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Chowdhury A, Saad Eddin A, Kim Hsieh S, Policeni FC. Review of Breast Imaging in Transgender and Gender-Diverse Patients: Gender-Affirming Care, Histopathologic Findings, Breast Cancer Risk, and Screening Recommendations. JOURNAL OF BREAST IMAGING 2024; 6:238-245. [PMID: 38613363 DOI: 10.1093/jbi/wbae016] [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: 10/25/2023] [Indexed: 04/14/2024]
Abstract
Gender diversity, especially pertaining to transgender and gender-diverse (TGD) populations, is often stigmatized. A small but not insignificant number of adults in the United States identify as TGD, including transgender, nonbinary, and other gender identities than cisgender. Accessing health care remains a significant challenge for TGD individuals because many health care systems adhere to a gender binary model and many TGD individuals experience negative interactions when interfacing with health care. There is also a scarcity of literature addressing their unique health care needs, limiting our current understanding of breast cancer risks and screening recommendations for TGD patients. This article reviews important considerations when providing care to TGD patients. It covers background information on gender identity and sexuality, explores gender-affirming care, discusses histopathologic findings of breast biopsy specimens, examines breast cancer risks, and presents current breast cancer screening recommendations for TGD patients. Education on TGD breast cancer risks and screening and creating a standardized screening protocol for TGD patients who may receive gender-affirming care through hormonal and surgical therapies could help improve their health care equity and access.
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Affiliation(s)
- Ajmain Chowdhury
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Su Kim Hsieh
- Department of Radiology, University of Iowa, Iowa City, IA, USA
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Ye M, Qiu L, Jin Y, Huang Y. Stakeholders' experiences and perceptions of male breast cancer:A qualitative evidence synthesis. Breast 2024; 74:103694. [PMID: 38417232 PMCID: PMC10904996 DOI: 10.1016/j.breast.2024.103694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/06/2023] [Accepted: 02/19/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The experiences, physical and mental health and needs of women with breast cancer have been studied in some detail, but there is a lack of discussion of the experiences of stakeholder groups such as men with breast cancer, partners and carers and healthcare professionals. The aim of this study was to explore and understand the experiences and perceptions of male breast cancer stakeholders from diagnosis through to survivorship. METHODS We conducted a thematic review of qualitative studies included in a large published scoping review on male breast cancer (reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews extension). To be included in a qualitative evidence review, studies had to use qualitative methods for data collection and analysis to capture the perspectives of men with breast cancer, partners or caregivers, and healthcare workers. Key characteristics and findings were extracted and a conceptual coding framework was summarized using thematic analysis. RESULTS Out of a total of 310 studies in the research literature (published research articles and gray literature), 15 studies met the inclusion criteria. These studies reported on the experiences of men with breast cancer, partners or caregivers, and healthcare workers, with participant numbers ranging from 2 to 31. A total of 17 descriptive themes (study outcomes) were identified. From these, four high-level analytic themes emerged: (1) Predicament; (2) Emotion; (3) Support; (4) Coping. CONCLUSIONS The gender stigma that exists at the patient, healthcare system, and family-society levels largely influences the experiences of the male breast cancer stakeholder population. To address gender inequalities in breast cancer care, healthcare organizations and society at large should remain equally attentive to the needs of male and female breast cancer patients. These needs include reducing healthcare and social stigma, providing gender-specific information and emotional support, and access to support groups.
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Affiliation(s)
- Maodie Ye
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Lin Qiu
- Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China
| | - Yongmei Jin
- Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China.
| | - Yingying Huang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
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Khare VS, Huda F, Misra S, Amulya KR, Raj N, Karn S, Basu S. Male Breast Cancer: An Updated Review of Patient Characteristics, Genetics, and Outcome. Int J Breast Cancer 2024; 2024:9003572. [PMID: 38559438 PMCID: PMC10981544 DOI: 10.1155/2024/9003572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
Male breast cancer (MBC) is a rare entity, underrepresented in population studies and clinical trials, resulting in management of MBC to be informed by current research on female breast cancer (FBC). A literature review was conducted by accessing relevant articles on 2 databases, by searching keywords "male breast cancer". A total of 29 articles from year 2011 to 2022 were selected for this review. The authors found that male breast cancer generally occurs later in life with higher stage, higher grade, and more estrogen receptor (ER) positive tumours. Most of the studies noted the mean age for MBCs at the time of presentation as >60 years. Risk factors for male breast cancer include family history, obesity, lower physical activity, and syndromes like the Klinefelter syndrome. Positive family history is much higher in MBC compared to FBC (30.9 vs. 18.4%). BRCA 2 cancers constitute a higher proportion compared to FBCs. A lot of genetic mutations have been observed. Some show promise to assess disease-specific survival and proliferative rate like TWIST1 and RUNX3, among others. MBCs usually present with a palpable lump in central region, with a bigger size and chance of nodal involvement and metastasis compared to FBCs. They are mostly infiltrating ductal type and hormone receptor positive, with worse histological grade. Treatment usually follows the same principles as FBCs (systemic therapy, surgical excision, and radiotherapy), with poorer prognosis to same treatment approach, possibly owing to its advanced stage at presentation. This is a rare entity which requires further research to ascertain need for different management approach than FBCs.
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Affiliation(s)
- Vidhu Shekhar Khare
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Farhanul Huda
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Subhasis Misra
- Department of Surgical Oncology, BayCare Health System, Department of Medical Education, University of South Florida, Tampa, USA
| | - Kanmatha Reddy Amulya
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Nirmal Raj
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Summi Karn
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Somprakas Basu
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
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Abboah-Offei M, Bayuo J, Salifu Y, Afolabi O, Akudjedu TN. Experiences and perceptions of men following breast cancer diagnosis: a mixed method systematic review. BMC Cancer 2024; 24:179. [PMID: 38317128 PMCID: PMC10845771 DOI: 10.1186/s12885-024-11911-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Men with breast cancer experience unique physical and emotional challenges. However, a thorough understanding of these experiences including the psychosocial effects and supportive care needs have received less attention. In some settings, men with breast cancer experience stigma within the healthcare system and their care needs are not prioritised. This influences the level of professional support offered, consequently worsening their health and well-being outcomes. This review explored the variabilities in the experiences and treatment modalities of male breast cancer (MBC) across different contexts. METHODS All primary study designs including qualitative, quantitative, and mixed methods studies that reported on the experiences, treatment approaches and outcomes of MBC were included in this systematic review. Six databases (Embase, Medline, PsycINFO, Global Health, CINAHL and Web of Science) were searched for articles from January 2000 to September 2023. A results-based convergence synthesis was used for data analysis and reported using PRISMA guidelines. RESULTS Of the studies screened (n = 29,687), forty-four fulfilled the predetermined criteria and were included. Our findings relating to the experiences and treatment approaches of MBC are broadly themed into three parts. Theme 1-Navigating through a threat to masculinity: describes how males experienced the illness reflecting on detection, diagnosis, coming to terms with breast cancer, and disclosure. Theme 2- Navigating through treatment: captures the experiences of undergoing breast cancer treatment/ management following their diagnosis. Theme 3-Coping and support systems: describes how MBC patients coped with the disease, treatment process, aftercare/rehabilitative care, and the available support structures. CONCLUSIONS Men experience a myriad of issues following a breast cancer diagnosis, especially with their masculinity. Awareness creation efforts of MBC among the public and healthcare practitioners are urgently required, which could change the perception of men in promoting early diagnosis, adherence to treatments, post-treatment monitoring, oncological results and a better quality of life. Considerations for training, education and development of specialised guidelines for healthcare practitioners on MBC would provide the necessary knowledge and skills to enhance their practice through the adoption of person-centred and male-specific care strategies. Professional care intervention and support for MBC should not end after the diagnosis phase but should extend to the entire treatment continuum and aftercare including future research focusing on MBC specific clinical trials. TRIAL REGISTRATION PROSPERO Registration No. CRD42021228778.
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Affiliation(s)
- Mary Abboah-Offei
- School of Health and Social Care, Edinburgh Napier University, Sighthill Court, Sighthill Campus, Edinburgh, UK
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, Hongkong, China
| | - Yakubu Salifu
- International Observatory On End of Life Care (IOELC), Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, LA1 4AT, UK.
| | - Oladayo Afolabi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, WC2R 2LS, UK
| | - Theophilus N Akudjedu
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Science, Bournemouth University, Bournemouth, UK
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Sahin SI, Balci S, Guler G, Altundag K. Clinicopathological analysis of 38 male patients diagnosed with breast cancer. Breast Dis 2024; 43:1-8. [PMID: 38363600 PMCID: PMC10894578 DOI: 10.3233/bd-230050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Male breast cancer (MBC) accounts for one percent of all breast cancers. Due to the lack of awareness and routine screening programs, most patients present with systemic disease at the time of diagnosis with low overall survival. OBJECTIVES This study aims to investigate the prognostic factors of male breast cancer and its correlation with established prognostic parameters and patient outcomes. METHODS Thirty-eight male breast cancer patients are identified from the MKA Breast Cancer Clinic database, and their corresponding clinical and pathological characteristics are obtained. Cut-off values of 1% and 10% are applied to further classify ER and PR results. RESULTS Older men are more likely to develop MBC than younger men and are more likely to have spread to axillary lymph nodes. Invasive ductal carcinoma is a more common histologic type in MBC. All the tested patients have ER and PR positivity. Distant metastasis developed in 17/38 (44.7%) patients. Bone metastasis is seen commonly in metastatic MBC. CONCLUSIONS According to our cohort, MBC is seen in older males, presents in later stages, and shows hormone receptor positivity and a tendency to bone involvement. MBC is a heterogenous but distinct biological entity requiring a specific clinical and pathological approach.
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Affiliation(s)
- Seniha Irem Sahin
- Department of Pathology and Laboratory Medicine, Division of Anatomic Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Serdar Balci
- Memorial Hospital Group, Pathology Laboratory, Istanbul, Turkey
| | - Gulnur Guler
- Bilen Pathology, Sakir Baki Sokak, Ankara, Turkey
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Schultz EB, Zubac D, Bloch W, Baurecht H, Rickert J, Baumann FT. Moderate Intensity Exercise Reduces Side Effects of Cancer Therapy and Maintains Cardiorespiratory Fitness in Male Breast Cancer Patients: Findings from the BRECA Male Crossover Study. Breast Care (Basel) 2023; 18:483-492. [PMID: 38130815 PMCID: PMC10731027 DOI: 10.1159/000534090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/11/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction There is growing evidence that aerobic exercise mitigates cancer therapy-related side effects and improves cardiorespiratory fitness (CRF). However, to the best of our knowledge, no exercise study has been conducted in male breast cancer (MBC) patients. The aim of this study was to investigate the feasibility and efficacy of different exercise intensities on CRF and self-reported questionnaire items in MBC patients. Methods Twenty-two MBC patients (60 ± 9 years) participated in this randomized crossover study. After completion of medical treatment, MBC patients were randomly assigned to either moderate (40-50% of heart rate [HR] max. and self-perceived exertion: 11) or vigorous (70-80% of HR max. and self-perceived exertion: 15) exercise intensity during the first 3 months of the study. After a 1-month washout period, participants switched group assignments. Primary endpoints were CRF and questionnaire items. Results We observed a dropout rate of 36% over 7 months, with the number of participants decreasing from 22 to 14. The results showed significant improvements in "Physical Function" (p = 0.037) and "Social Function" (p = 0.016) after moderate training. A non-significant improvement was also observed in "Breast Symptoms" (p = 0.095), but there was no change in "Fatigue" (p = 0.306). There were no differences observed in cardiovascular fitness (V̇O2 peak) between the treatment groups. Conclusion This study emphasizes the effectiveness of exercise intervention for an exceedingly rare cancer, highlighting the vital role of moderate intensity aerobic exercise in mitigating treatment side effects. Despite minimal peak V̇O2 differences, both exercise protocols adequately sustain CRF. Future studies are imperative to design optimized, sex-specific rehabilitation strategies tailored to the unique requirements of MBC patients, advancing our understanding of this under explored realm.
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Affiliation(s)
- Eva B. Schultz
- Department Section Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Damir Zubac
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - Wilhelm Bloch
- Department Section Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Hansjörg Baurecht
- Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Jana Rickert
- Department Section Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Freerk T. Baumann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
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Hyeong JH, Jeong SH, Park EJ, Kim KJ, Kim KH. A Case of Breast Carcinoma en Cuirasse in Male. Ann Dermatol 2023; 35:S323-S326. [PMID: 38061731 PMCID: PMC10727906 DOI: 10.5021/ad.22.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/04/2022] [Accepted: 01/20/2023] [Indexed: 12/20/2023] Open
Abstract
A 63-year-old male presented with a painful skin lesion on the left side of the neck and upper chest approximately two months prior to presentation. Diffuse erythematous to purplish-colored sclerotic patches were observed. He had been treated with intravenous antibiotics for two weeks for cellulitis, but the lesion did not improve. Punch biopsy, and neck computed tomography (CT) with contrast enhancement were performed to differentiate between cellulitis and scleroderma. Histopathological examination revealed infiltration of pleomorphic and poorly differentiated tumor cells extending into thickened collagen bundles, and mitotic activity. Based on histologic and radiologic findings, the patient was suspected to have poorly differentiated carcinoma, and further evaluation of the origin of the carcinoma was performed. A subareolar mass on the left breast was observed on chest CT, and a needle biopsy was performed; results were consistent with findings from the skin biopsy. Finally, the patient was diagnosed with carcinoma en cuirasse, a subtype of cutaneous metastasis of breast cancer, was transferred to oncology, and underwent palliative chemotherapy.
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Affiliation(s)
- Jin Hyeok Hyeong
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Soo Hyun Jeong
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Joo Park
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang Ho Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
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Garrido MP, Hernandez A, Vega M, Araya E, Romero C. Conventional and new proposals of GnRH therapy for ovarian, breast, and prostatic cancers. Front Endocrinol (Lausanne) 2023; 14:1143261. [PMID: 37056674 PMCID: PMC10086188 DOI: 10.3389/fendo.2023.1143261] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
For many years, luteinizing hormone-releasing hormone or gonadotropin-releasing hormone (GnRH) analogs have been used to treat androgen or estrogen-dependent tumors. However, emerging evidence shows that the GnRH receptor (GnRH-R) is overexpressed in several cancer cells, including ovarian, endometrial, and prostate cancer cells, suggesting that GnRH analogs could exert direct antitumoral actions in tumoral tissues that express GnRH-R. Another recent approach based on this knowledge was the use of GnRH peptides for developing specific targeted therapies, improving the delivery and accumulation of drugs in tumoral cells, and decreasing most side effects of current treatments. In this review, we discuss the conventional uses of GnRH analogs, together with the recent advances in GnRH-based drug delivery for ovarian, breast, and prostatic cancer cells.
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Affiliation(s)
- Maritza P. Garrido
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago, Chile
- Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andrea Hernandez
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Margarita Vega
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago, Chile
- Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Eyleen Araya
- Departamento de Ciencias Quimicas, Facultad de Ciencias Exactas, Universidad Andres Bello, Santiago, Chile
| | - Carmen Romero
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago, Chile
- Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Giacobbe G, Granata V, Trovato P, Fusco R, Simonetti I, De Muzio F, Cutolo C, Palumbo P, Borgheresi A, Flammia F, Cozzi D, Gabelloni M, Grassi F, Miele V, Barile A, Giovagnoni A, Gandolfo N. Gender Medicine in Clinical Radiology Practice. J Pers Med 2023; 13:jpm13020223. [PMID: 36836457 PMCID: PMC9966684 DOI: 10.3390/jpm13020223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Gender Medicine is rapidly emerging as a branch of medicine that studies how many diseases common to men and women differ in terms of prevention, clinical manifestations, diagnostic-therapeutic approach, prognosis, and psychological and social impact. Nowadays, the presentation and identification of many pathological conditions pose unique diagnostic challenges. However, women have always been paradoxically underestimated in epidemiological studies, drug trials, as well as clinical trials, so many clinical conditions affecting the female population are often underestimated and/or delayed and may result in inadequate clinical management. Knowing and valuing these differences in healthcare, thus taking into account individual variability, will make it possible to ensure that each individual receives the best care through the personalization of therapies, the guarantee of diagnostic-therapeutic pathways declined according to gender, as well as through the promotion of gender-specific prevention initiatives. This article aims to assess potential gender differences in clinical-radiological practice extracted from the literature and their impact on health and healthcare. Indeed, in this context, radiomics and radiogenomics are rapidly emerging as new frontiers of imaging in precision medicine. The development of clinical practice support tools supported by artificial intelligence allows through quantitative analysis to characterize tissues noninvasively with the ultimate goal of extracting directly from images indications of disease aggressiveness, prognosis, and therapeutic response. The integration of quantitative data with gene expression and patient clinical data, with the help of structured reporting as well, will in the near future give rise to decision support models for clinical practice that will hopefully improve diagnostic accuracy and prognostic power as well as ensure a more advanced level of precision medicine.
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Affiliation(s)
- Giuliana Giacobbe
- General and Emergency Radiology Department, “Antonio Cardarelli” Hospital, 80131 Naples, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Piero Trovato
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
- Correspondence:
| | - Igino Simonetti
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Federica De Muzio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Carmen Cutolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy
| | - Pierpaolo Palumbo
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, 67100 L’Aquila, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy
| | - Federica Flammia
- Department of Emergency Radiology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Diletta Cozzi
- Department of Emergency Radiology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Michela Gabelloni
- Department of Translational Research, Diagnostic and Interventional Radiology, University of Pisa, 56126 Pisa, Italy
| | - Francesca Grassi
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Emergency Radiology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Antonio Barile
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, Corso Scassi 1, 16149 Genoa, Italy
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Profile of Male Breast Cancer in Makkah Region of Saudi Arabia: A 4-Year Retrospective Analysis of Radiology and Histopathology. Int J Breast Cancer 2022; 2022:8831011. [PMID: 35784659 PMCID: PMC9242822 DOI: 10.1155/2022/8831011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 05/08/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mammography is a method widely used for the diagnosis of breast disorders in women and may help detect breast cancer in its early stages. Male breast cancer often remains undiagnosed or is poorly controlled until serious complications arise; therefore, the use of screening methods is needed to help with early diagnosis. Methods From a total of 1,667 registered mammography cases screened, 17 male breast disease cases were included in this study. Mammography and ultrasound data were analyzed by Statistical Package of Social Sciences v.22 (SPSS). Diagnosis was made following biopsy in suspicious cases, and histopathological and immunological findings of all such patients were obtained for final diagnosis. Results The mean age of the patients was 35 years (range, 14-70 years); 17.6% of the cases were aged 37 yrs, and 2 cases were aged 51 and 52 yrs. Of the 17 cases, 11 had breast lesions, and skin thickening was observed in only 1 case. The different patterns of lesions detected were asymmetry of the parenchyma, mastitis, and hamartoma (n = 1 each), malignant lesions (n = 2), and gynecomastia (n = 6). According to the BI-RADS categorization, 8 cases were benign, one case was probably benign, and 2 cases were likely malignant. In the 2 cases with malignant lesions, pathological diagnosis was made after hematoxylin and eosin and immunocytochemistry examination as invasive ductal carcinoma (IDC) of no special type (NST), grade II and grade III. Conclusions Most breast lesions in this study population were benign, while IDC was the most common malignancy encountered. Mammography is currently the most accurate and cost-effective method for detecting breast lesions. The findings of our study may help increase awareness of male breast cancer and encourage Saudi men at risk to perform self-breast exam and undergo routine breast screening.
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Postmastectomy Reconstruction in Male Breast Cancer. Breast J 2022; 2022:5482261. [PMID: 35711890 PMCID: PMC9187266 DOI: 10.1155/2022/5482261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022]
Abstract
Introduction Less than 1% of all breast cancers are diagnosed in males. In females, postmastectomy breast reconstruction is associated with increased patient satisfaction. However, there is a paucity of literature describing reconstructive options for postmastectomy deformity in the male chest. The purpose of this systematic review was to evaluate postmastectomy reconstruction outcomes in males with breast cancer. Methods A systematic review was performed in accordance with PRISMA guidelines. Ovid MEDLINE, Embase, Cochrane, and Web of Science were queried for records pertaining to the study question using medical subject heading (MeSH) terms such as “male breast cancer,” “mastectomy,” and “reconstruction.” No limitations were placed on the year of publication, country of origin, or study size. Study characteristics and patient demographics were collected. Primary outcomes of interest included postoperative complications, recurrence rate, and mortality rate. Results A total of 11 articles examining 29 male patients with breast cancer who underwent postmastectomy reconstruction were included for analysis. Literature was most commonly available in the form of case reports. The average age was 59.6 +/−11.4 years. Reconstruction methods included fat grafting (n = 1, 3.4%), silicone implants (n = 1, 3.4%), and autologous chest wall reconstruction with local flaps (n = 26, 89.7%). Postoperative complications occurred in two patients (6.8%), including partial nipple necrosis (n = 1) and hypertrophic scarring (n = 1). Of the studies reporting patient satisfaction, all patients were pleased with the aesthetic appearance of their chest. Conclusion This systematic review revealed the limited availability of research regarding postmastectomy chest reconstruction in males with breast cancer. Nevertheless, the evidence available suggests that reconstruction can restore a patient's body image and, thus, should be regularly considered and discussed with male patients. Larger studies are warranted to further shed light on this population.
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12
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Tari DU, Morelli L, Guida A, Pinto F. Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management. Diagnostics (Basel) 2021; 11:diagnostics11122199. [PMID: 34943439 PMCID: PMC8700459 DOI: 10.3390/diagnostics11122199] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 12/12/2022] Open
Abstract
Ductal carcinoma in situ (DCIS) of male breast is a rare lesion, often associated with invasive carcinoma. When the in situ component is present in pure form, histological grade is usually low or intermediate. Imaging is difficult as gynaecomastia is often present and can mask underlying findings. We report a rare case of pure high-grade DCIS in a young male patient, with associated intraductal papilloma and atypical ductal hyperplasia. Digital breast tomosynthesis (DBT) showed an area of architectural distortion at the union of outer quadrants of the left breast without gynaecomastia. Triple assessment suggested performing a nipple-sparing mastectomy, which revealed the presence of a focal area of high-grade DCIS of 2 mm. DCIS, even of high grade, is difficult to detect with mammography and even more rare, especially when associated with other proliferative lesions. DBT with 2D synthetic reconstruction is useful as the imaging step of a triple assessment and it should be performed in both symptomatic and asymptomatic high-risk men to differentiate between malignant and benign lesions. We propose a diagnostic model to early detect breast cancer in men, optimizing resources according to efficiency, effectiveness and economy, and look forward to radiomics as a powerful tool to help radiologists.
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Affiliation(s)
- Daniele Ugo Tari
- Department of Diagnostic Senology, District 12, Palazzo della Salute, Caserta LHA, 81100 Caserta, Italy
- Correspondence: ; Tel.: +39-3493659922
| | - Luigi Morelli
- Department of Pathological Anatomy A. di Tuoro, Caserta LHA, 81031 Aversa, Italy;
| | - Antonella Guida
- Head Office, District 12, Palazzo della Salute, Caserta LHA, 81100 Caserta, Italy;
| | - Fabio Pinto
- Department of Radiology, A. Guerriero Hospital, Caserta LHA, 81025 Marcianise, Italy;
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13
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Sieberg R, Soriano K, Zuurbier R. A rare case of breast cancer in a transgender woman. Radiol Case Rep 2021; 16:3285-3288. [PMID: 34484532 PMCID: PMC8403717 DOI: 10.1016/j.radcr.2021.07.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/17/2021] [Accepted: 07/18/2021] [Indexed: 12/03/2022] Open
Abstract
We report a case of breast cancer in a transgender woman (assigned male sex at birth, gender identity female) of Ashkenazi Jewish descent with BRCA2 mutation who had been taking cross-sex hormone therapy for 2 years. In addition to demonstrating breast cancer imaging findings and risk factors, this case draws attention to the paucity of research and data regarding breast cancer in transgender women and exemplifies the need for evidence-based consensus breast cancer screening recommendations for transgender women.
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Affiliation(s)
- Ryan Sieberg
- Department of Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA
| | - Katrina Soriano
- Department of Internal Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, USA
| | - Rebecca Zuurbier
- Department of Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA
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14
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Stahl KA, Wong W, Olecki EJ, McLaughlin C, Perez-Holguin R, Lewcun JA, Dodge D, Shen C. Benefits of Trimodality Therapy Compared with Systemic Therapy Alone in Male Patients with Stage IV Breast Cancer. Ann Surg Oncol 2021; 29:1005-1017. [PMID: 34480282 DOI: 10.1245/s10434-021-10729-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Male breast cancer (MBC) represents <1% of all breast cancer (BC) diagnoses. Recent publications in female stage IV BC have shown that surgical intervention has a survival benefit. This study aims to determine the impact of surgical intervention in men with stage IV BC and known estrogen (ER) and progesterone receptor (PR) status. METHODS The National Cancer Database was used to identify 539 stage IV MBC patients with known ER/PR status from 2004 to 2017. Chi-square tests examined subgroup differences between the treatment modalities received. Overall survival (OS) was assessed using the Kaplan-Meier method. Multivariate Cox proportional hazard models examined factors associated with survival. RESULTS The Kaplan-Meier estimation showed that ER-positive (ER+) and PR-positive (PR+) patients who received surgery, systemic therapy, and radiation (Trimodality) or systemic therapy and surgery (ST+Surg) had improved survival compared with systemic therapy alone (ST) [ER+, p < 0.003; PR+, p < 0.033]. For ER+ patients, the 5-year OS rates by treatment were: Trimodality, 40%; ST+Surg, 27%; and ST, 20%. For PR+ patients, the 5-year OS rates were: Trimodality, 39%; ST+Surg, 24%; and ST, 20%. The Cox proportional hazard model revealed a survival advantage in patients who received Trimodality compared with ST (hazard ratio 0.622; p < 0.002). The timing of systemic therapy in relation to surgery was not found to be significant. CONCLUSIONS Trimodality therapy has a survival benefit in stage IV MBC patients with known ER+ status than in male patients who receive systemic therapy alone.
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Affiliation(s)
- Kelly A Stahl
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - William Wong
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Elizabeth J Olecki
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Christopher McLaughlin
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Rolfy Perez-Holguin
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Joseph A Lewcun
- Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Daleela Dodge
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Chan Shen
- Division of Outcomes Research and Quality, Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA. .,Division of Health Services and Behavioral Research, Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
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15
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Chhabra MK, Chintamani, Kadyaprath G, Srivastva A, Selvakumar V, Ranjan P, Durga CK, Thomas S, Kaur N, Singh M, Govil M, Gupta A. Male Breast Cancer—an Indian Multicenter Series of 106 Cases. Indian J Surg 2021. [DOI: 10.1007/s12262-019-01953-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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16
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Piciu A, Piciu D, Polocoser N, Kovendi AA, Almasan I, Mester A, Morariu DS, Cainap C, Cainap SS. Diagnostic Performance of F18-FDG PET/CT in Male Breast Cancers Patients. Diagnostics (Basel) 2021; 11:diagnostics11010119. [PMID: 33451072 PMCID: PMC7828478 DOI: 10.3390/diagnostics11010119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION F18-FDG PET/CT is the most important hybrid imaging used in the diagnostic, staging, follow-up, and treatment evaluation response in cancer patients. However, it is well-known that in breast cancer the use of F18-FDG is not included in the first line protocol of initial diagnostic, both in female and male breast cancer patients. F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. This study assesses F18-FDG PET/CT systemic staging in male patients with diagnosed breast cancer and determines detection rates for unsuspected distant metastases and synchronous malignancies. METHODS We analyzed a number of 170 male patients with breast cancer, seen between 2000-2020, in a tertiary center. From this group, between 2013-2020 a number of 23 patients underwent F18-FDG PET/CT. Rates of upstaging were determined for each case and the detection of other primary malignancies was analyzed. RESULTS Median age of male breast cancer group was 61.3 y (range, 34-85 y), most had intraductal carcinoma (82.4%) and unsuspected distant metastases, which increased patient stage to IV, observed in 27%. In 4 out 23 patients (17.4%), F18-FDG PET/CT identified synchronous cancers (2 prostate cancers, 1 thyroid and 1 colon cancer). CONCLUSION F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. Baseline F18-FDG PET/CT has a substantial impact on the initial staging and on clinical management in male breast patients and should be considered for use in newly diagnosed patients.
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Affiliation(s)
- Andra Piciu
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Doina Piciu
- PhD School of Iuliu Hatieganu, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
- Department of Endocrine Tumors and Nuclear Medicine, Institute of Oncology, 400012 Cluj-Napoca, Romania
- Correspondence:
| | - Narcis Polocoser
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Anita A. Kovendi
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Iulia Almasan
- PhD School of Iuliu Hatieganu, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
- Department of Endocrine Tumors and Nuclear Medicine, Institute of Oncology, 400012 Cluj-Napoca, Romania
| | - Alexandru Mester
- Departement of Oral Health, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Dragos-Stefan Morariu
- Department of Surgery, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Calin Cainap
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Simona Sorana Cainap
- Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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17
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Corti C, Crimini E, Criscitiello C, Trapani D, Curigliano G. Adjuvant treatment of early male breast cancer. Curr Opin Oncol 2020; 32:594-602. [PMID: 32852309 DOI: 10.1097/cco.0000000000000678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Male breast cancer (MaBC) is a rare disease, and some challenges exist in its management because current treatment recommendations are extrapolated from trials that mostly excluded men. This review will revise all available data that could improve the treatment of MaBC, with a special focus on adjuvant systemic treatments. RECENT FINDINGS To date, men with hormone receptor-positive breast cancer, who are candidates for adjuvant endocrine therapy, should be offered tamoxifen (TAM) for five years. Additional five years are possible, according to tolerance and recurrence risk. If TAM is contraindicated, a gonadotropin-releasing hormone (GnRH) agonist or antagonist and aromatase inhibitor should be proposed. Chemotherapy and targeted therapy in the other breast cancer subtypes should be used with the same indications offered to women with breast cancer. All men with breast cancer should be offered genetic counseling and germline genetic testing of cancer predisposition genes. SUMMARY For decades, men with breast cancer have been treated suboptimally and denied the participation in clinical trials. Recently, many clinical trials started enrolling both genders, as strongly endorsed by the Food and Drug Administration. Hopefully, this turnaround will help subdue the disparities in the quality of care.
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Affiliation(s)
- Chiara Corti
- Department of Oncology and Haematology (DIPO), University of Milan.,Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Edoardo Crimini
- Department of Oncology and Haematology (DIPO), University of Milan.,Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Carmen Criscitiello
- Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Dario Trapani
- Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Haematology (DIPO), University of Milan.,Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy
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18
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Moosavi L, Kim P, Uche A, Cobos E. A Synchronous Diagnosis of Metastatic Male Breast Cancer and Prostate Cancer. J Investig Med High Impact Case Rep 2020; 7:2324709619847230. [PMID: 31053047 PMCID: PMC6505228 DOI: 10.1177/2324709619847230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In this article, we present a patient diagnosed synchronously with metastatic
male breast cancer and prostate cancer. This is a 63-year-old male and recent
immigrant from Nigeria, who sought medical attention for progressively worsening
of shortness of breath and acute progression of a chronic right breast mass. An
invasive breast carcinoma was diagnosed by the core biopsy of the right breast
mass. Within 2 months of his breast cancer diagnosis, the patient also was
diagnosed with prostate adenocarcinoma after being worked up for urinary
retention. By presenting this patient with a synchronous diagnosis with
metastatic male breast cancer and prostate cancer, history of chronic right
breast mass, and gynecomastia, we speculate on possible cancer etiologies and
risk factors.
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Affiliation(s)
| | - Phyllis Kim
- 2 Kaiser Permanente Medical Center, Los Angeles, CA, USA
| | - An Uche
- 3 Los Angeles County Harbor-UCLA Medical Center, Torrance, CA, USA
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19
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Younas A. Epistemic Injustice in Health Care Professionals and Male Breast Cancer Patients Encounters. ETHICS & BEHAVIOR 2020. [DOI: 10.1080/10508422.2020.1756819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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20
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Agahozo MC, Timmermans MAM, Sleddens HFBM, Foekens R, Trapman-Jansen AMAC, Schröder CP, van Leeuwen-Stok E, Martens JWM, N. M. Dinjens W, van Deurzen CHM. Loss of Y-Chromosome during Male Breast Carcinogenesis. Cancers (Basel) 2020; 12:cancers12030631. [PMID: 32182822 PMCID: PMC7139680 DOI: 10.3390/cancers12030631] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 01/18/2023] Open
Abstract
Loss of Y-chromosome (LOY) is associated with increased cancer mortality in males. The prevalence of LOY in male breast cancer (BC) is unknown. The aim of this study is to assess the presence and prognostic effect of LOY during male BC progression. We included male BC patients diagnosed between 1989 and 2009 (n = 796). A tissue microarray (TMA) was constructed to perform immunohistochemistry and fluorescent in situ hybridization (FISH), using an X and Y probe. We also performed this FISH on a selected number of patients using whole tissue slides to study LOY during progression from ductal carcinoma in situ (DCIS) to invasive BC. In total, LOY was present in 12.7% (n = 92) of cases, whereby LOY was associated with ER and PR negative tumors (p = 0.017 and p = 0.01). LOY was not associated with the outcome. Using whole slides including invasive BC and adjacent DCIS (n = 22), we detected a concordant LOY status between both components in 17 patients. In conclusion, LOY is an early event in male breast carcinogenesis, which generally starts at the DCIS stage and is associated with ER and PR negative tumors.
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Affiliation(s)
- Marie Colombe Agahozo
- Department of Pathology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (M.C.A.); (H.F.B.M.S.); (W.N.M.D.)
| | - Mieke A. M. Timmermans
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015GD Rotterdam, The Netherlands; (M.A.M.T.); (R.F.); (A.M.A.C.T.-J.); (J.W.M.M.)
| | - Hein F. B. M. Sleddens
- Department of Pathology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (M.C.A.); (H.F.B.M.S.); (W.N.M.D.)
| | - Renée Foekens
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015GD Rotterdam, The Netherlands; (M.A.M.T.); (R.F.); (A.M.A.C.T.-J.); (J.W.M.M.)
| | - Anita M. A. C. Trapman-Jansen
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015GD Rotterdam, The Netherlands; (M.A.M.T.); (R.F.); (A.M.A.C.T.-J.); (J.W.M.M.)
| | - Carolien P. Schröder
- Department of Medical Oncology, University Medical Center Groningen, 9700AB Groningen, The Netherlands
| | - Elise van Leeuwen-Stok
- Dutch Breast Cancer Research Group, BOOG Study Center, 1006 AE Amsterdam, The Netherlands;
| | - John W. M. Martens
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015GD Rotterdam, The Netherlands; (M.A.M.T.); (R.F.); (A.M.A.C.T.-J.); (J.W.M.M.)
| | - Winand N. M. Dinjens
- Department of Pathology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (M.C.A.); (H.F.B.M.S.); (W.N.M.D.)
| | - Carolien H. M. van Deurzen
- Department of Pathology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (M.C.A.); (H.F.B.M.S.); (W.N.M.D.)
- Correspondence: ; Tel.: +31-107043901
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21
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Halbach SM, Midding E, Ernstmann N, Würstlein R, Weber R, Christmann S, Kowalski C. Male Breast Cancer Patients' Perspectives on Their Health Care Situation: A Mixed-Methods Study. Breast Care (Basel) 2020; 15:22-29. [PMID: 32231494 PMCID: PMC7098323 DOI: 10.1159/000501956] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/07/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Male breast cancer is rare. No information was available on how male breast cancer patients (MBCPs) experience the health care they receive in Germany in a setting that is tailored to women. The aim of this study was to explore the health care situation of MBCPs from their perspectives. METHODS The study follows a mixed-methods design, combining quantitative data from a standardized written questionnaire with qualitative data from personal interviews. Descriptive statistics (quantitative data) and qualitative content analysis (qualitative data) were used for data analysis. RESULTS Questionnaires completed by 100 and personal interviews of 27 MBCPs were analyzed. Several men reported mainly positive experiences while others experienced shortcomings. These included delays in diagnosis, health care provider uncertainty about treatment (tamoxifen, radiation therapy), experiences of stigmatization, and issues of continuity of care including unclear responsibilities for aftercare and access challenges to breast-cancer-specific care in gynecology settings. CONCLUSIONS The awareness of male breast cancer needs to be increased among the public, health care providers and researchers in order to avoid delays in diagnosis and reduce stigmatization and uncertainty about treatment. Health care structures ensuring access to gynecology care and clear responsibilities for aftercare need to be established.
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Affiliation(s)
- Sarah Maria Halbach
- Center for Health Communication and Health Service Research (CHSR), Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology, Bonn, Germany
| | - Evamarie Midding
- Center for Health Communication and Health Service Research (CHSR), Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology, Bonn, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Service Research (CHSR), Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology, Bonn, Germany
| | - Rachel Würstlein
- Department of Gynecology and Obstetrics, Breast Center and CCCLMU, University of Munich (LMU), Munich, Germany
| | - Rainer Weber
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Sherin Christmann
- Center for Health Communication and Health Service Research (CHSR), Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology, Bonn, Germany
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22
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Nguyen TS, Bauer M, Maass N, Kaduszkiewicz H. Living with Male Breast Cancer: A Qualitative Study of Men's Experiences and Care Needs. Breast Care (Basel) 2019; 15:6-12. [PMID: 32231492 DOI: 10.1159/000501542] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/17/2019] [Indexed: 11/19/2022] Open
Abstract
Background Male breast cancer (MBC) is rare, and most previous studies limited their focus on clinical aspects of the disease. Psychosocial implications and care needs of MBC patients are poorly understood. Objectives The aim of this study is to explore the experiences of men living with breast cancer and to identify supportive care needs. Methods Eighteen men were interviewed using qualitative, semi-structured telephone interviews. Qualitative content analysis was used to analyze the data. Results The majority of men did not have negative feelings about having a "women's disease," although some felt that stigmatization threatened their masculinity. Male sex was perceived as hindering access to adequate care. Patients identified key barriers including (1) a lack of awareness and experience of treating males among health professionals; (2) treatment and available information were based on evidence for females; and (3) lacking support services. Conclusion To improve MBC care, it is important to raise awareness of the disease and to adapt treatment strategies, patient information, and support services to meet the needs of men.
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Affiliation(s)
- Truc Sophia Nguyen
- Institute of General Practice, Faculty of Medicine, Christian Albrecht University Kiel, Kiel, Germany.,Institute of General Practice, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | | | - Nicolai Maass
- Clinic for Gynaecology and Obstetrics, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Faculty of Medicine, Christian Albrecht University Kiel, Kiel, Germany
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23
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Alsayed B, Abdulla HA, Alaskar H, Dhaif A. Male occult triple-negative breast cancer. BMJ Case Rep 2019; 12:12/4/e229482. [PMID: 31005873 DOI: 10.1136/bcr-2019-229482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Male breast cancer is a rare but important condition accounting for only 1% of breast cancer worldwide and less than 1% of all male malignancies. Occult male breast cancer is an extremely rare type of male breast cancer that manifests as axillary metastases without an identifiable breast lesion. We report a case of triple-negative occult male breast cancer who underwent modified radical mastectomy.
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Affiliation(s)
- Basma Alsayed
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
| | | | - Hadi Alaskar
- Department of Surgery, King Fahad Hospital, Hofuf, Saudi Arabia
| | - Ali Dhaif
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
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24
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Aldossary MY, Alquraish F, Alazhri J. A Case of Locally Advanced Breast Cancer in a 59-Year-Old Man Requiring a Modified Approach to Management. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:531-536. [PMID: 30992422 PMCID: PMC6485044 DOI: 10.12659/ajcr.915377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Patient: Male, 59 Final Diagnosis: Invasive ductal carcinoma Symptoms: Foul-smelling discharge • painful breast mass Medication: — Clinical Procedure: Modified radical mastectomy Specialty: Surgery
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Affiliation(s)
- Mohammed Yousef Aldossary
- Department of General Surgery, Surgical Oncology Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Fatimah Alquraish
- Department of General Surgery, King Abdulaziz Air Base Hospital, Dhahran, Saudi Arabia
| | - Jamila Alazhri
- Department of General Surgery, Surgical Oncology Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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25
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Soltani M, Rahpeima R, Kashkooli FM. Breast cancer diagnosis with a microwave thermoacoustic imaging technique—a numerical approach. Med Biol Eng Comput 2019; 57:1497-1513. [DOI: 10.1007/s11517-019-01961-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 02/02/2019] [Indexed: 10/27/2022]
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26
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Wang W, Xu X, Tian B, Wang Y, Du L, Sun T, Shi Y, Zhao X, Jia Y, Xi Y, Jing J. Clinical features of patients with male breast cancer in Shanxi province of China from 2007 to 2016. J Investig Med 2018; 67:699-705. [PMID: 30368484 DOI: 10.1136/jim-2018-000823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2018] [Indexed: 01/11/2023]
Abstract
This study aims to understand the clinical features, treatment, and prognosis of patients with male breast cancer (MBC) in Shanxi province of China from 2007 to 2016. Data for 77 patients with MBC were collected for analysis. Immunohistochemistry, pathological results, and other data such as demographic characteristics (age, marital status, smoking history, drinking history, and family history of cancer) as well as clinical data were investigated by retrieving information from the patients' medical records. A total of 12,404 patients were diagnosed with breast cancer between 2007 and 2016, and 77 were patients with MBC among them. The median diagnosis age of patients with MBC was 62 years (range, 24-84 years). The most common complaint was a painless lump in the breast, accounting for 68.8% of the patients, and the main pathological type in MBC was infiltrating ductal carcinoma (66.2%). In terms of hormone receptors, 80.5% (62/77) of patients with MBC were estrogen receptor positive, 75.3% (58/77) of patients were progesterone receptor positive, and only 6.5% (5/77) of patients were HER2 overexpressing. The multivariant Cox proportional hazards regression analysis showed that M stage is an independent prognostic factor (p=0.018, HR=18.791, 95% CI 1.663 to 212.6). The epidemiological and clinical features of Chinese MBC are similar to that of other countries. As the Chinese public have limited knowledge of MBC, it is necessary to increase awareness among them about it. Further research with a large sample size is required for better understanding of the risks associated with MBC.
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Affiliation(s)
- Weigang Wang
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Xiaoqin Xu
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Baoguo Tian
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Yan Wang
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Lili Du
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Ting Sun
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Yanchun Shi
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Xianwen Zhao
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
| | - Yali Jia
- Department of Preventive Health Care, Shanxi Cancer Hospital, Shanxi, China
| | - Yanfeng Xi
- Department of Pathology, Shanxi Cancer Hospital, Shanxi, China
| | - Jiexian Jing
- Department of Etiology and Tumor Marker Laboratory, Shanxi Cancer Hospital, Shanxi, China
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Nemchek L. Male Breast Cancer: Examining Gender Disparity in Diagnosis and Treatment. Clin J Oncol Nurs 2018; 22:E127-E133. [DOI: 10.1188/18.cjon.e127-e133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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28
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Male breast cancer: a disease distinct from female breast cancer. Breast Cancer Res Treat 2018; 173:37-48. [PMID: 30267249 DOI: 10.1007/s10549-018-4921-9] [Citation(s) in RCA: 167] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE Male breast cancer (BC) is rare, representing approximately 1% of cancers that occur in men and approximately 1% of all BCs worldwide. Because male BC is rare, not much is known about the disease, and treatment recommendations are typically extrapolated from data available from clinical trials enrolling female BC patients. METHODS We review the epidemiology, risk factors, prognosis, and the varied molecular and clinicopathologic features that characterize male BC. In addition, we summarize the available data for the use of systemic therapy in the treatment of male BC and explore the ongoing development of targeted therapeutic agents for the treatment of this subgroup of BCs. RESULTS There are important biological differences between male and female BC. Male BC is almost exclusively hormone receptor positive (+), including the androgen receptor (AR), and is associated with an increased prevalence of BRCA2 germline mutations, especially in men with increased risk for developing high-risk BC. Additional research is warranted to better characterize male BC. To accomplish this, a multi-national consortium approach, such as the International Male Breast Cancer Program, is needed in response to the scarcity of patients. This approach allows the pooling of information from a large number of men with BC and the creation of registries for future therapeutic-focused clinical trials. CONCLUSIONS Given the unique biology of BC in men, promising new therapeutic targets are currently under investigation, including the use of poly-ADP-ribose polymerase inhibitors or AR-targeted agents either as monotherapy or in combination with other agents.
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Zongo N, Ouédraogo S, Korsaga-Somé N, Somé OR, GO N, Ouangré E, Zida M, Bonkoungou G, Ouédraogo AS, Bambara AH, Tozoula BA, Traoré SS, Dem A, Niamba P, Traoré A, Sanou A, Soares DG, Lotz JP. Male breast cancer: diagnosis stages, treatment and survival in a country with limited resources (Burkina Faso). World J Surg Oncol 2018; 16:4. [PMID: 29325566 PMCID: PMC5765600 DOI: 10.1186/s12957-017-1297-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 12/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Male breast cancer is a rare and less known disease. Therapeutic modalities affect survival. In Burkina Faso, male breast cancers are diagnosed in everyday practice, but the prognosis at short-, middle-, and long-term remains unknown. The objective of this study is to study the diagnosis stages, therapeutic modalities, and 5-year survival in male breast cancer at the General Surgery Unit of Yalgado Ouedraogo University Hospital from 1990 to 2009. METHODS A cohort longitudinal study concerning cases of breast cancer diagnosed in man. Survival was assessed using the Kaplan-Meier method and survival curves were compared through the LogRank test. RESULTS Fifty-one cases of male breast cancer were followed-up, i.e., 2.6% of all breast cancers. Stages III and IV represented 88% of cases. Eleven patients (21.6%) were at metastatic stage. Patients were operated in 60.8% of cases. The surgery included axillary dissection in 25 (80.6%) out of 31 cases. Lumpectomy was performed on 6.5% of patients (2 cases). Fifteen (29.4%) and 11 (21.6%) patients underwent chemotherapy and hormonal therapy, respectively. The FAC protocol was mostly used. Radiation therapy was possible in two cases. The median deadline for follow-up was 14.8 months. A local recurrence was noticed in 3.2% of cases. The overall 5-year survival rate was 49.9%. The median survival was over 5 years for stages I and II. It was 54 down to 36 months for stages III and IV. CONCLUSION Diagnosis is late. The lack of immunohistochemistry makes it difficult to define the proportion of their hormonal dependence. Surgery is the basic treatment. Five-year survival is slow and the median survival depends on the diagnosis stage. It can be improved through awareness-raising campaigns and the conduct of individual screening.
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Affiliation(s)
- Nayi Zongo
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
- Department of General Surgery, Yalgado Ouédraogo University Hospital of Ouagadougou, Ouagadougou, BP 7021 Burkina Faso
| | - Smaïla Ouédraogo
- Division of Epidemiology and Public Health, Yalgado Ouédraogo University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Nina Korsaga-Somé
- Division of Dermatology and Venerology, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Ollo Roland Somé
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Naïma GO
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Edgar Ouangré
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Maurice Zida
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Gilbert Bonkoungou
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Aimé Sosthène Ouédraogo
- Division of Pathologic Anatomy, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | | | | | - Si Simon Traoré
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Ahmadou Dem
- Oncology Institute Joliot Curie of Dakar (Senegal), Dakar, Senegal
| | - Pascal Niamba
- Division of Dermatology and Venerology, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Adama Traoré
- Division of Dermatology and Venerology, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Adama Sanou
- Division of General surgery, University Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Danielé Grazziotin Soares
- Alliance for Research in Cancerology - APREC, Medical Oncology Service, Tenon Hospital, Paris, France
| | - Jean-Pierre Lotz
- Tenon Hospital, division of Onco-Hematology, University Hospitals of Eastern Paris, APHP, Pierre and Marie Curie University, Paris, France
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Melo Abreu E, Pereira P, Marques JC, Esteves G. Invasive lobular carcinoma: a rare presentation in the male breast. BMJ Case Rep 2016; 2016:bcr-2016-215665. [PMID: 27151060 DOI: 10.1136/bcr-2016-215665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Breast cancer in men is uncommon, accounting for <1% of all breast cancers. Even though lobular structures are quite infrequent in the male breast, rare cases of invasive lobular breast carcinoma have been described, representing 1-2% of all breast cancers in men. Risk factors include undescended testes, congenital inguinal hernia, orchiectomy, orchitis, testicular injury, infertility and Klinefelter's syndrome, previous thoracic radiotherapy, alterations of the oestrogen-testosterone ratio and familial history (BRCA 2 and 1). The authors present a case of a 52-year-old man with no relevant predisposing factors to breast cancer, who presented with a painless, firm nodule, fixed to the nipple on the left breast, associated with nipple retraction and ulceration, and fully characterised by mammogram and ultrasound. Histopathological and immunohistochemical analysis revealed the diagnosis of invasive lobular breast carcinoma and the patient underwent left radical mastectomy, followed by adjuvant chemotherapy, radiotherapy and hormonotherapy. A brief review of the literature is presented.
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Affiliation(s)
- Elisa Melo Abreu
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Pedro Pereira
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - José Carlos Marques
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Gonçalo Esteves
- Pathology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
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31
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Liu M, Wang Q, Liu B, Gao L, Wu D, Yang S, Liu B, Dong L. Male breast carcinoma: radiotherapy contributed to favorable local control in two cases and related literature review. Eur J Med Res 2015; 20:94. [PMID: 26612408 PMCID: PMC4662040 DOI: 10.1186/s40001-015-0173-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 09/09/2015] [Indexed: 01/03/2023] Open
Abstract
Male breast carcinoma (MBC) is rarely encountered in clinical practice. Due to its paucity, our knowledge of MBC only rely on small or single-institutional studies and sporadic cases. The current guidelines for MBC are extrapolated from its female counterparts Rudlowski (Breast Care (Basel) 3(3):183–189, 2008). Nowadays, MBC is actively studied and viewed as a potentially different entity on the aspects of etiology, biological behavior and prognosis. Thus, special treatment strategy guidelines should be established for MBC. Additionally, advance in the systemic chemotherapy and hormonal therapy also contribute to the local control. The indication of radiotherapy need to be clarified and over-treatment should be avoided. Here we present two cases of MBC in which radiotherapy help to sustain a satisfactory disease free survival. Our cases will provide valuable experience for identifying the role of radiotherapy in MBC.
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Affiliation(s)
- Min Liu
- Department of Radiation Oncology, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
| | - Qiang Wang
- Department of Radiation Oncology, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
| | - Bin Liu
- Department of Hand Surgery, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
| | - Ling Gao
- Department of Radiation Oncology, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
| | - Di Wu
- Department of Breast Surgery, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
| | - Shuo Yang
- Department of Radiation Oncology, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
| | - Bailong Liu
- Department of Radiation Oncology, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
| | - Lihua Dong
- Department of Radiation Oncology, The First Hospital, Jilin University, 71 Xinmin Street, 130021, Changchun, China.
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Upadhyay R, Kumar P, Sharma DN, Haresh KP, Gupta S, Julka PK, Rath GK, Bhankar H. Invasive lobular carcinoma of the male breast: A rare histology of an uncommon disease. J Egypt Natl Canc Inst 2015; 28:55-8. [PMID: 26530727 DOI: 10.1016/j.jnci.2015.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/11/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022] Open
Abstract
Male breast carcinoma is a rare malignancy comprising less than 1% of all breast cancers. It is a serious disease with most patients presenting in advanced stages. Infiltrating ductal carcinoma is the most common histology while lobular carcinoma represents less than 1% of all these tumors. We report a case of locally advanced lobular carcinoma of breast in a 60 year old male.
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Affiliation(s)
- Rituraj Upadhyay
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Pavnesh Kumar
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - D N Sharma
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - K P Haresh
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Subhash Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - P K Julka
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - G K Rath
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Himani Bhankar
- Department of Pathology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi 110049, India
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33
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D'Onofrio L, Tonini G, Santini D. Clinical Features of Male Breast Cancer and Multimodal Treatment: A Comment to Retrospective Survey Analysis at Italian Centers. TUMORI JOURNAL 2014. [DOI: 10.1177/1636.17944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Loretta D'Onofrio
- Department of Medical Oncology, University Campus Bio-Medico Hospital, Rome, Italy
| | - Giuseppe Tonini
- Department of Medical Oncology, University Campus Bio-Medico Hospital, Rome, Italy
| | - Daniele Santini
- Department of Medical Oncology, University Campus Bio-Medico Hospital, Rome, Italy
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Tariq KB, Al-Saffar F, Ibrahim S, Pham D, Farhangi A, Rana F, Zaiden R. Male Breast Cancer and Hyperestrogenemia: A Thirteen-Year Review. World J Oncol 2014; 5:55-61. [PMID: 29147378 PMCID: PMC5649874 DOI: 10.14740/wjon803w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2014] [Indexed: 11/11/2022] Open
Abstract
Background Male breast cancer (MBC) is a very rare malignancy and accounts for 0.1% of all male cancers. MBC has not been studied as extensively as its female counterpart. Certain clinical and pathological risk factors like smoking history, age at onset, family history of cancer, obesity, ethnicity, estrogen/progesterone receptor status and BRCA gene mutation status have all been studied well in the female breast cancer (FBC) patients and the clinical trial evidence from these studies is then extrapolated to treat and manage patients with MBC. One such area of interest is high levels of estrogen and its relationship with MBC. In our retrospect research study we aim to find an association between MBC and high levels of circulating estrogen at the time of diagnosis. Methods A 13-year retrospective review of the male breast cases at University of Florida College of Medicine's Tumor Registry was conducted. Data regarding certain clinic-pathological risk factors and MBC were collected and reviewed. Main surrogate indicators for elevated estrogen were examined, namely, low HDL (< 40 mg/dL), low albumin (< 4 g/dL) and high BMI (> 25). Presence of any one of these surrogates was seen as an indirect marker for high estrogen level. For cancer staging, the American Joint Committee on Cancer (AJCC) staging system was used. Stages 0-2 were grouped together as they are less extensive compared to stages 3-4 (also grouped together) which represent extensive disease. Univariate analysis was conducted using STATA 13 to do Fischer's exact test as cross-tables showed cell counts of five or less. The main comparison was that between extensive MBC (stages 3-4) and non-extensive breast cancer (stages 0-2). Results Between January 2000 and November 2013, we found a total of 2,129 cases of breast cancer patients at our institute. Out of these 2,113 (99.24%) were female and 16 (0.75%) were men. Four MBC patients were excluded because their complete charts could not be found in the medical records department. Six (50%) patients had one indicator, four (33%) patients had two indicators and one (8.3%) patient had all three. Eleven (91.6%) patients had precursors suggestive of hyperestrogenemia. Only one (8.33%) patient did not have any surrogate marker indicator of high estrogen levels. Two (16%) were black and 10 (83.33%) were white. Mean age was 61.75. Five (41%) had a first degree relative with a malignancy. Laterality was nine (75%) in the left breast, three (35%) in right breast. Eight (66.6%) found a mass on physical exam. Five (41.6%) had a positive smoking history. One patient had no data in the chart. Remaining all 11 (91.6%) had non-TNBC. One patient did not have complete documentation. Five (41.6%) had mastectomy, six (50%) received RT, four (33.3%) received chemotherapy and another four received hormone therapy. In terms of stage, four (33.3%) had stage 4, two (16.6%) stage 3B, two (16.6%) stage 2B, two (16.6%) stage 2A, one (8.33%) had stage 1C and one had stage 0. HDL data were available in seven (58.3%) with mean of 37, albumin in 10 (83.3%) with mean of 3.61, BMI in 11 (91.66%) patients with a mean of 33.30. Within subgroups, two patients were black and 10 white. Both black patients had LE disease (stage 0-2). Of the white patients, four (40%) had limited disease while six (60%) had extensive breast cancer. Family history assumed a similar distribution as three (60%) of patients with negative family history for cancer had limited disease and two (40%) had extensive one, same numbers applied for family-history-positive population. Three (60%) of patients with limited disease smoker and two (40%) did not. As for laterality, a total of nine patients had left-sided breast cancer, of whom five had had limited disease and four fell into the extensive disease category. The hormonal status for most patients were HER/NEU negative (seven out of 10 patients, two patients did not have this information on file), ER positive (11 out of 12) and PR positive (8 out of 12). Estrogen status: Low HDL was seen in three out of seven patients, low albumin in four out of 10 and obese BMI in nine out of 11. Finally, 11 out of 12 patients had at least one indicator of high estrogen. No significant change in prevalence of these markers was seen when comparing patients with limited and extensive disease. Conclusion None of the aforementioned variables assumed statistical significance between the two subgroups. Results, however, show that as a whole, 11 out of the 12 patients had at least one indicator of high estrogen. Our results point in the direction that elevated estrogen is probably associated with MBC. Further meta-analysis of similar studies can be helpful to explain the dynamics of this association. Our statistical analysis was limited due to the small sample size, which is due to the extreme rarity of the disease.
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Affiliation(s)
- Khurram Bilal Tariq
- Department of Internal Medicine, University of Florida, College of Medicine, 653 West 8th Street, Box L 18, Jacksonville, FL 32209, USA
| | - Farah Al-Saffar
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Saif Ibrahim
- Department of Internal Medicine, University of Florida, College of Medicine, 653 West 8th Street, Box L 18, Jacksonville, FL 32209, USA
| | - Dat Pham
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Arezo Farhangi
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Fauzia Rana
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
| | - Robert Zaiden
- Division of Hematology and Medical Oncology, University of Florida, Jacksonville, FL, USA
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Andres SA, Smolenkova IA, Wittliff JL. Gender-associated expression of tumor markers and a small gene set in breast carcinoma. Breast 2014; 23:226-33. [PMID: 24656773 DOI: 10.1016/j.breast.2014.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 02/06/2014] [Accepted: 02/22/2014] [Indexed: 11/28/2022] Open
Abstract
Breast carcinomas in both genders share pathological features, although differences in incidence, prognosis and survival are reported. Expression of 33 genes was investigated in male and female breast carcinomas in association with ER, PR, HER-2/neu and EGF-receptor. Among 98 male breast cancers, 82 were ER+ and 78 were PR+. ER and PR protein levels were greater in males compared to females, although no differences were observed in ESR1 and PGR expression. A difference was observed in binding affinities of PR but not ER between genders. No differences were observed in HER-2/neu, EGFR protein, or patient age. Expression of NAT1, TBC1D9, IL6ST, RABEP1, PLK1 and LRBA was elevated in carcinomas of males compared to those of females, in which ER status appeared to be related to expression. Over-expression of protein products of these genes represents novel molecular targets for development of gender-specific therapeutics and companion diagnostics.
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Affiliation(s)
- Sarah A Andres
- Department of Biochemistry & Molecular Biology, J. Graham Brown Cancer Center and Institute for Molecular Diversity & Drug Design, University of Louisville, Louisville, KY 40202, USA
| | - Irina A Smolenkova
- Department of Biochemistry & Molecular Biology, J. Graham Brown Cancer Center and Institute for Molecular Diversity & Drug Design, University of Louisville, Louisville, KY 40202, USA
| | - James L Wittliff
- Department of Biochemistry & Molecular Biology, J. Graham Brown Cancer Center and Institute for Molecular Diversity & Drug Design, University of Louisville, Louisville, KY 40202, USA.
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Patten DK, Sharifi LK, Fazel M. New approaches in the management of male breast cancer. Clin Breast Cancer 2013; 13:309-14. [PMID: 23845572 DOI: 10.1016/j.clbc.2013.04.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 04/12/2013] [Accepted: 04/16/2013] [Indexed: 11/15/2022]
Abstract
Male breast cancer (MBC) is a rare condition that accounts for 0.1% of all male cancers. Our current evidence base for treatment is derived from female breast cancer (FBC) patients. Risk factors for MBC include age, genetic predisposition, race, sex hormone exposure, and environmental factors. Most patients present later and with more advanced disease than comparable FBC patients. Tumors are likely to be estrogen receptor and progesterone receptor positive, with the most common histologic type being invasive ductal carcinoma. Triple assessment remains the criterion standard for diagnosis. Primary MBC is mostly managed initially by simple mastectomy, with the option of breast conserving surgery, which carries an increased risk of recurrence. Sentinel node biopsy is recommended as the initial procedure for staging the axilla. Reconstructive surgery focuses on achieving primary skin closure, and radiotherapy largely follows treatment protocols validated in FBC. We recommend chemotherapy for men with more advanced disease, in particular, those with estrogen receptor negative histology. MBC responds well to endocrine therapy, although it is associated with significant adverse effects. Third-generation aromatase inhibitors are promising but raise concerns due to their failure to prevent estrogen synthesis in the testes. Fulvestrant remains unproven as a therapy, and data on trastuzumab is equivocal with HER2 receptor expression and functionality unclear in MBC. In metastatic disease, drug-based hormonal manipulation remains a first-line therapy, followed by systemic chemotherapy for hormone-refractory disease. Prognosis for MBC has improved over the past 30 years, with survival affected by disease staging, histologic classification, and comorbidity.
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Affiliation(s)
- Darren K Patten
- Department of Biosurgery and Surgical Oncology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK; Department of Breast and General Surgery, Croydon University Hospital, Croydon Health Services NHS Trust, UK.
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DABAKUYO T, DIALLA O, GENTIL J, POILLOT ML, ROIGNOT P, CUISENIER J, ARVEUX P. Breast cancer in men in Cote d'Or (France): epidemiological characteristics, treatments and prognostic factors. Eur J Cancer Care (Engl) 2012; 21:809-16. [DOI: 10.1111/j.1365-2354.2012.01365.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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38
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Health-related quality of life in male breast cancer patients. Breast Cancer Res Treat 2012; 133:753-7. [DOI: 10.1007/s10549-012-1970-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 01/18/2012] [Indexed: 10/14/2022]
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Ilhan E, Bati B, Alemdar A, Coskun A, Sezgin A, Yildirim M, Engin O, Purten M. A Clinicopathological Evaluation of Male Patients with Breast Cancer. Breast Care (Basel) 2009; 4:308-314. [PMID: 30397402 PMCID: PMC6206969 DOI: 10.1159/000230912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although male breast cancer constitutes only 1% of all breast cancers, its incidence is increasing and it is becoming an important public health issue. The present study aims to present the clinicopathological characteristics of surgically treated male breast cancer patients from multiple centers. PATIENTS AND METHODS Twenty-one male patients operated on for breast cancer were retrospectively examined in terms of clinical presentation, pathological characteristics, TNM staging status, and type of surgical treatment. RESULTS The mean age of the 21 patients was 62.3 years (range 38-94), with the majority being in the range of 50-69 years (61.9%). The most frequent finding was breast mass (85.7%). Most patients underwent modified radical mastectomy (76.1%), and the most prevalent histological type was invasive ductal carcinoma (85.7%). The majority of patients had stage II or III disease, and estrogen receptors were positive in 18 (85.7%) of the patients. CONCLUSION Since male breast cancer is a rare condition, it is challenging to conduct prospective randomized trials. Currently, there is a lack of comprehensive data on the diagnosis and management of this condition. Thus, further studies and the implementation of specific guidelines or protocols for this subgroup of patients will aid better management.
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Affiliation(s)
- Enver Ilhan
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Bakir Bati
- Department of General Surgery, Istanbul Okmeydani Education and Research Hospital, Turkey
| | - Ali Alemdar
- Department of General Surgery, Istanbul Okmeydani Education and Research Hospital, Turkey
| | - Ali Coskun
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Arsenal Sezgin
- Department of Pathology, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Mehmet Yildirim
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Omer Engin
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Mete Purten
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
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Ilhan E, Bati B, Alemdar A, Coskun A, Sezgin A, Yildirim M, Engin O, Purten M. A Clinicopathological Evaluation of Male Patients with Breast Cancer. BREAST CARE (BASEL, SWITZERLAND) 2009. [PMID: 30397402 DOI: 10.1159/000230912.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Although male breast cancer constitutes only 1% of all breast cancers, its incidence is increasing and it is becoming an important public health issue. The present study aims to present the clinicopathological characteristics of surgically treated male breast cancer patients from multiple centers. Patients and Methods Twenty-one male patients operated on for breast cancer were retrospectively examined in terms of clinical presentation, pathological characteristics, TNM staging status, and type of surgical treatment. Results The mean age of the 21 patients was 62.3 years (range 38-94), with the majority being in the range of 50-69 years (61.9%). The most frequent finding was breast mass (85.7%). Most patients underwent modified radical mastectomy (76.1%), and the most prevalent histological type was invasive ductal carcinoma (85.7%). The majority of patients had stage II or III disease, and estrogen receptors were positive in 18 (85.7%) of the patients. Conclusion Since male breast cancer is a rare condition, it is challenging to conduct prospective randomized trials. Currently, there is a lack of comprehensive data on the diagnosis and management of this condition. Thus, further studies and the implementation of specific guidelines or protocols for this subgroup of patients will aid better management.
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Affiliation(s)
- Enver Ilhan
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Bakir Bati
- Department of General Surgery, Istanbul Okmeydani Education and Research Hospital, Turkey
| | - Ali Alemdar
- Department of General Surgery, Istanbul Okmeydani Education and Research Hospital, Turkey
| | - Ali Coskun
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Arsenal Sezgin
- Department of Pathology, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Mehmet Yildirim
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Omer Engin
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Mete Purten
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Turkey
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Multilayer imaging and compositional analysis of human male breast by laser reflectometry and Monte Carlo simulation. Med Biol Eng Comput 2009; 47:1197-206. [PMID: 19820979 DOI: 10.1007/s11517-009-0531-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Accepted: 09/05/2009] [Indexed: 10/20/2022]
Abstract
The laser backscattering from biological tissues depends on their composition and blood flow. The onset of abnormalities in tissues is associated with the change in composition at a specific location which may affect laser backscattering. The objective of this work is to study the point-to-point compositional variation of male breast tissues as this site has been prone to cancer development. The normalized backscattered intensity (NBI) profiles at various locations of human chest region of five subjects by multi-probe laser reflectometer are obtained. Based on these data the images of tissue composition, showing the point-to-point changes at various depths from the tissue surface, are reconstructed. The analysis of data shows that the maximum NBI variation is at the pectoralis major muscle and minimum variation is observed at the sternum. The optical parameters, based on the NBI data obtained for five human subjects, show the maximum increase in absorption (p < 0.0001) and minimum change in scattering (p < 0.0001) coefficients compared to that as observed at the sternum. Also the minimum absorption and maximum scattering coefficients are observed at the pectoralis major muscles. The regional variations of NBI and optical parameters further support these findings. The variations in the NBI and optical parameters may indicate the compositional change in tissues, which could be used for diagnostic and therapeutic applications of laser.
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Abstract
BACKGROUND AND OBJECTIVES Because breast cancer in men is rare, few patients are available for prospective studies. To learn more about its epidemiology, risk factors, clinical features, genetics and pathology in our country, we conducted a retrospective study of all cases seen in recent decades at our institution. PATIENTS AND METHODS We identified each case of male breast cancer in the database at the Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India, between the years 1983 to 2007. RESULTS We identified only 32 cases of male breast cancer over the 24-year period. Male breast cancer accounted for 32 (2.8%) of 1141 resected breast specimens, which included all breast lesions and 32 (4.1%) of 780 breast cancer cases. Of the 32 cases, 20 (62.5%) had various associated risk factors. Invasive ductal carcinoma was seen in 30 cases (93.7%). Of 20 cases that underwent molecular studies, 16 (80%) patients had estrogen receptor positivity whereas 14 (70%) had progesterone receptor positivity. Six cases (30%) overexpressed HER2 and p53. The BRCA2 mutation was observed in 4 cases (40%) while no patient presented with the BRCA1 mutation. CONCLUSION An incidence of 4.1% for male breast cancer indicates that this disease is not as uncommon as presumed in this part of the world. Breast cancer in men seems more frequently to be hormone receptor positive and the BRCA2 mutation confers a significant risk to men.
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Affiliation(s)
- Parveen Shah
- Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kasmir, 190010, India
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Gu GL, Wang SL, Wei XM, Ren L, Zou FX. Axillary Metastasis as the First Manifestation of Occult Breast Cancer in a Male Patient. Breast Care (Basel) 2009; 4:43-45. [PMID: 20877684 DOI: 10.1159/000193032] [Citation(s) in RCA: 8] [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: The aim of this study was to investigate the clinicopathologic features of male breast cancer. CASE REPORT: We present the clinicopathologic data of a 72-year-old male patient with occult breast cancer, who was diagnosed and underwent surgery in our hospital. The diagnosis was confirmed by histological examination, and the patient underwent modified radical mastectomy and axillary dissection. The histological examination showed no tumor foci in the resected breast tissue, but 2 of 15 dissected axillary lymph nodes were invaded by infiltrating ductal carcinoma. Immunohistochemistry staining was negative for both estrogen and progesterone receptors, but showed expression of p53 protein (+++), proliferating cell nuclear antigen (PCNA) (+++), Bcl-2 on-coprotein (+++), nm23 protein (++), multidrug resistance protein (MRP) (++), and human epidermal receptor (HER-2) oncoprotein (+++). 24 months after being diagnosed, the patient is alive without any residual or metastatic disease. CONCLUSIONS: Breast cancer is very rare in men, and the occurrence of occult breast cancer is even less common. Axillary metastases can present as the first manifestation of breast cancer in a male.
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Affiliation(s)
- Guo-Li Gu
- Department of General Surgery, The General Hospital of Chinese PLA Air Force, Beijing, China
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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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Tiefenbacher K, Daxenbichler G. The Role of Androgens in Normal and Malignant Breast Tissue. Breast Care (Basel) 2008; 3:325-331. [PMID: 20824027 DOI: 10.1159/000158055] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Androgens, like estrogens, can be synthesized in the breast. As both active androgens and their corresponding receptors are present in breast tissue, we conclude that they play a role in breast physiology. This is supported by the fact that insufficient androgen production or sensitivity results in the development of gynecomastia. Complete androgen insensitivity due to receptor defects leads to normal female breast development in these XY women. While breast development is completely inhibited by male testosterone levels, partial but not total degradation of a developed breast by androgen treatment appears to be possible. Breast cancer in early stages seems to fulfill the prerequisites of androgen responsiveness. Androgen treatment of advanced breast cancer has shown similar effectiveness as anti-estrogen or estrogen-ablative therapy, but also considerable side effects. It has been speculated that the use of selective androgen modulators (SARMs), either alone or preferably in addition to anti-estrogens or aromatase inhibitors, may be a promising alternative to current therapy modalities in hormone-dependent breast cancer. In addition, future studies on the use of SARMs in prophylactic settings seem to be justified.
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Affiliation(s)
- Bernd Gerber
- Breast Unit, Department of Obstetrics and Gynecology, University of Rostock, Germany
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