse survival. CONCLUSIONS Male breast cancer remains a rare diagnosis. Despite this, the majority of patients in this study received standard of care therapy and experienced excellent oncologic outcomes. Penetration for genetic testing improved over time.
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Impact of Mastectomy on Body Image and Sexuality from a LGBTQ Perspective: A Narrative Review. J Clin Med 2021; 10:jcm10040567. [PMID: 33546220 PMCID: PMC7913342 DOI: 10.3390/jcm10040567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 01/01/2023] Open
Abstract
Although mastectomy could lead to a decrease in sexual performance among patients, only a handful of studies focused on the psychological and sexual behavioral aspects after the surgery. Research on post-mastectomy sexuality has focused mainly on female subjects but barely on lesbian, gay, bisexual, transgender, queer (LGBTQ), and male patients. This narrative review aimed to explore the importance of sexuality after mastectomy from a LGBTQ perspective. Each sexual minority group has been addressed individually. In general, sexual and gender minority breast cancer (BC) patients undergoing bilateral mastectomy expect a complex treatment plan in terms of physical and emotional outcomes. Bilateral mastectomy or top surgery for masculinization reasons was reported to be the most popular procedure among transmen, which resulted in a significant improvement in the quality of life. Heterosexual and lesbian female patients are willing to undergo mastectomy after repeated lumpectomies or to avoid radiation, despite potential post-operative somatic and quality-of-life complications. Transwomen would seek gender-affirming surgery to improve physical satisfaction and psychological well-being. There is not enough evidence for non-oncological reasons and consequences of mastectomy in gay men and cisgender heterosexual men. Establishing the awareness of the sexuality impact of mastectomy will allow the implementation of tailored perioperative psychological care.
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Abstract
No national data have been available on descriptive epidemiology of mammary Paget's disease (MPD) in China. This population-based study aimed to estimate the prevalence of MPD and its pattens by sex, age and area in China. We conducted a population-based study using data in 2016 from China's Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance, covering approximately 0.43 billion residents. MPD cases were identified based on the diagnostic names and codes in claim data. A total of 825 patients of confirmed diagnosis of MPD were found during the study period. The prevalence of MPD in 2016 was 0.42 per 100,000 population (95% CI 0.19 to 0.73), with marked female predominance. The prevalence rates peaked at 40-59 years and ≥ 80 years in females and males, respectively. The prevalence rates varied among different regions, ranging from 0.06 (95% CI 0.00 to 0.23) in Northeast China to 1.21 (95% CI 0.07 to 3.72) in Northwest China. MPD showed marked female predominance in China. Chinese female patients were much younger, with lower prevalence than that in the United States. Obvious sex difference in the age pattern of MPD prevalence was also observed in China.
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Adjuvant Radiation Therapy for Male Breast Cancer-A Rare Indication? Cancers (Basel) 2020; 12:cancers12123645. [PMID: 33291697 PMCID: PMC7761961 DOI: 10.3390/cancers12123645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/17/2022] Open
Abstract
Due to its rarity, there are no randomized trials investigating the outcome of adjuvant radiotherapy in MBC. This study reports on patient and tumor characteristics of 41 consecutive MBC patients treated between 1990 and 2018 and on clinical outcomes after surgical resection of tumors and adjuvant radiotherapy of the chest wall or breast. Local control (LC), locoregional control (LRC), overall survival (OS), disease-free survival (DFS), and toxicity were evaluated. After a median follow-up of 80 months (95% CI: 14.6-213.8 months) there was only one recurrence, in a patient's locoregional lymph nodes 17 months after start of radiotherapy, resulting in an LC rate of 100% at 5 years and a 5-year LRC rate of 97.4% (standard deviation (SD): 0.025). Five-year DFS and OS rates were 64.6% (SD: 0.085) and 57.2% (SD: 0.082), respectively. Adjuvant radiotherapy was tolerated well without high-grade (CTCAE grade > II) adverse events. After tumor resection and adjuvant radiotherapy, LC and LRC rates in MBC patients are excellent and comparable to results found for female breast cancer (FBC) patients. However, as patients are often diagnosed with locally advanced, higher-risk tumors, distant recurrences remain the major failure pattern.
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Shin K, Whitman GJ. Clinical Indications for Mammography in Men and Correlation With Breast Cancer. Curr Probl Diagn Radiol 2020; 50:792-798. [PMID: 33250296 DOI: 10.1067/j.cpradiol.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE The purpose of this study is to examine the correlation between presenting clinical symptoms and imaging findings in men with breast cancer. METHOD AND MATERIALS Four hundred twenty-nine male patients who presented for mammography at one institution between January 2004 and December 2014 were retrospectively evaluated. Of the 429 patients, 291 presented with clinical symptoms for diagnostic mammography. The presenting clinical symptoms in 291 patients were recorded and correlated with imaging and histopathologic findings. RESULTS Two hundred ninety-one male patients were included. Some presented with multiple symptoms, for a total of 318 clinical symptoms. One hundred and ninety (65%) men presented with palpable abnormalities, 44 (15%) with nonfocal pain, 31 (11%) with breast swelling, 14 (5%) with breast enlargement, 13 (4%) with focal pain, 7 (2%) with skin changes, 6 (2%) with nipple discharge/changes and 13 (4%) with other symptoms (itching, throbbing and breast heaviness). A total of 290 patients underwent mammography and 176 underwent sonography. Forty-one malignancies were diagnosed, of which 24 (59%) were invasive ductal carcinoma. Nipple changes/discharge had a 100% positive predictive value for malignancy while breast pain showed a 0% positive predictive value. Fifty-two patients showed either a mass or a focal asymmetry on mammography, of which 38 (73%) were malignant. Three patients (1%) without a mass or focal asymmetry were diagnosed with malignancy. CONCLUSION Correlating clinical symptoms and imaging findings can help with timely and accurate diagnosis of breast cancer in men. Nipple discharge/changes and skin changes with palpable abnormalities and mammographic findings of masses and focal asymmetries were associated with breast cancer. Pain, breast enlargement, and breast swelling were unlikely to be associated with malignancy.
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Affiliation(s)
- Kyungmin Shin
- Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer, Houston, TX.
| | - Gary J Whitman
- Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer, Houston, TX
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Meyer T, Borgen P, Rojas K. A spontaneous unveiling of bilateral DCIS in an elderly male. J Surg Case Rep 2020; 2020:rjaa399. [PMID: 33154807 PMCID: PMC7602696 DOI: 10.1093/jscr/rjaa399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 09/06/2020] [Indexed: 11/23/2022] Open
Abstract
The rarity of male breast cancer continues to limit its study despite increasing incidence rates, particularly within the past decade [Speirs V, Shaaban AM. The rising incidence of male breast cancer. Breast Cancer Res Treat 2009;115:429–30]. Although this trend appears to be substantially documented, male patients with breast cancer have been and continue to be excluded from landmark breast cancer trials. Currently, there are no standardized breast cancer screening protocols in place for men, including those with pathogenic BRCA mutations. As a result, men with breast cancer typically present at a later stage, and on average, 8–10 years later than females [Ruddy KJ, Winer EP. Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship. Ann Oncol 2013;24:1434–43]. As the incidence of disease continues to rise, the need for algorithmic standardization with regards to screening, diagnosing, treating and managing male breast cancer has become imperative. We report the case of a 71-year-old male who presented with spontaneous bloody nipple discharge and was found to have bilateral ductal carcinoma in situ.
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Affiliation(s)
- Tessa Meyer
- Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Patrick Borgen
- Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Kristen Rojas
- Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA
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Li C, Yang X, Wang P, Wen L, Wang X. Mammary Paget's disease diagnosed with reflectance confocal microscopy. Photodiagnosis Photodyn Ther 2020; 32:102069. [PMID: 33099038 DOI: 10.1016/j.pdpdt.2020.102069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/04/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
Mammary Paget's disease (MPD) is a rare breast carcinoma represented with an eczematoid cutaneous manifestation. Imitating inflammatory or infectious diseases, it makes early diagnosis and prompt treatment difficult. Non-invasive imaging examinations such as reflectance confocal microscopy (RCM) could extend assistance in making a diagnosis because of its near-cellular resolution in skin diseases. Herein, the RCM feature of two cases of MPD, and the corresponding dermoscopy, ultrasonography examination and immunohistochemistry staining results were described.
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Affiliation(s)
- Chunxiao Li
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoqin Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Long Wen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
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50
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Li WP, Gao HF, Ji F, Zhu T, Cheng MY, Yang M, Yang CQ, Zhang LL, Li JQ, Zhang JS, Wang K. The role of adjuvant chemotherapy in stage I-III male breast cancer: a SEER-based analysis. Ther Adv Med Oncol 2020; 12:1758835920958358. [PMID: 33014148 PMCID: PMC7509722 DOI: 10.1177/1758835920958358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
Background and aims: Male breast cancer is an uncommon disease. The benefit of adjuvant chemotherapy in the treatment of male breast cancer patients has not been determined. The aim of this study was to explore the value of adjuvant chemotherapy in men with stage I–III breast cancer, and we hypothesized that some male patients may safely skip adjuvant chemotherapy. Methods: Male breast cancer patients between 2010 and 2015 from the Surveillance Epidemiology and End Results database were included. Univariate and multivariate Cox analyses were used to analyse the factors associated with survival. The propensity score matching method was adopted to balance baseline characteristics. Kaplan–Meier curves were used to evaluate the impacts of adjuvant chemotherapy on survival. The primary endpoint was survival. Results: We enrolled 514 patients for this study, including 257 patients treated with chemotherapy and 257 patients without. There was a significant difference in overall survival (OS) but not in breast cancer-specific survival (BCSS) between the two groups (p < 0.001 for OS and p = 0.128 for BCSS, respectively). Compared with the non-chemotherapy group, the chemotherapy group had a higher 4-year OS rate (97.5% versus 95.2%, p < 0.001), while 4-year BCSS was similar (98% versus 98.8%, p = 0.128). The chemotherapy group had longer OS than the non-chemotherapy group among HR+, HER2–, tumour size >2 cm, lymph node-positive male breast cancer patients (p < 0.05). Regardless of tumour size, there were no differences in OS or BCSS between the chemotherapy and non-chemotherapy cohorts for lymph node-negative patients (OS: p > 0.05, BCSS: p > 0.05). Adjuvant chemotherapy showed no significant effects on both OS and BCSS in patients with stage I (OS: p = 0.100, BCSS: p = 0.858) and stage IIA breast cancer (OS: p > 0.05, BCSS: p > 0.05). Conclusion: For stage I and stage IIA patients, adjuvant chemotherapy could not improve OS and BCSS. Therefore, adjuvant chemotherapy might be skipped for stage I and stage IIA male breast cancer patients.
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Affiliation(s)
- Wei-Ping Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Hong-Fei Gao
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Fei Ji
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Teng Zhu
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Min-Yi Cheng
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mei Yang
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ci-Qiu Yang
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Liu-Lu Zhang
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jie-Qing Li
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jun-Sheng Zhang
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kun Wang
- Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.123 Huifu West, Yuexiu District, Guangzhou510080, China
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