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Fentiman IS. Risk factors for male breast cancer. Am J Transl Res 2023; 15:6918-6925. [PMID: 38186995 PMCID: PMC10767513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024]
Abstract
Male breast cancer (MBC) presents problems with identification of high-risk groups. Risk factors include hepatic dysfunction, high ambient working temperature, exposure to exhaust fumes and obesity, but none identify a group with a high absolute number of MBC cases. The two significant cohorts are BRCA2 mutation carriers and individuals with Klinefelter's syndrome (KS), responsible for up to 15% of cases. Since >90% of male tumours are ER+ve, endocrine intervention is logical with the likely agent being tamoxifen. In terms of an acceptable endocrine agent, compliance studies. Compliance studies indicate that men do not tolerate tamoxifen well because of side-effects. Although certain groups with an increased risk of MBC can be identified, the absolute number of cases is small so, at present, a meaningful prevention study is not an option.
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Affiliation(s)
- Ian S Fentiman
- Department of Surgical Oncology and Breast Surgery, Guy's Hospital London SE1 9RT, UK
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2
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Hinchliffe A, Kogevinas M, Molina AJ, Moreno V, Aragonés N, Castaño-Vinyals G, Jiménez Moleón JJ, Gómez Acebo I, Ederra M, Amiano P, Molina-Barceló A, Fernandez-Tardon G, Alguacil J, Chirlaque MD, Hernández-Segura N, Pérez-Gómez B, Pollan M, Turner MC. Association of occupational heat exposure and colorectal cancer in the MCC-Spain study. Scand J Work Environ Health 2023; 49:211-221. [PMID: 36807489 PMCID: PMC10621896 DOI: 10.5271/sjweh.4082] [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: 11/03/2022] [Indexed: 02/21/2023] Open
Abstract
OBJECTIVE Heat exposure and heat stress/strain is a concern for many workers. There is increasing interest in potential chronic health effects of occupational heat exposure, including cancer risk. We examined potential associations of occupational heat exposure and colorectal cancer (CRC) risk in a large Spanish multi-case--control study. METHODS We analyzed data on 1198 histologically confirmed CRC cases and 2690 frequency-matched controls. The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to the lifetime occupations of participants. Three exposure indices were assessed: ever versus never exposed, cumulative exposure and duration (years). We estimated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for potential confounders. RESULTS Overall, there was no association of ever, compared with never, occupational heat exposure and CRC (OR 1.09, 95% CI 0.92-1.29). There were also no associations observed according to categories of cumulative exposure or duration, and there was no evidence for a trend. There was no clear association of ever occupational heat exposure and CRC in analysis conducted among either men or women when analyzed separately. Positive associations were observed among women in the highest categories of cumulative exposure (OR 1.81, 95% CI 1.09-3.03) and duration (OR 2.89, 95% CI 1.50-5.59) as well as some evidence for a trend (P<0.05). CONCLUSION Overall, this study provides no clear evidence for an association between occupational heat exposure and CRC.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Michelle C Turner
- ISGlobal, Barcelona Institute for Global Health, Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader, 88 Barcelona 08003 Spain.
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3
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Hinchliffe A, Alguacil J, Bijoux W, Kogevinas M, Menegaux F, Parent ME, Pérez Gomez B, Uuksulainen S, Turner MC. Occupational heat exposure and prostate cancer risk: A pooled analysis of case-control studies. ENVIRONMENTAL RESEARCH 2023; 216:114592. [PMID: 36272590 DOI: 10.1016/j.envres.2022.114592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/23/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Heat exposures occur in many occupations. Heat has been linked to key carcinogenic processes, however, evidence for associations with cancer risk is sparse. We examined potential associations between occupational heat exposure and prostate cancer risk in a multi-country study. METHODS We analysed a large, pooled dataset of 3142 histologically confirmed prostate cancer cases and 3512 frequency-matched controls from three countries: Canada, France, and Spain. Three exposure indices: ever exposure, lifetime cumulative exposure and duration of exposure, were developed using the Finnish Job-Exposure Matrix, FINJEM, applied to the lifetime occupational history of participants. We estimated odds ratios (ORs) and 95% confidence intervals (CIs), using conditional logistic regression models stratified by 5-year age groups and study, adjusting for potential confounders. Potential interactions with exposure to other occupational agents were also explored. RESULTS Overall, we found no association for ever occupational heat exposure (OR 0.97; 95% CI 0.87, 1.09), nor in the highest categories of lifetime cumulative exposure (OR 1.04; 95% CI 0.89, 1.23) or duration (OR 1.03; 95% CI 0.88, 1.22). When using only the Spanish case-control study and a Spanish Job Exposure Matrix (JEM), some weakly elevated ORs were observed. CONCLUSIONS Findings from this study provide no clear evidence for an association between occupational heat exposure and prostate cancer risk.
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Affiliation(s)
- Alice Hinchliffe
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Wendy Bijoux
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
| | - Manolis Kogevinas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; IMIM (Hospital Del Mar Medical Research Institute), Carrer Del Dr. Aiguader, 88, 08003, Barcelona, Spain
| | - Florence Menegaux
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
| | - Marie-Elise Parent
- Centre Armand-Frappier Santé Biotechnologie, Institut National de La Recherche Scientifique, Laval, Quebec, H7V 1B7, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, H3N 1X9, Canada; University of Montreal Hospital Research Center, Montreal, Quebec, H2X 0A9, Canada
| | - Beatriz Pérez Gomez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Department of Epidemiology for Chronic Diseases, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
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4
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Zheng G, Leone JP. Male Breast Cancer: An Updated Review of Epidemiology, Clinicopathology, and Treatment. JOURNAL OF ONCOLOGY 2022; 2022:1734049. [PMID: 35656339 PMCID: PMC9155932 DOI: 10.1155/2022/1734049] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/23/2022] [Accepted: 05/05/2022] [Indexed: 12/11/2022]
Abstract
Male breast cancer (MaBC) is a rare clinical entity, which makes up approximately 1% of all breast cancers. However, the incidence of MaBC has been steadily increasing over the past few decades. The risk factors for MaBC include age, black race, family history of breast cancer, genetic mutations, liver cirrhosis, and testicular abnormalities. The majority of patients with MaBC present with painless lumps, and about half of the patients have at least one lymph node involved at the time of diagnosis. The treatment of MaBC models that of female breast cancer (FeBC), but this is mainly due to lack of prospective studies for MaBC patients. The treatment modality includes surgery, adjuvant radiation, endocrine therapy, and chemotherapy. However, there are some distinct features of MaBC, both clinically and molecularly, that may warrant a different clinical approach. Ongoing multinational effort is required, to conduct clinical trials for MaBC, or the inclusion of MaBC patients in FeBC trials, to help clinicians improve care for MaBC patients.
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Affiliation(s)
- Guoliang Zheng
- Department of Medicine, St Elizabeth Medical Center, A Teaching Hospital of Boston University, 736 Cambridge Street, Boston, MA, USA
| | - Jose Pablo Leone
- Dana Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA
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5
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Xiao W, Huang J, Wang J, Chen Y, Hu N, Cao S. Occupational exposure to organic solvents and breast cancer risk: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:1605-1618. [PMID: 34686960 DOI: 10.1007/s11356-021-17100-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
Breast cancer is the most common cancer worldwide. Recent studies suggest that organic solvent exposure could be closely related to breast cancer, although the evidence remains controversial. Thus, we evaluated existing epidemiological evidence for the association between occupational solvent exposure and breast cancer. PubMed, Embase, and Cochrane Library were searched to identify published case-control and cohort studies that addressed occupational exposure to organic solvents and breast cancer, up to April, 2021. Meta-analyses using random-effects models were conducted to obtain the pooled odds ratios (OR) and 95% confidence intervals (CI) on the incidence of breast cancer in relation to occupational exposure. The pooled OR of breast cancer among workers exposed to organic solvents overall was 1.18 (95%CI, 1.11 ~ 1.25; I2 = 76.3%; 24 studies), compared to those with no exposure. After stratification by menopause and study location, it was revealed that the association between occupational exposure to organic solvents and the risk of breast cancer in postmenopausal women (OR, 1.35; 95% CI, 1.09 ~ 1.67; I2 = 73.4%; 7 studies) was significant, and there was also a clear association in workers in Europe (OR, 1.21; 95% CI, 1.12 ~ 1.32; I2 = 82.9%; 13 studies). We observed a significant association between occupational exposure to organic solvents and breast cancer in both cohort and case-control studies.
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Affiliation(s)
- Wenxuan Xiao
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jinglong Huang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jianing Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Youli Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Nan Hu
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Shiyi Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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6
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Hinchliffe A, Kogevinas M, Pérez-Gómez B, Ardanaz E, Amiano P, Marcos-Delgado A, Castaño-Vinyals G, Llorca J, Moreno V, Alguacil J, Fernandez-Tardón G, Salas D, Marcos-Gragera R, Aragonés N, Guevara M, Gil L, Martin V, Benavente Y, Gomez-Acebo I, Santibáñez M, Ángel Alba M, García AM, Pollán M, Turner MC. Occupational Heat Exposure and Breast Cancer Risk in the MCC-Spain Study. Cancer Epidemiol Biomarkers Prev 2020; 30:364-372. [PMID: 33268491 DOI: 10.1158/1055-9965.epi-20-0732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/30/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Mechanisms linking occupational heat exposure with chronic diseases have been proposed. However, evidence on occupational heat exposure and cancer risk is limited. METHODS We evaluated occupational heat exposure and female breast cancer risk in a large Spanish case-control study. We enrolled 1,738 breast cancer cases and 1,910 frequency-matched population controls. A Spanish job-exposure matrix, MatEmEsp, was used to assign estimates of the proportion of workers exposed (P ≥ 25% for at least 1 year) and work time with heat stress (wet bulb globe temperature ISO 7243) for each occupation. We used three exposure indices: ever versus never exposed, lifetime cumulative exposure, and duration of exposure (years). We estimated ORs and 95% confidence intervals (CI), applying a lag period of 5 years and adjusting for potential confounders. RESULTS Ever occupational heat exposure was associated with a moderate but statistically significant higher risk of breast cancer (OR 1.22; 95% CI, 1.01-1.46), with significant trends across categories of lifetime cumulative exposure and duration (P trend = 0.01 and 0.03, respectively). Stronger associations were found for hormone receptor-positive disease (OR ever exposure = 1.38; 95% CI, 1.12-1.67). We found no confounding effects from multiple other common occupational exposures; however, results attenuated with adjustment for occupational detergent exposure. CONCLUSIONS This study provides some evidence of an association between occupational heat exposure and female breast cancer risk. IMPACT Our results contribute substantially to the scientific literature. Further investigations are needed considering multiple occupational exposures.
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Affiliation(s)
- Alice Hinchliffe
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Manolis Kogevinas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Beatriz Pérez-Gómez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Ministry of Health of the Basque Government, San Sebastian, Spain
| | | | - Gemma Castaño-Vinyals
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,University of Cantabria - IDIVAL, Santander, Spain
| | - Víctor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO) and Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospital Duran i Reynals, Barcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Guillermo Fernandez-Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Institute of Health Research of the Principality of Asturias (ISPA), Public Health Department, University of Oviedo, Oviedo, Spain
| | - Dolores Salas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain.,General Directorate Public Health, Valencian Community, Valencia, Spain
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona, Spain.,Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain
| | - Leire Gil
- Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Ministry of Health of the Basque Government, San Sebastian, Spain
| | - Vicente Martin
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Instituto de Biomedicina (IBIOMED)
| | - Yolanda Benavente
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d'Oncologia, L'Hospitalet De Llobregat, Barcelona, Spain
| | - Ines Gomez-Acebo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,University of Cantabria - IDIVAL, Santander, Spain
| | | | - Miguel Ángel Alba
- Industrial Hygiene Department, Quirón Prevención, S.L.U., Barcelona, Barcelona, Spain
| | - Ana M García
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Departamento de Medicina Preventiva y Salud Pública, Universitat de València, València, Spain.,Center for Research in Occupational Health (CISAL), Universitat Pompeu Fabra, Barcelona, Spain
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
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7
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Sritharan J, MacLeod JS, Dakouo M, Qadri M, McLeod CB, Peter A, Demers PA. Breast cancer risk by occupation and industry in women and men: Results from the Occupational Disease Surveillance System (ODSS). Am J Ind Med 2019; 62:205-211. [PMID: 30648268 DOI: 10.1002/ajim.22942] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND The recently established Occupational Disease Surveillance System (ODSS) was used to examine breast cancer risk in women and men by occupation and industry. METHODS Ontario workers in the ODSS cohort (1983-2016) were followed up for breast cancer diagnosis through the Ontario Cancer Registry. Cox-proportional hazard models were used to calculate age-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS A total of 17 865 and 492 cases were identified in working women (W) and men (M), respectively. Elevated risks were observed in management (W: HR = 1.54, 95% CI = 1.40-1.70; M: HR = 2.79, 95% CI = 1.44-5.39), administrative/clerical (W: HR = 1.16, 95% CI = 1.11-1.21; M: HR = 1.45, 95% CI = 1.06-1.99), and teaching (W: HR = 1.54, 95% CI = 1.44-1.63; M: HR = 3.00, 95% CI = 1.49-6.03). Other elevated risks were observed in nursing/health, social sciences, and janitor/cleaning services for both genders. CONCLUSIONS Common occupational associations in both genders warrant investigation into job-related risk factors, such as sedentary behavior, shift work, ionizing radiation, and chemical exposures.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre; Cancer Care Ontario; Ontario Canada
| | - Jill S. MacLeod
- Occupational Cancer Research Centre; Cancer Care Ontario; Ontario Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre; Cancer Care Ontario; Ontario Canada
| | - Maria Qadri
- Occupational Cancer Research Centre; Cancer Care Ontario; Ontario Canada
| | - Chris B. McLeod
- School of Population and Public Health; University of British Columbia; British Columbia Canada
- Institute for Work & Health; Ontario Canada
| | - Alice Peter
- Population Health and Prevention; Cancer Care Ontario; Ontario Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre; Cancer Care Ontario; Ontario Canada
- Dalla Lana School of Public Health; University of Toronto; Ontario Canada
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8
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Emile G. Cancer du sein chez l’homme : ce qui différencie les hommes des femmes. PSYCHO-ONCOLOGIE 2017. [DOI: 10.1007/s11839-017-0636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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10
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Abstract
Male breast cancer is a rare disease, accounting for only 1% of breast cancer diagnoses in the USA. The current literature suggests that genetic factors including BRCA2 mutations, family history, age, androgen/estrogen imbalance, and environmental exposures may predispose to male breast cancer. In this manuscript, we will review known and possible risk factors for male breast cancer, as well as describe the clinical patterns of the disease.
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Affiliation(s)
- Raina M Ferzoco
- Department of Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
| | - Kathryn J Ruddy
- Department of Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
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11
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Grundy A, Harris SA, Demers PA, Johnson KC, Agnew DA, Villeneuve PJ. Occupational exposure to magnetic fields and breast cancer among Canadian men. Cancer Med 2016; 5:586-96. [PMID: 26792203 PMCID: PMC4799956 DOI: 10.1002/cam4.581] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 10/01/2015] [Accepted: 10/15/2015] [Indexed: 01/13/2023] Open
Abstract
Occupational magnetic field (MF) exposure has been suggested as a risk factor for breast cancer in both men and women. Due to the rarity of this disease in men, most epidemiologic studies investigating this relationship have been limited by small sample sizes. Herein, associations of several measures of occupational MF exposure with breast cancer in men were investigated using data from the population-based case-control component of the Canadian National Enhanced Cancer Surveillance System. Lifetime job histories were provided by 115 cases and 570 controls. Average MF exposure of individual jobs was classified into three categories (<0.3, 0.3 to <0.6, or ≥0.6 μT) through expert blinded review of participant's lifetime occupational histories. The impact of highest average and cumulative MF exposure, as well as exposure duration and specific exposure-time windows, on cancer risk was examined using logistic regression. The proportion of cases (25%) with a highest average exposure of ≥0.3 μT was higher than among controls (22%). We found an elevated risk of breast cancer in men who were exposed to ≥0.6 μT (odds ratio [OR] = 1.80, 95% CI = 0.82-3.95) when compared to those with exposures <0.3 μT. Those exposed to occupational MF fields for at least 30 years had a nearly threefold increase in risk of breast cancer (OR = 2.77, 95% CI = 0.98-7.82) when compared to those with background levels of exposure. Findings for the other time-related MF variables were inconsistent. Our analysis, in one of the largest case-control studies of breast cancer in men conducted to date, provides limited support for the hypothesis that exposure to MF increases the risk breast cancer in men.
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Affiliation(s)
- Anne Grundy
- Department of Cancer Epidemiology and Prevention ResearchAlberta Health Services – Cancer Control AlbertaCalgaryAlbertaCanada
| | - Shelley A. Harris
- Prevention and Cancer ControlCancer Care OntarioTorontoOntarioCanada
- Occupational Cancer Research CenterCancer Care OntarioTorontoOntarioCanada
- Division of Occupational and Environmental HealthDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Division of EpidemiologyDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Paul A. Demers
- Occupational Cancer Research CenterCancer Care OntarioTorontoOntarioCanada
- Division of Occupational and Environmental HealthDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Kenneth C. Johnson
- Department of Epidemiology and Community MedicineUniversity of OttawaOttawaOntarioCanada
| | - David A. Agnew
- University of Ontario Institute of TechnologyOshawaOntarioCanada
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12
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Yalaza M, İnan A, Bozer M. Male Breast Cancer. THE JOURNAL OF BREAST HEALTH 2016; 12:1-8. [PMID: 28331724 DOI: 10.5152/tjbh.2015.2711] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/03/2015] [Indexed: 12/24/2022]
Abstract
Male breast cancer (MBC) is a rare disease, accounting for less than 1% of all breast cancer diagnoses worldwide. Although breast carcinomas share certain characteristics in both genders, there are notable differences. Most studies on men with breast cancer are very small. Thus, most data on male breast cancer are derived from studies on females. However, when a number of these small studies are grouped together, we can learn more from them. This review emphasizes the incidence, etiology, clinical features, diagnosis, treatment, pathology, survival, and prognostic factors related to MBC.
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Affiliation(s)
- Metin Yalaza
- Clinic of Surgical Oncology, Konya Training and Research Hospital, Konya, Turkey
| | - Aydın İnan
- Department of General Surgery, Turgut Özal University Faculty of Medicine, Ankara, Turkey
| | - Mikdat Bozer
- Department of General Surgery, Division of Surgical Oncology, Fatih University Faculty of Medicine, İstanbul, Turkey
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13
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Heavner K, Gross-Davis CA, Frank AL, Newschaffer C, Klotz J, Burstyn I. Working environment and myeloproliferative neoplasm: A population-based case-control study following a cluster investigation. Am J Ind Med 2015; 58:595-604. [PMID: 25880722 DOI: 10.1002/ajim.22451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Occupational exposures, including those to polycyclic aromatic hydrocarbons (PAH), are suspected risk factors for myeloproliferative neoplasms (MPN). METHODS We investigated occupational exposures and MPN risk (54 cases and 472 controls) in a population-based case-control study in three rural Pennsylvania counties. Occupational histories, coded to SIC/SOC 1980, were linked to a previously created PAH job-exposure matrix. Odds ratios for industry (17 categories), occupation (26 categories), and PAH exposure were adjusted using logistic regression. RESULTS No industries or occupations were strongly or consistently associated with increased MPN risk. Analysis of employment duration found that being employed for 5 or more years in transportation, communications, and other public utilities was associated with MPN risk. There was no indication of an association with cumulative PAH exposure. CONCLUSIONS These few associations did not appear to have a common exposure. This exploratory study does not support the hypothesis that occupational exposure, including PAH, are strong risk factors for MPNs.
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Affiliation(s)
- Karyn Heavner
- Department of Environmental and Occupational Health; Drexel University; Philadelphia Pennsylvania
| | - Carol Ann Gross-Davis
- Department of Environmental and Occupational Health; Drexel University; Philadelphia Pennsylvania
- Environmental Protection Agency; Region 3; Philadelphia Pennsylvania
| | - Arthur L. Frank
- Department of Environmental and Occupational Health; Drexel University; Philadelphia Pennsylvania
| | - Craig Newschaffer
- Drexel University; A.J. Drexel Autism Institute; Philadelphia Pennsylvania
- Drexel University; Department of Epidemiology and Biostatistics; Philadelphia Pennsylvania
| | - Judith Klotz
- Department of Environmental and Occupational Health; Drexel University; Philadelphia Pennsylvania
| | - Igor Burstyn
- Department of Environmental and Occupational Health; Drexel University; Philadelphia Pennsylvania
- Drexel University; A.J. Drexel Autism Institute; Philadelphia Pennsylvania
- Drexel University; Department of Epidemiology and Biostatistics; Philadelphia Pennsylvania
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14
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Khan MH, Allerton R, Pettit L. Hormone Therapy for Breast Cancer in Men. Clin Breast Cancer 2015; 15:245-50. [PMID: 26165199 DOI: 10.1016/j.clbc.2015.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 01/26/2015] [Accepted: 01/31/2015] [Indexed: 01/19/2023]
Abstract
Breast cancer in men is rare, but its incidence is increasing, in keeping with the aging population. The majority of breast cancers in men are estrogen receptor positive. There is a paucity of clinical trials to inform practice, and much has been extrapolated from breast cancer in women. Hormone therapy represents the mainstay of adjuvant and palliative therapy but may have contraindications or poor tolerability. We review the evidence for choice of hormone therapy in both the adjuvant and palliative setting in breast cancer in men.
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Affiliation(s)
| | | | - Laura Pettit
- Royal Shrewsbury Hospital NHS Trust, Shropshire, UK.
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15
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Charbotel B, Fervers B, Droz J. Occupational exposures in rare cancers: A critical review of the literature. Crit Rev Oncol Hematol 2014; 90:99-134. [DOI: 10.1016/j.critrevonc.2013.12.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 12/03/2013] [Accepted: 12/04/2013] [Indexed: 01/06/2023] Open
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16
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Sousa B, Moser E, Cardoso F. An update on male breast cancer and future directions for research and treatment. Eur J Pharmacol 2013; 717:71-83. [PMID: 23545364 DOI: 10.1016/j.ejphar.2013.03.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 03/21/2013] [Accepted: 03/24/2013] [Indexed: 11/19/2022]
Abstract
Male breast cancer is a rare disease for which treatment has been based on the evidence available from female breast cancer. The new genomic tools can better characterize the biology of breast cancer. It is hoping that these will help to clarify possible differences of breast cancer behaviour in male patients, which will have a major impact on treatment strategies and on the conduct of clinical trials in this setting. In this review we will summarize available information on epidemiology, risk factors for breast cancer in men, the new insights of the biology of this disease, current recommendations for treatment and insights for future research.
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Affiliation(s)
- Berta Sousa
- Breast Unit, Champalimaud Cancer Center, Av. De Brasília-Doca de Pedrouços, 1400-048 Lisbon, Portugal
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17
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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.
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Affiliation(s)
- K J Ruddy
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
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18
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19
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Landero J, Touloei K, Glick BP. Invasive ductal breast carcinoma underneath a lipoma in a male patient. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2012; 5:33-37. [PMID: 23125888 PMCID: PMC3486776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Male breast cancer is a rare malignancy and accounts for less than one percent of all cancers in men. The authors describe the case of a 76-year-old Caucasian man with invasive ductal breast carcinoma who presented with a common lipoma. This paper reviews the current literature on epidemiology, risk factors, etiology, different types of breast cancer, clinical presentation, imaging, diagnostic workup, and treatment.
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Affiliation(s)
- James Landero
- Wellington Regional Medical Center, Wellington, Florida
| | - Khasha Touloei
- Western University of Health Sciences, Pomona, California
| | - Bradley P. Glick
- Wellington Regional Medical Center, Dermatology Residency Program, Wellington, Florida
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20
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Sandhu NP, Bride MBM, Dilaveri CA, Neal L, Farley DR, Loprinzi CL, Wahner-Roedler DL, Ghosh K. Male breast cancer. JOURNAL OF MEN'S HEALTH 2012. [DOI: 10.1016/j.jomh.2012.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Villeneuve S, Cyr D, Lynge E, Orsi L, Sabroe S, Merletti F, Gorini G, Morales-Suarez-Varela M, Ahrens W, Baumgardt-Elms C, Kaerlev L, Eriksson M, Hardell L, Févotte J, Guénel P. Occupation and occupational exposure to endocrine disrupting chemicals in male breast cancer: a case-control study in Europe. Occup Environ Med 2010; 67:837-44. [PMID: 20798010 DOI: 10.1136/oem.2009.052175] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Male breast cancer is a rare disease of largely unknown aetiology. In addition to genetic and hormone-related risk factors, a large number of environmental chemicals are suspected of playing a role in breast cancer. The identification of occupations or occupational exposures associated with an increased incidence of breast cancer in men may help to identify mammary carcinogens in the environment. METHODS Occupational risk factors for male breast cancer were investigated in a multi-centre case-control study conducted in eight European countries which included 104 cases and 1901 controls. Lifetime work history was obtained during in-person interviews. Occupational exposures to endocrine disrupting chemicals (alkylphenolic compounds, phthalates, polychlorinated biphenyls and dioxins) were assessed on a case-by-case basis using expert judgement. RESULTS Male breast cancer incidence was particularly increased in motor vehicle mechanics (OR 2.1, 95% CI 1.0 to 4.4) with a dose-effect relationship with duration of employment. It was also increased in paper makers and painters, forestry and logging workers, health and social workers, and furniture manufacture workers. The OR for exposure to alkylphenolic compounds above the median was 3.8 (95% CI 1.5 to 9.5). This association persisted after adjustment for occupational exposures to other environmental oestrogens. CONCLUSION These findings suggest that some environmental chemicals are possible mammary carcinogens. Petrol, organic petroleum solvents or polycyclic aromatic hydrocarbons are suspect because of the consistent elevated risk of male breast cancer observed in motor vehicle mechanics. Endocrine disruptors such as alkylphenolic compounds may play a role in breast cancer.
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Affiliation(s)
- Sara Villeneuve
- CESP-INSERM (National Institute of Health and Medical Research), Villejuif, France
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Ahmad R, Lewis S, Maharaj D. A male patient from the West Indies with invasive ductal carcinoma in the right breast: a case report and literature review. GENDER MEDICINE 2010; 7:179-183. [PMID: 20435280 DOI: 10.1016/j.genm.2010.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2009] [Indexed: 05/29/2023]
Abstract
BACKGROUND Men with breast carcinoma have a poor prognosis, especially in the younger age group (30-40 years of age), because most breast enlargements in young men are dismissed as gynecomastia, resulting in an unnecessary delay in treatment. OBJECTIVE We describe the case of a young male patient with invasive ductal breast carcinoma. CASE SUMMARY In November 2005, a 30-year-old Afro-Caribbean man presented at St. Clair Medical Centre in Port of Spain, Trinidad, with a painless lump in the right breast. Diagnostic findings revealed that the patient had stage II invasive ductal carcinoma, for which he underwent a mastectomy with total axillary clearance. CONCLUSION Surgeons investigating unilateral breast swellings in young males should not dismiss them simply as gynecomastia, and should be wary of cancer.
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MESH Headings
- Adult
- Age Distribution
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Axilla
- Biopsy
- Breast Neoplasms, Male/diagnosis
- Breast Neoplasms, Male/epidemiology
- Breast Neoplasms, Male/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/therapy
- Chemotherapy, Adjuvant
- Delayed Diagnosis
- Humans
- Incidence
- Lymph Node Excision
- Male
- Mastectomy, Simple
- Neoplasm Staging
- Prognosis
- Sex Distribution
- Tomography, X-Ray Computed
- Trinidad and Tobago/epidemiology
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Affiliation(s)
- Rizwan Ahmad
- The University of the West Indies, St. Augustine, Trinidad, West Indies
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23
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Marianne Ewertz, Lars Holmberg, Ste. Risk Factors for Male Breast Cancer? A Case-Control Study from Scandinavia. Acta Oncol 2009. [DOI: 10.1080/02841860117406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Briest S, Vang R, Terrell K, Emens L, R Lange J. Invasive Lobular Carcinoma of the Male Breast: A Rare Histology in an Uncommon Disease. Breast Care (Basel) 2009; 4:36-38. [PMID: 20877682 DOI: 10.1159/000190078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
SUMMARY: BACKGROUND: Breast cancer in men is an uncommon disease. Nearly all cases of male breast cancer originate in the terminal ductulolobular unit, with exceedingly rare reports of lobular carcinoma in men. Invasive lobular cancer is found in no more than 1-2% of male breast cancer cases. Most of what is known about this disease is in the form of approximately 30 case reports in the literature. CASE REPORT: We report the case of a 52-year-old man who presented at our institution with a lump in his left breast. Ultrasound-guided biopsy revealed an invasive lobular cancer. The rare histological type was confirmed by the result of the histological examination of the mastectomy specimen. The treatment was completed by dose dense chemotherapy, radiation, and endocrine therapy. CONCLUSION: Even though lobular structures are quite infrequent in the normal male, sporadic cases of invasive lobular breast cancer have been described. A short overview will be given in this case report.
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Affiliation(s)
- Susanne Briest
- Department of Gynecology and Obstetrics, University of Leipzig, Germany
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25
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Brinton LA, Richesson DA, Gierach GL, Lacey JV, Park Y, Hollenbeck AR, Schatzkin A. Prospective evaluation of risk factors for male breast cancer. J Natl Cancer Inst 2008; 100:1477-81. [PMID: 18840816 DOI: 10.1093/jnci/djn329] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Most risk factors for male breast cancer have been derived from retrospective studies that may reflect selective recall. In the prospective National Institutes of Health-AARP Diet and Health Study, we studied 324 920 men, among whom 121 developed breast cancer. Men who reported a first-degree relative with breast cancer had an increased risk of breast cancer (relative risk [RR] = 1.92, 95% confidence interval [CI] = 1.19 to 3.09). Among the medical conditions examined, a new finding emerged regarding increased male breast cancer risk associated with a history of a bone fracture (RR = 2.20, 95% CI = 1.24 to 3.91). Obesity was positively related to risk (RR = 1.79, 95% CI = 1.10 to 2.91, for body mass indices of >or=30 vs <25 kg/m2) and physical activity inversely related, even after adjustment for body mass index. Smokers were at somewhat elevated risk, although trends with smoking characteristics were inconsistent. Alcohol consumption was not related to risk. The identified risk factors show some commonalities with female breast cancer and indicate the importance of hormonal mechanisms. Differences in risk factors may reflect unique mechanisms associated with androgens and their ratio to bioavailable estrogens.
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Affiliation(s)
- Louise A Brinton
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20852-7234, USA.
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Abstract
Male breast cancer is a rare condition with scant research into its psychosocial impact. This phenomenologic study sought to elicit its lived experience. Following analysis of interview data, 4 key themes emerged: Living with male breast cancer, concealment as a strategy for managing the diagnosis, a contested masculinity, interacting with health services. Male breast cancer constitutes a unique lived experience for men that is unparalleled in other disease profiles. The idea of living with a feminized illness was very distressing and stigmatizing for some men. Furthermore, treatment resulted in a profound change to the concept of their embodied selves and constituted a significant change to body image and sexuality. This was reinforced in participants who experienced erectile dysfunction related to tamoxifen therapy. Sadly, some health professionals were unable to offer specific psychosocial support, and participants felt marginalized from the potential benefits of the treatment environment. However, participants adapted to the illness by reasserting and renegotiating masculinity and finding ways to accommodate life with a stigmatizing condition and an altered body image.
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27
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Agrawal A, Ayantunde AA, Rampaul R, Robertson JFR. Male breast cancer: a review of clinical management. Breast Cancer Res Treat 2006; 103:11-21. [PMID: 17033919 DOI: 10.1007/s10549-006-9356-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2006] [Accepted: 07/24/2006] [Indexed: 11/29/2022]
Abstract
AIMS Male breast cancer incidence is 1% of all breast cancers and is increasing. We aim to present an overview of male breast cancer with particular emphasis on clinical management. METHODS Studies were identified by an online search of literature in the MEDLINE database till June 2006 followed by an extensive review of bibliographies. RESULTS Increased risk factors include genetic predisposition as in BRCA2 families; testicular dysfunction due to chromosomal abnormality such as Klinefelter's syndrome or environmental factors such as chronic heat exposure and radiation. Clinical assessment with biopsy is the hallmark of diagnosis. Earlier presentations are becoming commoner but there are wide geographical differences. Surgical treatment involves simple or modified radical mastectomy along with surgical assessment of the axilla, either via sentinel node biopsy in clinically node-negative disease or axillary sampling/clearance in node-positive disease. Reconstructions for restoring body image have been recently reported. Indications for adjuvant therapies are similar to that in women. For metastatic disease, tamoxifen is still the mainstay for oestrogen receptor positive disease. For oestrogen receptor negative disease, doxorubicin based chemotherapy regimens are used. In addition, the oft neglected psychological aspects of men having a "cancer of women" are increasingly being recognised. CONCLUSIONS There is, thus, need for further increasing awareness among men to reduce stigma associated with presentation of symptoms related to breast. This should be in addition to stressing to clinicians the ways of earlier detection and tailor-made "gender oriented" treatment of breast cancer in men.
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Affiliation(s)
- A Agrawal
- Professorial Unit of Surgery, City Hospital, University of Nottingham, Nottingham, NG5 1PB, UK.
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29
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Abstract
Gynaecomastia, the enlargement of the male breast, is considered as an andrological disease. To date, a review on male breast cancer (MBC) has not been published in an andrological journal. The papers underlying this review were published from authors of different institutions: Clinical Genetics, Dermatology, Gynaecology, Internal Medicine, Oncology, Pathology, Psychiatry, Radiology and Surgery. MBC accounts for approximately 1% of breast cancer patients. A total of 182 men died of breast cancer in 1999, in Germany. In the US, 1500 new cases per year occur. MBC accounts for <5% of surgically removed breast lumps. Diseases with increased oestrogen action increase the risk of MBC. Mutations of distinct genes are estimated to account for up to roughly 10% of MBC. BRCA1 and BRCA2 gene mutations are responsible for approximately 80% of the families with hereditary breast cancer. The diagnosis of MBC is not possible without histological examination. Different diagnostic procedures such as clinical diagnosis, sonography, mammography, fine-needle biopsy and core needle facilitate the decision whether a biopsy is necessary.
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Affiliation(s)
- W Krause
- Department of Andrology, University Hospital, Philipp University, Marburg, Germany.
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30
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Abstract
Abstract
Breast cancer in men is a rare disease, accounting for ∼1% of all breast cancer cases. Although the epidemiologic literature regarding female breast cancer is extensive, relatively little is known about the etiology of male breast cancer (MBC). This review is intended to summarize the existing body of evidence on genetic and epidemiologic risk factors for breast cancer in men. Overall, the epidemiology of MBC presents similarities with the epidemiology of female breast cancer. Major genetic factors associated with an increased risk of breast cancer for men include BRCA2 mutations, which are believed to account for the majority of inherited breast cancer in men, Klinefelter syndrome, and a positive family history. Suspected genetic factors include AR gene mutations, CYP17 polymorphism, Cowden syndrome, and CHEK2. Epidemiologic risk factors for MBC include disorders relating to hormonal imbalances, such as obesity, testicular disorders (e.g., cryptorchidism, mumps orchitis, and orchiectomy), and radiation exposure. Suspected epidemiologic risk factors include prostate cancer,prostate cancer treatment, gynecomastia, occupational exposures (e.g., electromagnetic fields, polycyclic aromatic hydrocarbons, and high temperatures), dietary factors (e.g., meat intake and fruit and vegetable consumption), and alcohol intake.
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Affiliation(s)
- Joli R. Weiss
- 1Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, New York and
| | - Kirsten B. Moysich
- 1Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, New York and
| | - Helen Swede
- 2Connecticut Tumor Registry, Hartford, Connecticut
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31
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Palli D, Masala G, Mariani-Costantini R, Zanna I, Saieva C, Sera F, Decarli A, Ottini L. A gene-environment interaction between occupation and BRCA1/BRCA2 mutations in male breast cancer? Eur J Cancer 2004; 40:2474-9. [PMID: 15519522 DOI: 10.1016/j.ejca.2004.07.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2004] [Revised: 06/21/2004] [Accepted: 07/16/2004] [Indexed: 11/18/2022]
Abstract
The association of male breast cancer (MBC) with a positive breast cancer (BC) family history and with BRCA1/2 germ-line mutations points to a genetic component; a relationship with occupation has also been reported. Recently, we identified pathogenetic BRCA1/2 mutations in a population-based series of Italian MBC patients: here in, we investigated interactions between a carrier status for BRCA1/2 mutations and occupation using a case-case design and estimating case-only odds ratios (CORs). Truck-driving was the most frequent occupation (3/4 BRCA-related cases and 2/19 unrelated cases). An interaction between carrier status and working as a truck-driver emerged, when we classified MBC cases as "ever/never-held" this job title (COR 25.5; 95% Confidence Limits (CL): 1.1-1,412.5) or according to truck-driving as the "longest-held" work (COR 54.0; 95% CL: 1.6-2,997.5). The possible modifying effect on MBC risk in subjects carrying BRCA1/2 germ-line mutations of an occupation characterised by exposure to chemicals such as polycyclic aromatic hydrocarbons (PAH) that are capable of inducing DNA damage, may provide clues to the role of environmental exposures in modifying BC risk in mutation carriers in both genders.
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Affiliation(s)
- Domenico Palli
- Molecular and Nutritional Epidemiology Unit, CSPO, Scientific Institute of Tuscany, Via di San Salvi 12, 50135 Florence, Italy.
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32
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Abstract
Some studies have suggested a role of pesticide exposure in the development of neurobehavioral disorders. This case-control study examined the association between mortality from mental disorders and occupational exposure to pesticides. The study population consisted of 7756 deaths and 330,452 eligible controls identified from US death certificate files for the years 1988 through 1992. Exposure assignment was based on job title reported on the death certificates. Employment in jobs potentially involving pesticide exposure was weakly associated with the risk of death from mental disorders (odds ratio [OR] = 1.46; 95% confidence interval (95% CI) = 1.33-1.60). This association was stronger among women (OR = 2.65; 95% CI = 1.89-3.71), in particular for deaths from neurotic disorders (OR = 4.32; 95% CI = 2.44-7.64). These results must be interpreted with caution, however, because the impact of social and work-related factors other than pesticide exposure is not known.
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Affiliation(s)
- Samson Munn
- Department of Radiology, Lemuel Shattuck Hospital, 170 Morton St., Boston, MA 02130-3735, USA
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34
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Abstract
Relatively little attention has been paid to the aetiology of male breast cancer and the current understanding of female breast cancer, primarily related to reproductive events, cannot be readily transferred to understanding the cancer in males. However, since male breast cancer occurs in the absence of factors related to childbearing and menstruation, its aetiology may provide special insights into the causes of breast cancer in women. We examined lifestyle risk factors for male breast cancer as part of a Canadian, multi-site, population-based, case-control study. Eighty-one newly diagnosed, histologically confirmed cases and 1905 male controls aged 42-74 were analysed using unconditional logistic regression. Increased risks were found for men with a mother or sister with breast cancer (adjusted odds ratio (OR) 3.65, 95% confidence interval (95% CI) 1.62-8.19). Higher physical activity levels (moderate, and strenuous recreational plus occupational) were associated with a decreased risk of male breast cancer (highest quartile, adjusted OR 0.48, 95% CI 0.26-0.91). Similarly, higher risks were associated with higher weight 2 years before interview (2.19, 95% CI 1.08-4.43), maximum weight (OR 2.66) and higher body mass index (OR 1.60). Higher vegetable consumption and coffee consumption were associated with decreased risk, whereas higher beta-carotene, vitamin E and calcium supplementation were associated with statistically significant increased risk. The small number of cases and multiple comparisons preclude strong conclusions, but our study is consistent with studies suggesting obesity and family history increase risk, and physical activity decreases risk of breast cancer.
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Affiliation(s)
- K C Johnson
- Surveillance and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Population and Public Health Branch, Health Canada, Tunney's Pasture, Locator 0601C1, Ottawa, Ontario, Canada K1A 0L2.
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Cocco P. On the rumors about the silent spring. Review of the scientific evidence linking occupational and environmental pesticide exposure to endocrine disruption health effects. CAD SAUDE PUBLICA 2002; 18:379-402. [PMID: 11923880 DOI: 10.1590/s0102-311x2002000200003] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Occupational exposure to some pesticides, and particularly DBCP and chlordecone, may adversely affect male fertility. However, apart from the therapeutic use of diethylstilbestrol, the threat to human reproduction posed by "endocrine disrupting" environmental contaminants has not been supported by epidemiological evidence thus far. As it concerns other endocrine effects described in experimental animals, only thyroid inhibition following occupational exposure to amitrole and mancozeb has been confirmed in humans. Cancer of the breast, endometrium, ovary, prostate, testis, and thyroid are hormone-dependent, which fostered research on the potential risk associated with occupational and environmental exposure to the so-called endocrine-disrupting pesticides. The most recent studies have ruled out the hypothesis of DDT derivatives as responsible for excess risks of cancer of the reproductive organs. Still, we cannot exclude a role for high level exposure to o,p'-DDE, particularly in post-menopausal ER+ breast cancer. On the other hand, other organochlorine pesticides and triazine herbicides require further investigation for a possible etiologic role in some hormone-dependent cancers.
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Affiliation(s)
- Pierluigi Cocco
- Sezione di Medicina del Lavoro, Dipartimento di Igiene e Sanitá Publica, Facoltà di Medicina e Chirurgia, Università degli Studi di Cagliari, Cagliari, Italia.
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36
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Koc M, Polat P. Epidemiology and aetiological factors of male breast cancer: a ten years retrospective study in eastern Turkey. Eur J Cancer Prev 2001; 10:531-4. [PMID: 11916352 DOI: 10.1097/00008469-200112000-00008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to assess the epidemiological and aetiological factors of male breast carcinoma in eastern Turkey. For this purpose we evaluated breast carcinoma patients admitted to our regional hospital from 1990 to 2000. A total of 196 patients were admitted during that time, 11 of whom were male (5%). The average age at presentation was 60.7 +/- 7.5. Infiltrating ductal carcinoma was the most frequent histopathological type; lobular carcinoma was detected in only one of our cases. Right-sided male breast carcinoma was seen in 7 of 11 cases, left-sided in four cases. We detected gynaecomastia in two patients. Other factors were excessive alcohol consumption for 35 years in one patient, family history in one patient and exposure to electromagnetic fields (EMFs) and light at night in four patients. We demonstrated no risk factor in the other three cases. Of the patients in our study, the youngest was 45 years old--the patient with post-pubertal gynaecomastia. The overall rate of male breast carcinoma seen among people who had worked for the Turkish Institution of Electricity in eastern Turkey was 0.3%. In our study we demonstrated a close relation between exposure to EMFs and light at night and male breast carcinoma in eastern Turkey. We also supposed that not only exposure to EMFs but also the duration of the exposure could affect the risk of development of male breast carcinoma.
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Affiliation(s)
- M Koc
- Department of Radiation Oncology, Medical School of Atatürk University, Erzurum, Turkey.
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Wallace WA, Balsitis M, Harrison BJ. Male breast neoplasia in association with selective serotonin re-uptake inhibitor therapy: a report of three cases. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2001; 27:429-31. [PMID: 11417992 DOI: 10.1053/ejso.2000.1066] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Male breast cancer is a rare condition with very poorly understood risk factors. We report three cases of men with malignant and pre-malignant breast disease who had all been prescribed selective serotonin re-uptake inhibitors (SSRIs) for depression. Concerns about an association between this group of drugs and breast cancer in women have been previously raised and experimental evidence has suggested that these drugs could influence regulation of cellular proliferation acting through internal cellular messengers. Risk factors for the development of breast cancer are likely to be multifactorial, possibly more so in women given the complex physiological changes that occur in the female breast. Whilst the cases we report are anecdotal and other risk factors may be present, we suggest that assessment of any possible contribution that SSRI therapy may make to the development of breast neoplasia may be more easily assessed in a male population.
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Affiliation(s)
- W A Wallace
- Department of Histopathology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
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Abstract
BACKGROUND Investigations of breast cancer among men may provide clues for environmental and occupational risk factors that may be difficult to study in women, because of confounding or effect modification from reproductive female characteristics. The objective was to estimate occupation-specific risks of male breast cancer and to assess the effect of occupational exposure to extremely low-frequency magnetic fields (ELFMF). METHODS Standardized incidence ratios were computed for the period 1971-1989 among Swedish men who were 25-59 years of age at start of follow-up and gainfully employed in 1970. Log-linear Poisson models were fitted to adjust for geographical area. A job exposure matrix was used to classify occupational ELFMF exposure. RESULTS A marked and consistent excess risk was found for machinery repairers. Increased relative risks based on few cases were also noted for librarians/archivists/curators, bank employees, non-specified clerical workers, metal processing workers, tanners/fur dressers, policemen, and custom surveillance officials. The relative risk among subjects with an estimated ELFMF exposure above the first quartile (0.12 microT) was 1.31 (95% confidence interval = 0.94-1.81), without a clear exposure-response pattern. Indications of an exposure-response relationship were found in workers with intermittent ELFMF exposure. CONCLUSIONS The findings give no clear evidence for an etiological role of ELFMF in the development of breast cancer in men, but suggest that large variations in exposure over the work-day may be associated with an increased risk.
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Affiliation(s)
- M Pollán
- Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
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Abstract
BACKGROUND Automotive gasoline contains benzene, 1,3-butadiene, 1, 2-dibromoethane and 1,2-dichloroethane, and the combustion products include certain polycyclic aromatic hydrocarbons, all of which have shown mammary gland carcinogenicity in long-term bioassays. It is the aim of this paper to investigate whether men occupationally exposed to gasoline and its combustion products have an elevated risk of breast cancer. METHODS A nationwide register based case control study on male breast cancer morbidity was established among members of a pension fund, compulsory for all employees. Employment histories were reconstructed for each of 230 cases and 12,880 control subjects based on computerized records. The odds ratios, adjusted for socioeconomic status, were estimated by conditional logistic regression analysis. RESULTS When a lag time of at least 10 years was included, the odds ratio for breast cancer among men with over three months of employment in trades with potential exposure to gasoline and combustion products was 2.5 (95% confidence interval: 1.3-4.5). Among men younger than 40 years at the time of first employment, the odds ratio was 5.4 (2.4-11.9). CONCLUSIONS This study supports the hypothesis that occupational exposure to gasoline vapors and combustion products may play a role in the causation of male breast cancer. This hypothesis warrants further evaluation particularly in women.
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Affiliation(s)
- J Hansen
- Danish Cancer Society, Institute of Cancer Epidemiology, Strandboulevarden 49, DK-2100 Copenhagen o, Denmark.
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Anderson LE, Boorman GA, Morris JE, Sasser LB, Mann PC, Grumbein SL, Hailey JR, McNally A, Sills RC, Haseman JK. Effect of 13 week magnetic field exposures on DMBA-initiated mammary gland carcinomas in female Sprague-Dawley rats. Carcinogenesis 1999; 20:1615-20. [PMID: 10426815 PMCID: PMC7185195 DOI: 10.1093/carcin/20.8.1615] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Several studies suggest that exposure to 50 Hz magnetic fields may promote chemically induced breast cancer in rats. Groups of 100 female Sprague-Dawley rats were initiated with four weekly 5 mg gavage doses of 7,12-dimethylbenz[a]anthracene (DMBA) starting at 50 days of age. After the first weekly DMBA administration, exposure to ambient fields (sham exposed), 50 Hz magnetic fields at either 1 or 5 G field intensity or 60 Hz fields at 1 G for 18.5 h/day, 7 days/week was initiated. Exposure continued for 13 weeks. A vehicle control group without DMBA was included. In a second study, using lower doses of DMBA, groups of 100 female Sprague-Dawley rats were initiated with four weekly doses of 2 mg of DMBA starting at 50 days of age followed, after the first weekly DMBA administration, by exposure to ambient fields (sham exposed) or 50 Hz magnetic fields at either 1 or 5 G field intensity for 18.5 h/day, 7 days/week for 13 weeks. Rats were weighed and palpated weekly for the presence of tumors. There was no effect of magnetic field exposure on body weight gains or on the time of appearance of mammary tumors in either study. At the end of 13 weeks, the animals were killed and the mammary tumors counted and measured. Mammary gland masses found grossly were examined histologically. In the first 13 week study, the mammary gland carcinoma incidences were 92, 86, 96 and 96% for the DMBA controls, 1 G, 50 Hz, 5 G, 50 Hz and 1 G, 60 Hz groups, respectively. The total numbers of carcinomas were 691, 528 (P < 0. 05, decrease), 561 and 692 for the DMBA controls, 1 G, 50 Hz, 5 G, 50 Hz and 1 G, 60 Hz groups, respectively. In study 2, the mammary gland carcinoma incidences were 43, 48 and 38% for the DMBA controls, 1 G, 50 Hz and 5 G, 50 Hz groups, respectively. The total numbers of carcinomas were 102, 90 and 79 for the DMBA controls, 1 G, 50 Hz and 5 G, 50 Hz groups, respectively. There was no effect of magnetic field exposure on tumor size either by in-life palpation or by measurement at necropsy in either study. There was no evidence that 50 or 60 Hz magnetic fields promoted breast cancer in these studies in female rats. These studies do not support the hypothesis that magnetic field exposure promotes breast cancer in this DMBA rat model.
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Affiliation(s)
- L E Anderson
- Battelle Pacific Northwest Laboratories, PO Box 999, Richland, WA 99352, USA
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Abstract
BACKGROUND In a recent report, we found an elevated risk of cancer of the central nervous system (CNS) in several occupations and industries, and a modest association with exposure to solvents and to contact with the public. METHODS To further explore the occupational risk of CNS cancer among women, we extended the analysis of the previous death certificate-based case-control study, including 12,980 female cases (ICD-9 codes 191 and 192) in 24 US states in 1984-1992 and 51,920 female controls who died from diseases other than malignancies and neurological disorders. We applied newly designed job-exposure matrices for 11 occupational hazards, previously reported as brain cancer risk factors, to the occupation and industry codes in the death certificates. We also conducted a separate analysis of 161 meningioma cases (ICD-9 codes 192.1 and 192.3), a tumor more frequent among women, particularly in the postmenopausal age group. RESULTS Overall, CNS cancer risk showed a 20-30% increase among women exposed to electromagnetic fields (EMF), methylene chloride, insecticides and fungicides, and contact with the public. Risk for meningioma was elevated among women exposed to lead (OR = 1.9; 95% CI 1.0, 3.9). CNS cancer did not show a clear pattern of risk increase by probability and intensity of exposure to any of the explored risk factors. Cross-classification by probability and intensity of exposure did not reveal any significant trend. Cases were too few to explore trends of meningioma by probability and intensity of exposure to lead. CONCLUSIONS We did not find evidence of a strong contribution of 11 occupational hazards to the etiology of CNS cancer. However, limitations of the occupational information might have reduced our ability to detect clear patterns of risk.
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Affiliation(s)
- P Cocco
- Institute of Occupational Medicine, University of Cagliari, Italy.
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