1
|
O'Leary TR, Shriver CD, Wind G. Metachronous Contralateral Male Breast Cancer: Case Report and Literature Review. Mil Med 2019; 184:e581-e586. [PMID: 30938815 DOI: 10.1093/milmed/usz049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/05/2019] [Accepted: 02/26/2019] [Indexed: 12/30/2022] Open
Abstract
Male breast cancer (MBC) is rare and consequently understudied. Here we present the case of contralateral breast cancer in a male patient nearly a quarter century following his initial breast cancer diagnosis and treatment. The epidemiology, risk factors, diagnosis, characterization, treatment, and prognosis of male breast cancer are reviewed. MBC accounts for <1% of all breast cancer with an estimated incidence nearly 1.25 per 100,000 person years. Our patient tested positive for ATM mutation of undetermined significance. More commonly in males, a BRCA2 mutation confers a >1 in 15 lifetime risk of breast cancer and is present in >11% of MBC patients, while BRCA1 is present in an estimated <1.5% of MBC patients. The risk of contralateral breast cancer developing in a male with a unilateral lesion is much higher than for a primary male breast cancer in the general population. Men tend to be diagnosed at a later age and stage than females. Prognosis for male and female breast cancer is similar considering both age of patient and stage of the tumor at diagnosis, and similar treatment paradigms have resulted in similar outcomes. Although lumpectomy with radiation therapy may have the same prognosis as mastectomy, the standard of care for male breast cancer continues to be simple mastectomy with sentinel lymph node biopsy.
Collapse
Affiliation(s)
- Thomas R O'Leary
- Department of Surgery, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Craig D Shriver
- Department of Surgery, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Gary Wind
- Department of Surgery, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| |
Collapse
|
2
|
Almohanna HM, Perper M, Tosti A. Safety concerns when using novel medications to treat alopecia. Expert Opin Drug Saf 2018; 17:1115-1128. [PMID: 30318935 DOI: 10.1080/14740338.2018.1533549] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Alopecia is often a cause of great concern to patients for cosmetic and psychologic reasons. The aim of treating non-scarring alopecias is to reduce hair loss and, to some extent, enhance hair regrowth. However, therapies for scarring alopecias are limited and aiming to halt disease progression. Nonetheless, available modalities of treatment come with numerous side effects. Areas covered: Many new treatments for non-scarring alopecias have been introduced in recent years. This review summarizes the safety concerns when using novel therapeutic modalities such as JAK inhibitors, hair transplantation, mesotherapy, oral minoxidil, platelet-rich plasma, microneedling, and 5α-reductase inhibitors for treating hair loss. A broad literature search was performed using PubMed and Google Scholar in April 2018 to compile published articles that reported the adverse effects of new therapeutic modalities for alopecia. Expert opinion: Although emerging therapeutic modalities for alopecia have demonstrated efficacy in hair regrowth and treating established disease, their safety profiles vary widely. When considering the new treatments for alopecia, physicians should weigh the potential benefits and risks of each treatment or combination treatment to ensure safe and successful outcomes.
Collapse
Affiliation(s)
- Hind M Almohanna
- a Department of Dermatology and Dermatologic Surgery , Prince Sultan Military Medical City , Riyadh , Saudi Arabia
| | - Marina Perper
- b Department of Dermatology and Cutaneous Surgery , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Antonella Tosti
- b Department of Dermatology and Cutaneous Surgery , University of Miami Miller School of Medicine , Miami , FL , USA
| |
Collapse
|
3
|
Meijer M, Thygesen LC, Green A, Emneus M, Brasso K, Iversen P, Pukkala E, Bolin K, Stavem K, Ersbøll AK. Finasteride treatment and male breast cancer: a register-based cohort study in four Nordic countries. Cancer Med 2017; 7:254-260. [PMID: 29239131 PMCID: PMC5773955 DOI: 10.1002/cam4.1273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 11/04/2017] [Accepted: 11/06/2017] [Indexed: 12/19/2022] Open
Abstract
A potential link has been suggested between dispensed finasteride and increased risk of male breast cancer (MBC). Due to the rare occurrence of MBC, it remains to be established if such a relationship exists. The purpose of this study was to combine nationwide registers in four countries to assess the potential association between dispensed finasteride and MBC. A cohort of all males with dispensed finasteride in Denmark, Finland, Norway, and Sweden (1,365,088 person years) was followed up for up to 15 years for breast cancer, and compared to a cohort of males unexposed to finasteride. Individual‐level register data included country, dates of dispensed finasteride, MBC diagnosis, and death. Incidence rate ratios (IRRs) were estimated using a generalized linear model with a Poisson distribution. An increased risk of MBC was found among finasteride users (IRR = 1.44, 95% confidence interval [95% CI] = 1.11–1.88) compared to nonusers. The IRR increased to 1.60 (95% CI = 1.20–2.13) when users in Norway and Sweden with short follow‐up time were excluded. The highest IRR was seen among men with medium duration of dispensed finasteride, medium accumulated consumption of finasteride, and among men with first dispensed finasteride prescription 1–3 years prior to diagnosis. The analyses suggested possible ascertainment bias and did not support a clear relationship between dispensed finasteride and MBC. In conclusion, a significant association between dispensed finasteride and MBC was identified. However, due to limited data for adjustment of potential confounding and surveillance bias in the present study, further research is needed to confirm these results.
Collapse
Affiliation(s)
- Mathias Meijer
- National Institute of Public HealthUniversity of Southern DenmarkCopenhagenDenmark
- Department of NursingMetropolitan University CollegeCopenhagenDenmark
| | - Lau Caspar Thygesen
- National Institute of Public HealthUniversity of Southern DenmarkCopenhagenDenmark
| | - Anders Green
- Institute of Applied Economics and Health ResearchCopenhagenDenmark
- Odense Patient Data Explorative NetworkOdense University Hospital and University of Southern DenmarkOdenseDenmark
| | - Martha Emneus
- Institute of Applied Economics and Health ResearchCopenhagenDenmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center and Department of UrologyRigshospitaletCopenhagenDenmark
| | - Peter Iversen
- Copenhagen Prostate Cancer Center and Department of UrologyRigshospitaletCopenhagenDenmark
| | - Eero Pukkala
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
- School of Health SciencesUniversity of TampereTampereFinland
| | - Kristian Bolin
- Department of EconomicsUniversity of GothenburgGothenburgSweden
- Centre for Health Economics at the University of GothenburgGothenburgSweden
| | - Knut Stavem
- Health Services Research UnitAkershus University HospitalOsloNorway
- Department of Pulmonary MedicineMedical DivisionAkershus University HospitalOsloNorway
- Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway
| | - Annette K. Ersbøll
- National Institute of Public HealthUniversity of Southern DenmarkCopenhagenDenmark
| |
Collapse
|
4
|
Kim MW, Park HS, Park JS, Koh SJ, Cho S. Five-Alpha Reductase Inhibitor and Breast Cancer Risk in Men: A Systematic Review. Ann Dermatol 2017; 29:525-528. [PMID: 28761315 PMCID: PMC5500732 DOI: 10.5021/ad.2017.29.4.525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 12/14/2022] Open
Affiliation(s)
- Min-Woo Kim
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyun-Sun Park
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Jong Seo Park
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Seong-Joon Koh
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Soyun Cho
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| |
Collapse
|
5
|
Fertig R, Shapiro J, Bergfeld W, Tosti A. Investigation of the Plausibility of 5-Alpha-Reductase Inhibitor Syndrome. Skin Appendage Disord 2016; 2:120-129. [PMID: 28232919 DOI: 10.1159/000450617] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 09/05/2016] [Indexed: 11/19/2022] Open
Abstract
Postfinasteride syndrome (PFS) is a term recently coined to characterize a constellation of reported undesirable side effects described in postmarketing reports and small uncontrolled studies that developed during or after stopping finasteride treatment, and persisted after drug discontinuation. Symptoms included decreased libido, erectile dysfunction, sexual anhedonia, decreased sperm count, gynecomastia, skin changes, cognitive impairment, fatigue, anxiety, depression, and suicidal ideation. The aim of this study is to review the existing medical literature for evidence-based research of permanent sexual dysfunction and mood changes during treatment with 5-alpha-reductase inhibitors including finasteride and dutasteride.
Collapse
Affiliation(s)
- Raymond Fertig
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Fla, USA
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, N.Y., USA
| | - Wilma Bergfeld
- Departments of Dermatopathology Fellowship, Cleveland Clinic, Cleveland, Ohio, USA; Departments of Pathology, Dermatopathology Fellowship, Cleveland Clinic, Cleveland, Ohio, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Fla, USA
| |
Collapse
|
6
|
Fathalla AES, Hafez MNAE. Breast Cancer in Males (BCM), Does It Really Differ? National Cancer Institute Experience (NCI), Cairo University, Egypt. JOURNAL OF CANCER THERAPY 2016; 07:344-351. [DOI: 10.4236/jct.2016.75037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
|
7
|
Duijnhoven RG, Straus SMJM, Souverein PC, de Boer A, Bosch JLHR, Hoes AW, De Bruin ML. Long-term use of 5α-reductase inhibitors and the risk of male breast cancer. Cancer Causes Control 2014; 25:1577-82. [PMID: 25135615 DOI: 10.1007/s10552-014-0455-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/31/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The 5α-reductase inhibitors (5-ARI) finasteride and dutasteride are indicated for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia. Case reports have suggested that 5-ARIs increase the risk for male breast cancer, with no conclusive evidence. The objective of this study was to quantify the association between use of 5-ARIs and the risk for male breast cancer. METHODS A case-control study was conducted with data from the United Kingdom Clinical Practice Research Datalink database among all men aged 45 years and older in the period 1 January 1992 to 31 December 2011. Cases of men diagnosed with breast cancer were matched to up 10 controls on age and general practice. Crude and adjusted odds ratios were estimated for the risk of breast cancer associated with the use of 5-ARIs. RESULTS Three hundred and ninety-eight cases were identified and matched to 3,930 controls. Ever use of 5-ARIs was associated with an adjusted odds ratio for breast cancer of 1.08 (95 % CI 0.62-1.87) compared to non-users. Increasing cumulative duration of treatment showed no increasing risks: adjusted odds ratios for use for less than 280, for 280 to 1,036 and for more than 1,036 days were 1.21 (95 % CI 0.47-3.10), 0.94 (95 % CI 0.36-2.41) and 1.29 (95 % CI 0.54-3.08), respectively. CONCLUSIONS In this study, there was no evidence of an association between short- or long-term treatment with 5-ARIs and the risk for breast cancer in older men.
Collapse
Affiliation(s)
- Ruben G Duijnhoven
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands,
| | | | | | | | | | | | | |
Collapse
|
8
|
Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED. Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertil Steril 2014; 101:1271-9. [PMID: 24636400 DOI: 10.1016/j.fertnstert.2014.02.002] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 01/26/2014] [Accepted: 02/04/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To develop an understanding of hypogonadal men with a history of anabolic-androgenic steroid (AAS) use and to outline recommendations for management. DESIGN Review of published literature and expert opinions. Intended as a meta-analysis, but no quality studies met the inclusion criteria. SETTING Not applicable. PATIENT(S) Men seeking treatment for symptomatic hypogonadism who have used nonprescribed AAS. INTERVENTION(S) History and physical examination followed by medical intervention if necessary. MAIN OUTCOME MEASURES(S) Serum testosterone and gonadotropin levels, symptoms, and fertility restoration. RESULT(S) Symptomatic hypogonadism is a potential consequence of AAS use and may depend on dose, duration, and type of AAS used. Complete endocrine and metabolic assessment should be conducted. Management strategies for anabolic steroid-associated hypogonadism (ASIH) include judicious use of testosterone replacement therapy, hCG, and selective estrogen receptor modulators. CONCLUSION(S) Although complications of AAS use are variable and patient specific, they can be successfully managed. Treatment of ASIH depends on the type and duration of AAS use. Specific details regarding a patient's AAS cycle are important in medical management.
Collapse
Affiliation(s)
- Cyrus D Rahnema
- University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Larry I Lipshultz
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas
| | - Lindsey E Crosnoe
- University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Jason R Kovac
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas
| | - Edward D Kim
- University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
| |
Collapse
|
9
|
Francis A, Sarkar S, Pooja S, Surekha D, Rao DR, Rao L, Ramachandra L, Vishnupriya S, Satyamoorthy K, Thangaraj K, Rajender S. SRD5A2 gene polymorphisms affect the risk of breast cancer. Breast 2013; 23:137-41. [PMID: 24365257 DOI: 10.1016/j.breast.2013.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/04/2013] [Accepted: 11/24/2013] [Indexed: 10/25/2022] Open
Abstract
Androgens in breast cancer have been studied alone and in correlation with estrogens as estrogen to testosterone ratio. 5-α-reductase is one of the important enzymes participating in androgen metabolism, which affects androgen activity by affecting conversion of testosterone to dihydrotestosterone. We hypothesized that polymorphisms in the SRD5A2 gene (encoding 5-α-reductase) may affect breast cancer risk by affecting total androgen activity. Complete coding region of the SRD5A2 gene was sequenced in a group of 628 patients and 244 control samples from three southern states (Tamil Nadu, Andhra Pradesh, and Karnataka) of India. We observed three common polymorphisms in this gene; namely, A49T, V89L, and (TA)n repeats. A49T locus was monomorphic in the study population, but V89L showed a strong correlation with breast cancer (P = 0.03, OR = 1.40, CI = 1.02-1.91). (TA)0/(TA)9 and (TA)9/(TA)9 genotypes were at a lower risk of breast cancer (P = 0.01, OR = 0.64, CI = 0.46-0.90). We conclude that SRD5A2 genotypes significantly affect breast cancer risk in the South Indian populations.
Collapse
Affiliation(s)
| | - Saumya Sarkar
- Division of Endocrinology, Central Drug Research Institute, Lucknow, India
| | - Singh Pooja
- Department of Pathology, King George Medical University, Lucknow, India
| | | | | | - Lakshmi Rao
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal, India
| | | | | | | | | | - Singh Rajender
- Division of Endocrinology, Central Drug Research Institute, Lucknow, India.
| |
Collapse
|
10
|
|
11
|
Farida C, Faiza B. Severe gynecomastia due to anti androgens intake: A case report and literature review. Indian J Endocrinol Metab 2013; 17:730-732. [PMID: 23961495 PMCID: PMC3743379 DOI: 10.4103/2230-8210.113770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Gynecomastia is the most bothersome side effect in men taking antiandrogens. It is exceptionally severe and distressing physically and mentally as in the reported case. A man, aged 63, with a history of a well-treated macroprolactinoma, was referred in 2004 for gynecomastia that appeared after treatment by microsurgery, radiotherapy and flutamide for a lesion suspected to be prostate cancer. Clinical examination was normal except for huge enlargement of the breasts. Mammography and breasts MRI did not show any tumor. There was not any metastasis of the supposed prostate cancer and prostatic acid phosphates were within normal ranges. Hormonal exploration showed subclinical hypogonadism [testosterone: 7.4 ng/ml (n: 3-9), FSH: 14.9 mu/ml (n: 0.7-11) and LH: 9.7 mu/ml (n: 0.8-7.6)]. Testes ultrasounds were normal. Radiological and hormonal adrenal explorations were normal [Cortisol: 76 ng/ml (n: 50-250), DHEA-S: 59 μg/ml (n: 50-560), E2:40.2 pg/ml (n < 50)]. Body scan was normal too. The discussed etiologies were post radiation subclinical hypogonadism, and treatment with anti androgens. After flutamide withdraw, there was not any sign of prostate cancer recurrence, and gynecomastia decreased significantly, but did not disappear probably because of fibrosis.
Collapse
Affiliation(s)
- Chentli Farida
- Department of Endocrine and Metabolic Diseases, Bab El Oued Hospital, 5 Boulevard Said Touati Algiers, Algeria
| | - Belhimer Faiza
- Department of Endocrine and Metabolic Diseases, Bab El Oued Hospital, 5 Boulevard Said Touati Algiers, Algeria
| |
Collapse
|
12
|
Marberger M. Medical management of lower urinary tract symptoms in men with benign prostatic enlargement. Adv Ther 2013; 30:309-19. [PMID: 23584673 DOI: 10.1007/s12325-013-0022-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Indexed: 11/24/2022]
Abstract
With the high prevalence of bothersome lower urinary tract symptoms (LUTS) in older men, clinical management has to be fairly simple and straightforward. In the absence of severe problems requiring immediate action, and after excluding possible other etiological factors by a simple diagnostic algorithm, the key parameter for therapeutic decisions is the severity of LUTS, in particular the degree of annoyance and irritation, and prostatic enlargement. Patients with bothersome LUTS request rapid improvement but also worry about possible deterioration, complications, and the need for surgery. With a prostate volume above 30-40 mL and/or prostate-specific antigen (PSA) serum >1.5 ng/mL, the combination of an alpha-1 blocker with a 5-alpha-reductase inhibitor (5-ARI) should be first-line treatment. With prostates <30 mL at baseline the issue whether the prostate really is the culprit becomes central. Given the rapid onset of action of alpha-1 blockers, a 4-6-week trial appears to be a logical approach. If the International Prostate Symptom Score does not improve and storage symptoms prevail, an overactive bladder appears more likely as causative factor and antimuscarinics are the next step. Based on available data this is recommended as add-on medication to the alpha-1 blocker. With no improvement, or increasing postvoid residual the diagnostic algorithm needs to be revisited and more extensive urodynamic evaluation may be needed.
Collapse
Affiliation(s)
- Michael Marberger
- Department of Urology, Medical University Vienna, Waehringer Guertel, Vienna, Austria.
| |
Collapse
|
13
|
Ruddy KJ, Winer EP. Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship. Ann Oncol 2013; 24:1434-43. [PMID: 23425944 DOI: 10.1093/annonc/mdt025] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The causes, optimal treatments, and medical/psychosocial sequelae of breast cancer in men are poorly understood. DESIGN A systematic review of the English language literature was conducted to identify studies relevant to male breast cancer between 1987 and 2012 and including at least 20 patients. Searches were carried out on PubMed using the title terms 'male breast cancer' or 'male breast carcinoma'. RESULTS Relevant published data regarding risk factors, biological characteristics, presentation and prognosis, appropriate evaluation and treatment, and survivorship issues in male breast cancer patients are presented. BRCA2 mutations, age, conditions that alter the estrogen/androgen ratio, and radiation are proven risk factors. Disease biology is distinct in men, but diagnostic approaches and treatments for men are generally extrapolated from those in women due to inadequate research in men. Survivorship issues in men may include sexual and hormonal side-effects of endocrine therapies as well as unique psychosocial impacts of the disease. CONCLUSION Further research is needed to address gaps in knowledge pertaining to care of male breast cancer patients and survivors.
Collapse
Affiliation(s)
- K J Ruddy
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
| | | |
Collapse
|
14
|
Dauendorffer JN, Pages C, Abd Alsamad I, Bagot M, Fraitag S. [Primary pigmented breast adenocarcinoma in a male patient]. Ann Dermatol Venereol 2013; 140:52-5. [PMID: 23328361 DOI: 10.1016/j.annder.2012.10.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/21/2012] [Accepted: 10/31/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pigmented mammary tumours are rare. Herein, we report the third case of primary pigmented breast adenocarcinoma in a male patient with clinical mimicking of nodular melanoma of the nipple. PATIENTS AND METHODS A male patient presented with a pigmented nodule of the right nipple. Histological examination of the lesion showed dermal and subcutaneous adenocarcinomatous proliferation. The perilesional stroma contained melanin both inside and outside macrophages, leading us to conclude on primary pigmented breast adenocarcinoma clinically mimicking nodular melanoma of the nipple. DISCUSSION Local production of melanin by neoplastic cells in the mammary carcinoma was postulated as the cause of hyperpigmentation of the tumour. Other possible causes are transfer of melanin from overlying melanocytes of the pigmented areolar epidermis to the underlying neoplastic cells, or melanin synthesis by intratumoral melanocytes migrating from the epidermis (which strikes us as the most convincing interpretation for the reported case). CONCLUSION Breast adenocarcinoma is a rare tumour in men and may present clinically as a pigmented lesion of the nipple, resulting in the problem of differential diagnosis with primary or metastasised nodular melanoma.
Collapse
Affiliation(s)
- J-N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | | | | | | | | |
Collapse
|
15
|
Evolving trends in the initial locoregional management of male breast cancer. Breast 2012; 21:296-302. [DOI: 10.1016/j.breast.2012.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 01/03/2012] [Accepted: 01/11/2012] [Indexed: 11/19/2022] Open
|
16
|
Shenoy NK, Prabhakar SM. Finasteride and Male Breast Cancer: Does the MHRA Report Show a Link? J Cutan Aesthet Surg 2011; 3:102-5. [PMID: 21031070 PMCID: PMC2956950 DOI: 10.4103/0974-2077.69022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Finasteride is an important drug for the management of androgenetic alopecia. However, there are concerns about the possible side effects of the drug such as impotence. Recently stray reports have appeared about the occurrence of male breast carcinoma in patients who received the drug. These have been looked in to by Medicines and Health care products Regulatory Agency (MHRA). This article summarizes the MHRA report.
Collapse
Affiliation(s)
- Niraj K Shenoy
- #301-B, Ranka Colony, Bilekahalli, Bannerghatta Road, Bangalore - 560 076, India
| | | |
Collapse
|
17
|
Abstract
Male breast cancer is an uncommon condition. It often occurs in settings in which there is an imbalance between androgens and oestrogens. Genetics plays an important role, as many cases are associated with mutations in BRCA2 or other genes. Male breast cancer occurs at an older age than female breast cancer and is frequently diagnosed at a later stage. Tumors are predominantly oestrogen and progesterone positive. Prognosis is approximately equivalent to that of breast cancer in females when matched for age, stage and hormonal receptors. The recommended treatment for male breast cancer is similar to that for breast cancer in postmenopausal females. However, the presence of androgens in males has a strong effect on the hormonal milieu and the ability of male patients to respond to hormonal agents. When pharmacologic treatment is required, tamoxifen is effective for first-line therapy. Other hormonal approaches such as orchiectomy, aromatase inhibitors and androgen ablation may be useful in later lines of therapy.
Collapse
Affiliation(s)
- Teresa G Hayes
- Hematology Oncology Section, Department of Veterans' Affairs Medical Center, Baylor College of Medicine, Houston, TX 77030, USA.
| |
Collapse
|
18
|
|
19
|
Barquero-Romero J. Ginecomastia por finasteride. Semergen 2006. [DOI: 10.1016/s1138-3593(06)73321-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
Goodman MT, Tung KH, Wilkens LR. Comparative epidemiology of breast cancer among men and women in the US, 1996 to 2000. Cancer Causes Control 2006; 17:127-36. [PMID: 16425090 DOI: 10.1007/s10552-005-5384-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2004] [Accepted: 04/13/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Few investigations of breast cancer among men have been conducted because of the relative rarity of this malignancy. The objective of this analysis was to compare the demographic, pathological, and clinical features of breast cancer among men and women. METHODS Breast cancer among 6379 men and 744,275 women was identified through 34 US population-based registries in the US during the period 1996 to 2000. These registries were estimated to represent 69% of the US population. Age-adjusted incidence rates (AAIR) were calculated per million population using counts derived from the 2000 US census. RESULTS The AAIR of breast cancer among men (16.6) was substantially lower than the incidence among women (1557.7). Rates of breast cancer among black men were higher than among white and Asian-Pacific Island men, in contrast to women among whom rates in whites exceeded those among other ethnic groups. Similar to women, breast cancer rates among non-Hispanic men were 50% greater than among Hispanic men. Ductal cancer was the most common histologic type diagnosed in both sexes. The incidence of lobular cancer was rare in men, but Paget's disease and papillary carcinoma occurred with lower relative frequency in women than in men. Lobular breast cancers were less common among black men and women than among other ethnic groups. In situ breast cancer was diagnosed in 10.8% of men and 16.2% of women. Localized breast cancer was the most common stage at diagnosis in both sexes and all ethnic groups, although women were more likely than men to be diagnosed at a localized stage. Cancer was 10% more likely to be diagnosed in the left breast than the right breast among men compared to 4% in women. CONCLUSIONS In spite of the rare incidence of breast cancer in men, the descriptive epidemiology of this malignancy is surprisingly similar to that in women. An explanation for the greater relative incidence of breast cancer in black men is a research challenge.
Collapse
Affiliation(s)
- M T Goodman
- Epidemiology Program, Cancer Research Center Hawaii, University of Hawaii, 1236 Luahala Street, HI, 96813, USA.
| | | | | |
Collapse
|
21
|
Medras M, Filus A, Jozkow P, Jozkow P, Winowski J, Sicinska-Werner T, Sicinska Werner T. Breast cancer and long-term hormonal treatment of male hypogonadism. Breast Cancer Res Treat 2006; 96:263-5. [PMID: 16418796 DOI: 10.1007/s10549-005-9074-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2005] [Accepted: 09/09/2005] [Indexed: 12/28/2022]
Abstract
Breast cancer in men is rare and its etiology is multifactorial. Androgens may promote the development of breast carcinoma in men though data on the subject is scarce. We observed 45 men with hypergonadotropic hypogonadism (aged 18-57) who received 250 mg of testosterone esters (Omnadren 250, Jelfa, Poland) every 3-4 weeks for 5-26 years. Seventeen of them were treated for more than 10 years. During the observation period breast cancer was diagnosed in 2 subjects (11% of the followed men). In one case it occurred after 11 years and in the other after 15 years of the therapy. We point to a possible association between long-term androgen replacement and a risk of breast cancer in men.
Collapse
Affiliation(s)
- Marek Medras
- Department of Endocrinology, Diabetology and Nuclear Therapy, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | | | | | | |
Collapse
|