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Peng JY, Lee YK, Pham RQ, Shen XH, Chen IH, Chen YC, Fan HS. Trends and Age-Period-Cohort Effect on Incidence of Male Breast Cancer from 1980 to 2019 in Taiwan and the USA. Cancers (Basel) 2024; 16:444. [PMID: 38275884 PMCID: PMC10814864 DOI: 10.3390/cancers16020444] [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: 12/22/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Although male breast cancer (MBC) is globally rare, its incidence significantly increased from 1990 to 2017. The aim of this study was to examine variations in the trends of MBC incidence between populations in Taiwan and the USA from 1980 to 2019. The Taiwan Cancer Registry database and the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute of the USA were used. The age-standardized incidence rate was calculated using the world standard population in 2000. The long-term trends of the age, time period, and birth cohort effect on MBC incidence rates were estimated using the SEER Age-Period-Cohort Web Tool. The results revealed that the incidence of MBC in both countries increased from 2010 to 2019 (Taiwan: average annual percentage change (AAPC) = 2.59%; USA: AAPC = 0.64%). The age and period effects on the incidence rates in both countries strengthened, but the cohort effect was only identified in Taiwan (Rate ratio: 4.03). The identified cohort effect in this study bears resemblance to that noted in a previous investigation on female breast cancer in Taiwan. This suggests the possible presence of common environmental factors influencing breast cancer incidence in both genders, such as a high fat diet and xenoestrogen.
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Affiliation(s)
- Jhao-Yang Peng
- Graduate Institute of Business Administration, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan;
- Roche Diagnostics Ltd., Taipei City 10491, Taiwan
| | - Yu-Kwang Lee
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital, No. 7, Chung Shan S. Rd. (Zhongshan S. Rd.), Zhongzheng Dist., Taipei City 100225, Taiwan;
| | - Rong-Qi Pham
- Institute of Public Health, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei City 112304, Taiwan;
| | - Xiao-Han Shen
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan;
| | - I-Hui Chen
- MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City 104217, Taiwan;
| | - Yong-Chen Chen
- School of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan
- Data Science Center, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan
| | - Hung-Shu Fan
- Graduate Institute of Business Administration, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan;
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2
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Chung SH, de Geus SWL, Shewmaker G, Romatoski KS, Drake FT, Ko NY, Merrill AL, Hirsch AE, Tseng JF, Sachs TE, Cassidy MR. Axillary Lymph Node Dissection is Associated with Improved Survival Among Men with Invasive Breast Cancer and Sentinel Node Metastasis. Ann Surg Oncol 2023; 30:5610-5618. [PMID: 37204557 DOI: 10.1245/s10434-023-13475-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/21/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Male breast cancer (MBC) is rare, and management is extrapolated from trials that enroll only women. It is unclear whether contemporary axillary management based on data from landmark trials in women may also apply to men with breast cancer. This study aimed to compare survival in men with positive sentinel lymph nodes after sentinel lymph node biopsy (SLNB) alone versus complete axillary dissection (ALND). PATIENTS AND METHODS Using the National Cancer Database, men with clinically node-negative, T1 and T2 breast cancer and 1-2 positive sentinel nodes who underwent SLNB or ALND were identified from 2010 to 2020. Both 1:1 propensity score matching and multivariate regression were used to identify patient and disease variables associated with ALND versus SLNB. Survival between ALND and SLNB were compared using Kaplan-Meier methods. RESULTS A total of 1203 patients were identified: 61.1% underwent SLNB alone and 38.9% underwent ALND. Treatment in academic centers (36.1 vs. 27.7%; p < 0.0001), 2 positive lymph nodes on SLNB (32.9 vs. 17.3%, p < 0.0001) and receipt or recommendation of chemotherapy (66.5 vs. 52.2%, p < 0.0001) were associated with higher likelihood of ALND. After propensity score matching, ALND was associated with superior survival compared with SLNB (5-year overall survival of 83.8 vs. 76.0%; log-rank p = 0.0104). DISCUSSION The results of this study suggest that among patients with early-stage MBC with limited sentinel lymph node metastasis, ALND is associated with superior survival compared with SLNB alone. These findings indicate that it may be inappropriate to extrapolate the results of the ACOSOG Z0011 and EORTC AMAROS trials to MBC.
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Affiliation(s)
- Sophie H Chung
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Susanna W L de Geus
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Grant Shewmaker
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kelsey S Romatoski
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Frederick T Drake
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Naomi Y Ko
- Section of Hematology/Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Andrea L Merrill
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Ariel E Hirsch
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Jennifer F Tseng
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Teviah E Sachs
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Michael R Cassidy
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
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3
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Zeeshan S, Siddiqiui T, Shaukat F, Tariq MU, Khan N, Vohra L. Male Breast Cancer: The Three Decades' Experience of a Tertiary Care Hospital in a Lower-Middle Income Country. Cureus 2022; 14:e22670. [PMID: 35386144 PMCID: PMC8967081 DOI: 10.7759/cureus.22670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Male breast cancer is uncommon and managed on the guidelines of female breast cancer due to tumor rarity. We sought to identify the incidence, clinicopathological features, and survival of all male breast cancer patients managed in our hospital. Methods A retrospective cross-sectional study was conducted at Aga Khan University Hospital (AKUH), Karachi, Pakistan, from January 1986 to December 2018. Demographic data, treatment records, and follow-up data of all male breast cancer patients who were treated at AKUH was reviewed. Results Thirty-eight out of 42 patients who presented over a period of 32 years were included. The mean age was 63 years. The most common tumor type and subtype were invasive ductal carcinoma (89.5%) and luminal A (73.7%), respectively. The majority (36.8%) of the patients presented at stage III. Among 30 (78.9%) patients who underwent surgery, mastectomy was performed in 30 (78.9%), upfront axillary clearance in 24 (63.2%), axillary sampling in five (15.1%) cases, and sentinel lymph node biopsy in one (2.6%) case. Neoadjuvant chemotherapy was given to 10 (26.3%) patients, and adjuvant chemotherapy to eight (21.1%) patients. Adjuvant hormonal treatment was administered to 22 (57.9%) patients, and 13 (34%) patients received adjuvant radiation to the chest wall. The five-year overall survival was 38.2% and the median survival was 36 months. The five-year disease-free survival (DFS) was found to be 33.7%. Conclusion Breast cancer in males presents at an advanced stage with poor survival. Multicenter studies are required to accurately identify incidence, prognostic factors, and outcomes in order to have a better understanding of its management.
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4
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Kwok HT, Van M, Fan KS, Chan J. Top 100 cited articles in male breast cancer: A bibliometric analysis. Breast Dis 2022; 41:15-20. [PMID: 34219705 DOI: 10.3233/bd-201024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Male breast cancer is a considerably rare condition and only accounts for 1% of all breast cancer cases. Due to limited public awareness, the condition is likely to present late, leading to late diagnosis and treatment worsening morbidity and mortality. This article aims to identify the focus and most influential research on male breast cancer. Objective Identify the most influential papers in male breast cancer. METHODS Search on Web of Science using the search terms 'Male', 'Breast Cancer' and "Male breast cancer" to identify all full manuscripts in English language and were ranked by the total number of citations. The top 100 articles were then further analysed according to subject, author, journal, year and country of publications. RESULTS The mean number of citations per paper was 96. Most cited paper was by Thorlacius, S et al. evaluating the relationship between BRCA2 and female breast cancer, prostate cancer, pancreatic cancer and ovarian cancer. Cancer is the journal with the most published papers and received most citations in the male breast cancer research field. The USA contributed 49 of the manuscripts in the top 100. The most studied topic was risk factors for male breast cancer, with 20 articles. CONCLUSIONS The most cited papers identified in this study described the advance in the knowledge of genetics and epidemiology in male breast cancer and has led to improvements in the 4 management of the disease. Most of the highly cited articles in this field were published in high impact journals and had accumulated at least 100 citations to date, reflecting their quality and impact. By collating the most influential publications in this field, this analysis can serve to identify knowledge gaps in male breast cancer research as well as to help identify what makes a paper impactful and citable.
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Affiliation(s)
| | - Minh Van
- St. George's Medical School, London, UK
| | | | - Jeremy Chan
- Department of Cardiothoracic Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK
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5
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Chamseddine RS, Wang C, Yin K, Wang J, Singh P, Zhou J, Robson ME, Braun D, Hughes KS. Penetrance of male breast cancer susceptibility genes: a systematic review. Breast Cancer Res Treat 2021; 191:31-38. [PMID: 34642874 DOI: 10.1007/s10549-021-06413-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/30/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Several male breast cancer (MBC) susceptibility genes have been identified, but the MBC risk for individuals with a pathogenic variant in each of these genes (i.e., penetrance) remains unclear. We conducted a systematic review of studies reporting the penetrance of MBC susceptibility genes to better summarize current estimates of penetrance. METHODS A search query was developed to identify MBC-related papers indexed in PubMed/MEDLINE. A validated natural language processing method was applied to identify papers reporting penetrance estimates. These penetrance studies' bibliographies were reviewed to ensure comprehensiveness. We accessed the potential ascertainment bias for each enrolled study. RESULTS Fifteen penetrance studies were identified from 12,182 abstracts, covering five purported MBC susceptibility genes: ATM, BRCA1, BRCA2, CHEK2, and PALB2. Cohort (n = 6, 40%) and case-control (n = 5, 33%) studies were the two most common study designs, followed by family-based (n = 3, 20%), and a kin-cohort study (n = 1, 7%). Seven of the 15 studies (47%) adjusted for ascertainment adequately and therefore the MBC risks reported by these seven studies can be considered applicable to the general population. Based on these seven studies, we found pathogenic variants in ATM, BRCA2, CHEK2 c.1100delC, and PALB2 show an increased risk for MBC. The association between BRCA1 and MBC was not statistically significant. CONCLUSION This work supports the conclusion that pathogenic variants in ATM, BRCA2, CHEK2 c.1100delC, and PALB2 increase the risk of MBC, whereas pathogenic variants in BRCA1 may not be associated with increased MBC risk.
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Affiliation(s)
- Reem S Chamseddine
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.,Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Cathy Wang
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kanhua Yin
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Jin Wang
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA. .,Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, China.
| | - Preeti Singh
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Jingan Zhou
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.,Department of General Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Mark E Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Danielle Braun
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kevin S Hughes
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.,Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
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6
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van der Pol CC, Moelans CB, Manson QF, Batenburg MCT, van der Wall E, Borel Rinkes I, Verkooijen L, Raman V, van Diest PJ. Cytoplasmic DDX3 as prognosticator in male breast cancer. Virchows Arch 2021; 479:647-655. [PMID: 33974127 PMCID: PMC8516781 DOI: 10.1007/s00428-021-03107-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 12/23/2022]
Abstract
Male breast cancer (MBC) is a rare disease. Due to its rarity, treatment is still directed by data mainly extrapolated from female breast cancer (FBC) treatment, despite the fact that it has recently become clear that MBC has its own molecular characteristics. DDX3 is a RNA helicase with tumor suppressor and oncogenic potential that was described as a prognosticator in FBC and can be targeted by small molecule inhibitors of DDX3. The aim of this study was to evaluate if DDX3 is a useful prognosticator for MBC patients. Nuclear as well as cytoplasmic DDX3 expression was studied by immunohistochemistry in a Dutch retrospective cohort of 106 MBC patients. Differences in 10-year survival by DDX3 expression were analyzed using log-rank test. The association between clinicopathologic variables, DDX3 expression, and survival was tested in uni- and multivariate Cox-regression analysis. High cytoplasmic DDX3 was associated with high androgen receptor (AR) expression while low nuclear DDX3 was associated with negative lymph node status. Nuclear and cytoplasmic DDX3 were not associated with each other. In a univariate analysis, high cytoplasmic DDX3 (p = 0.045) was significantly associated with better 10-year overall survival. In multivariate analyses, cytoplasmic DDX3 had independent prognostic value (p = 0.017). In conclusion, cytoplasmic DDX3 expression seems to be a useful prognosticator in MBC, as high cytoplasmic DDX3 indicated better 10-year survival.
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Affiliation(s)
- Carmen C van der Pol
- Department of Surgical Oncology, Alrijne Hospital Leiderdorp, Leiderdorp, The Netherlands
| | - Cathy B Moelans
- Departments of Pathology, University Medical Center Utrecht Cancer Center, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Quirine F Manson
- Department of Surgical Oncology, Alrijne Hospital Leiderdorp, Leiderdorp, The Netherlands
| | - Marilot C T Batenburg
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inne Borel Rinkes
- Department of Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lenny Verkooijen
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Venu Raman
- Departments of Pathology, University Medical Center Utrecht Cancer Center, PO Box 85500, 3508 GA, Utrecht, The Netherlands.,Department of Radiology and Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Paul J van Diest
- Departments of Pathology, University Medical Center Utrecht Cancer Center, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
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7
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Presentation and Spectrum of Male Breast Cancer in a Rural Cancer Center in a Subunit of Tata Memorial Center, India. Indian J Surg Oncol 2021; 12:330-334. [PMID: 34295077 DOI: 10.1007/s13193-021-01306-8] [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: 11/28/2020] [Accepted: 03/01/2021] [Indexed: 10/21/2022] Open
Abstract
This is a retrospective study of the incidence and clinical profile of male breast cancer (MBC) presenting to a rural cancer center in Punjab, India. All MBC cases registered over a period of 4.5 years from January 2015 to July 2019 were included. The study included 34 MBC patients accounting for 1.9% of all breast cancer cases with median age of 62.5 years. All patients were from Punjab except one, with majority from district Sangrur. Family history was present in 7 (20.6%) patients. Mean BMI (n = 23) was 24.8. The median duration of symptoms was 6 months (range 1-60 months). Main complaint was lump in 58.8% of patients followed by lump with ulceration (41.2%). All cases were mostly unilateral, left in 21 (61.8%) and right in 13 (38.2%), and one had bilateral breast cancer. Most tumors were centrally located (70.6%). Infiltrating ductal carcinoma and grade 3 were the commonest histology. ER positivity was high seen in 76.5% cases. In our study, 16 (47.1%) patients presented with distant metastasis at the time of diagnosis, and 10 (39.1%) were locally advance. Bone (41%) followed by lung (17%) were the most common sites of metastasis. Thirteen patients were treated radically, nine were treated with palliative intent, and twelve patients defaulted. Median follow-up period was 16.5 months. MBC constituted 1.9% of all breast cancers registered at our institute, which is higher than worldwide average. Our study population had a longer time to presentation, and majority were metastatic.
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8
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Ishii T, Nakano E, Watanabe T, Higashi T. Epidemiology and practice patterns for male breast cancer compared with female breast cancer in Japan. Cancer Med 2020; 9:6069-6075. [PMID: 32613775 PMCID: PMC7433825 DOI: 10.1002/cam4.3267] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/12/2020] [Accepted: 06/11/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The incidence of male breast cancer (MBC), although rare, has shown an increase. However, the current epidemiology of and practice patterns for MBC remain unclear. This study evaluated the characteristics and care patterns for MBC compared with female breast cancer (FBC) in Japan. METHODS Using the National Database of Hospital-Based Cancer Registries (HBCR) linked to the Diagnosis Procedure Combination data, we analyzed newly diagnosed breast cancer cases between January 2012 and December 2015 at participating hospitals in a large quality-of-care monitoring project. We employed logistic regression models to assess cancer treatment differences between MBC and FBC in patients who were indicated for adjuvant radiation therapy and neo-adjuvant/adjuvant chemotherapy. RESULTS Of 142,636 breast cancer patients, 870 (0.61%) were MBC patients. At diagnosis, the mean age of MBC patients was 10 years older than FBC patients (70 vs 60 years; P < .001). Advanced-stage cancer was more frequently observed in MBC than in FBC (stage III/IV 18.9%/6.1% vs 10.6%/5.2%). Despite this, MBC patients were less likely to receive adjuvant radiation therapy and neo-adjuvant/adjuvant chemotherapy. Gender was an independent treatment determinant factor for chemotherapy decisions. CONCLUSION MBC patients were older and had higher stages of cancer than FBC patients at diagnosis, but received suboptimal treatment.
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Affiliation(s)
- Taisuke Ishii
- Division of Health Services ResearchNational Cancer CenterTokyoJapan
| | - Eriko Nakano
- Department of Medical OncologySt. Luke’s International HospitalTokyoJapan
| | - Tomone Watanabe
- Division of Health Services ResearchNational Cancer CenterTokyoJapan
| | - Takahiro Higashi
- Division of Health Services ResearchNational Cancer CenterTokyoJapan
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9
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Goyal A, Gupta J, Choudhary A, Harit K, Ragesvari KS, Gupta I. Awareness about breast cancer in males in urban area of Delhi. J Family Med Prim Care 2020; 9:1999-2001. [PMID: 32670954 PMCID: PMC7346897 DOI: 10.4103/jfmpc.jfmpc_1098_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/09/2019] [Accepted: 12/25/2019] [Indexed: 11/04/2022] Open
Abstract
Background Breast cancer in males is still an issue that is not known to majority of the population across the globe. People in general are not aware that breast cancer can occur in males too as increasing campaigns are done to raise awareness in females. Objective To assess the level of awareness of male breast cancer (MBC) in males of urban population residing in the Soami Nagar colony, Panchsheel, New Delhi. Methodology A cross sectional survey was conducted through a self-administered questionnaire to know the awareness of the occurrence of MBC, its diagnosis and criticality. Results It was found that only 19% of men were aware of the fact that breast cancer can occur in males as well and remaining 81% were ignorant. Conclusion Because a whopping 81% of the surveyed population did not know that breast cancer could even occur in males, they were made aware about all the symptoms to look for and not to ignore any sort of bulge/lumps/knots that they may feel in their breast region or under the armpits. Findings of this study would serve as a baseline to focus on making people aware of this life threatening problem. Increased awareness of MBC would help males to discuss the problem in initial phase and reach out to primary health care physicians for early diagnosis and treatment.
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Affiliation(s)
- Anjana Goyal
- Department of Biochemistry, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Jigyasa Gupta
- Department of Biochemistry, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Anushka Choudhary
- Department of Biochemistry, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Kadambari Harit
- Department of Biochemistry, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Kaja Sai Ragesvari
- Department of Biochemistry, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Ishu Gupta
- Department of Biochemistry, Manav Rachna Dental College, Faridabad, Haryana, India
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10
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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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11
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Co M, Lee A, Kwong A. Delayed presentation, diagnosis, and psychosocial aspects of male breast cancer. Cancer Med 2020; 9:3305-3309. [PMID: 32167660 PMCID: PMC7221437 DOI: 10.1002/cam4.2953] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction Male breast cancer is uncommon, delay in seeking medical attention often results in late presentation and poor prognosis. Methods Retrospective review of a prospectively maintained database was performed. Patients who were still having regular follow‐up were contacted for telephone interview. Results In this study, 56 male breast cancer patients were treated in our center from January 1998 to December 2018, accounting for 0.88% of all breast cancers treated during the same period of time. Median age of onset was 61 years old (Range: 33‐95). In this study, 6 (10.7%) patients presented with distant metastasis at the time of diagnosis and received palliative systemic treatment only. And, 50 patients were surgically treated and all had mastectomy. Axillary dissection was performed in 36 (72%) patients, while sentinel node biopsy was performed in 14 (28%) patients. Median tumor size was 23 mm (2‐100 mm). A Majority were diagnosed with invasive carcinoma (NOS), while 38 (67.8%) patients were node positive.Here 36 (64.3%) patients were alive at the time of the study, 31 (86.1%) patients responded to the telephone interview. More than 90% of our patients expressed various degrees of embarrassment at the time of breast symptom onset. Similarly, more than 90% of these patients experienced embarrassment while waiting in the breast center with predominant female patients. Most patients (N = 26) were not aware that breast cancer can occur in men prior to the diagnosis. Median duration from symptoms to the first medical consultation was 12.4 months (1‐120 months). Conclusion Male breast cancer is rare and patients usually present late, Lack of knowledge, public education, and embarrassment are the important related factors.
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Affiliation(s)
- Michael Co
- Division of Breast Surgery, The University of Hong Kong, Hong Kong.,Division of Breast Surgery, The University of Hong Kong Shenzhen Hospital, Shenzhen, China.,Department of Surgery, Queen Mary Hospital, Hong Kong
| | - Andrea Lee
- Division of Breast Surgery, The University of Hong Kong, Hong Kong.,Department of Surgery, Queen Mary Hospital, Hong Kong
| | - Ava Kwong
- Division of Breast Surgery, The University of Hong Kong, Hong Kong.,Division of Breast Surgery, The University of Hong Kong Shenzhen Hospital, Shenzhen, China.,Department of Surgery, Queen Mary Hospital, Hong Kong.,Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong.,Hong Kong Sanatorium and Hospital, Hong Kong
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12
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Kjaerulff TM, Ersbøll AK, Pukkala E, Bolin K, Green A, Emneus M, Brasso K, Iversen P, Thygesen LC. Characteristics of finasteride users in comparison with nonusers: A Nordic nationwide study based on individual-level data from Denmark, Finland, and Sweden. Pharmacoepidemiol Drug Saf 2020; 29:453-460. [PMID: 32048414 DOI: 10.1002/pds.4947] [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: 01/21/2019] [Revised: 11/13/2019] [Accepted: 11/27/2019] [Indexed: 11/10/2022]
Abstract
PURPOSE Published epidemiological studies on the association between finasteride use and the risk of male breast cancer have been inconclusive due to methodological limitations including a few male breast cancer cases included. Determinants of male breast cancer have been studied, but it remains unexplored whether these are also related to finasteride use and thereby constitute potential confounders. This study aimed to assess whether there are differences between finasteride users and nonusers with regard to numerous potential confounders. METHODS In total, 246 508 finasteride users (≥35 years) were identified in the prescription registries of Denmark (1995-2014), Finland (1997-2013), and Sweden (2005-2014). An equal number of nonusers were sampled. The directed acyclic graph (DAG) methodology was used to identify potential confounders for the association between finasteride and male breast cancer. A logistic regression model compared finasteride users and nonusers with regard to potential confounders that were measurable in registries and population surveys. RESULTS Finasteride users had higher odds of testicular abnormalities (odds ratio [OR] 1.40; 95% confidence interval [CI] 1.36-1.44), obesity (1.31; 1.23-1.39), exogenous testosterone (1.61; 1.48-1.74), radiation exposure (1.22; 1.18-1.27), and diabetes (1.07; 1.04-1.10) and lower odds of occupational exposure in perfume industry or in high temperature environments (0.93; 0.87-0.99), living alone (0.89; 0.88-0.91), living in urban/suburban areas (0.97; 0.95-0.99), and physical inactivity (0.70; 0.50-0.99) compared to nonusers. CONCLUSIONS Systematic differences between finasteride users and nonusers were found emphasizing the importance of confounder adjustment of associations between finasteride and male breast cancer.
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Affiliation(s)
| | - Annette Kjaer Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Eero Pukkala
- Cancer Society of Finland, Finnish Cancer Registry - Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.,Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kristian Bolin
- Centre for Health Economics and Department of Economics, University of Gothenburg, Gothenburg, Sweden
| | - Anders Green
- Open Patientdata Explorative Network (OPEN), Odense University Hospital and University of Southern Denmark, Odense, Denmark.,Institute of Applied Economics and Health Research, Copenhagen, Denmark
| | - Martha Emneus
- Institute of Applied Economics and Health Research, Copenhagen, Denmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter Iversen
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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13
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Kjærulff TM, Ersbøll AK, Green A, Emneus M, Brasso K, Iversen P, Pukkala E, Bolin K, Thygesen LC. Finasteride Use and Risk of Male Breast Cancer: A Case-Control Study Using Individual-Level Registry Data from Denmark, Finland, and Sweden. Cancer Epidemiol Biomarkers Prev 2019; 28:980-986. [PMID: 30842126 DOI: 10.1158/1055-9965.epi-18-0904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/05/2018] [Accepted: 02/25/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In case reports, concerns have been raised as to whether finasteride use increases the risk of male breast cancer. Previous epidemiologic evidence on the potential link is conflicting. This study aimed to assess whether an association between finasteride use and male breast cancer exists after accounting for potential confounders. METHODS The source population consisted of all men (≥35 years) from Denmark (1995-2014), Finland (1997-2013), and Sweden (2005-2014). Cases with incident male breast cancer were identified in the cancer registries and matched with 50 density-sampled, age, and country-matched male population controls per case. Exposure information on finasteride use was derived from the prescription registries. Potential confounders were identified using the directed acyclic graph methodology and measured by use of information from nation-wide registries. RESULTS The study population comprised 1,005 male breast cancer cases and 43,058 controls. Confounder-adjusted odds of finasteride exposure were not statistically significantly increased [OR, 1.09; 95% confidence interval (CI), 0.77-1.54] in breast cancer cases relative to controls. There was no evidence of a dose-response relationship, as the group with greatest exposure to finasteride was associated with lowest OR of male breast cancer [OR, 0.72 (95% CI, 0.40-1.30)]. Sensitivity analyses did not reveal marked changes in results with different exposure definitions or for specific subgroups. CONCLUSIONS Results from this study provided no evidence that finasteride use was associated with male breast cancer. IMPACT This large confounder-adjusted study supports the view that exposure to finasteride is not associated materially with male breast cancer risk.
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Affiliation(s)
- Thora M Kjærulff
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
| | - Annette K Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anders Green
- Odense University Hospital and University of Southern Denmark, Odense, Denmark.,Institute of Applied Economics and Health Research, Copenhagen, Denmark
| | - Martha Emneus
- Institute of Applied Economics and Health Research, Copenhagen, Denmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter Iversen
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Eero Pukkala
- Finnish Cancer Registry-Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.,Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Kristian Bolin
- Centre for Health Economics and Department of Economics with Statistics, University of Gothenburg, Gothenburg, Sweden
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Affiliation(s)
- Chandler S Cortina
- Department of Surgery (Cortina, Madrigano), Division of Surgical Oncology, Rush University Medical Center, Chicago, Ill.
| | - Andrea Madrigrano
- Department of Surgery (Cortina, Madrigano), Division of Surgical Oncology, Rush University Medical Center, Chicago, Ill
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15
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Midding E, Halbach SM, Kowalski C, Weber R, Würstlein R, Ernstmann N. Men With a "Woman's Disease": Stigmatization of Male Breast Cancer Patients-A Mixed Methods Analysis. Am J Mens Health 2018; 12:2194-2207. [PMID: 30222029 PMCID: PMC6199445 DOI: 10.1177/1557988318799025] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Male breast cancer (MBC) is rare and known as a typical woman’s disease. This study is part of the N-MALE project (Male breast cancer: patient’s needs in prevention, diagnosis, treatment, rehabilitation and follow-up-care) and aims to investigate how MBC patients (MBCP) feel about suffering from a “woman’s disease,” what character the stigmatization has, and how it can be prospectively reduced. Therefore, a mixed methods design is applied including data of N = 27 qualitative interviews with MBCP and quantitative data of N = 100 MBCP. Findings identify a diverse picture, as stigmatization varies between contexts and patients: Most stigmatization concentrates on sexual stigmatization and ignorance of MBC and mostly occurs in cancer care systems and work-related contexts. The level of stigmatization varies with age and amount of treatment methods received, as reported within the created typology of different MBCP stigma types. To prospectively reduce stigmatization in MBCP, more publicity of MBC is needed, as well as gender-neutral communication and information material.
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Affiliation(s)
- Evamarie Midding
- 1 Center for Health Communication and Health Services Research (CHSR). Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,2 Center for Integrated Oncology Cologne Bonn, Germany
| | - Sarah Maria Halbach
- 1 Center for Health Communication and Health Services Research (CHSR). Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,2 Center for Integrated Oncology Cologne Bonn, Germany
| | | | - Rainer Weber
- 4 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Rachel Würstlein
- 5 Breast Center, Department of Gynecology and Obstetrics and CCCLMU, University of Munich (LMU), Munich, Germany
| | - Nicole Ernstmann
- 1 Center for Health Communication and Health Services Research (CHSR). Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,2 Center for Integrated Oncology Cologne Bonn, Germany
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16
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Wang K, Wang QJ, Xiong YF, Shi Y, Yang WJ, Zhang X, Li HY. Survival Comparisons Between Early Male and Female Breast Cancer Patients. Sci Rep 2018; 8:8900. [PMID: 29891971 PMCID: PMC5995882 DOI: 10.1038/s41598-018-26199-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/23/2018] [Indexed: 12/18/2022] Open
Abstract
We aimed to compare the overall survival (OS) and standardized mortality rate (SMR) of the male breast cancer (MBC) with female breast cancer (FBC) after propensity score matching. Based on the Surveillance, Epidemiology, and End Results (SEER), the early breast cancer patients (T1-2N0-2M0) were extracted from 1998-2007. This study included 1,111 and 2,151 patients with early MBC and FBC, respectively, whose clinicopathological characteristics were well balanced. At a mean follow-up time of 97 months, 10-year OS rate was 58.3% in the MBC group and 68.7% in the FBC (log-rank test, P < 0.001; hazard ratio (HR) = 1.45, 95% confidence interval (CI) = 1.29 to 1.64). Adjusted HR for OS between MBC and FBC were revealed from propensity score matched-multivariable Cox proportional hazards models (HR = 1.53, 95% CI = 1.35 to 1.73). Similar adjusted SMRs between MBC and FBC ((SMR = 1.98, 95% CI = 1.83,2.14) for FBC and (SMR = 2.07, 95% CI = 1.88-2.28) for MBC) were observed. The nomogram was constructed for FBC, and predicted probabilities were generally good (C-index = 0.71), whose area under curve is higher than TNM stage classification (0.74 vs 0.62). OS was significantly decreased among early MBC patients compared with FBC, but similar SMRs and its trends by age groups were observed between MBC and FBC except for young patients.
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Affiliation(s)
- Kang Wang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical university, Chongqing Medical University, Chongqing, 400016, China.
| | - Qiu-Juan Wang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical university, Chongqing Medical University, Chongqing, 400016, China
| | - Yong-Fu Xiong
- Department of the Gastrointestinal Surgery, The First Affiliated hospital of Chongqing Medical university, Chongqing Medical University, Chongqing, 400016, China
| | - Yang Shi
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, China
| | - Wen-Jing Yang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical university, Chongqing Medical University, Chongqing, 400016, China
| | - Xiang Zhang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical university, Chongqing Medical University, Chongqing, 400016, China.
| | - Hong-Yuan Li
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical university, Chongqing Medical University, Chongqing, 400016, China.
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17
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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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18
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Farr DE, Thomas A, Khan SA, Schroeder MC. Male Breast Cancer as a Second Primary Cancer: Increased Risk Following Lymphoma. Oncologist 2017; 22:895-900. [PMID: 28487463 DOI: 10.1634/theoncologist.2016-0460] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/09/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Male breast cancer (MBC) as a second primary cancer (SPC) has a known association with prior MBC. However, its association with non-breast index malignancies, relative to population risk, has not been previously reported. MATERIALS AND METHODS Using Surveillance, Epidemiology, and End Results program (9 catchment area) data, we identified MBCs diagnosed from 1973-2012 as their SPC. Information regarding the index malignancy was also obtained. Standardized incidence ratios (SIR) of MBC as SPC were estimated, along with incidence rates and trends. Kaplan-Meier curves were used to estimate survival. RESULTS Over a 38-year period, 464 MBCs were identified as SPC. The most common index malignancies were breast (SIR 30.86, 95% confidence interval [CI] 21.50-42.92, p < .001), lymphoma (SIR 1.58, 95% CI 1.08-2.22, p = .014), melanoma (SIR 1.26, 95% CI 0.80-1.89), urinary (SIR 1.05, 95% CI 0.74-1.43), colorectal (SIR 0.94, 95% CI 0.69-1.24), and prostate (SIR 0.93 95% CI 0.81-1.07). Apart from the known association with prior breast cancer, the only significant association was with lymphoma as an index cancer, although not significant with a Bonferroni correction. From 1975-2012, incidence of breast cancer as a first cancer increased at an annual percentage change of 1.3% while breast cancer as a SPC increased at 4.7% (both p values < .001). CONCLUSION Male breast cancer as a SPC has increased markedly over 4 decades. Men with a history of lymphoma may experience higher-than-expected rates of breast SPC. These observations warrant further research, and suggest possible etiologic connections with disease biology, prior therapy, or genetics. IMPLICATIONS FOR PRACTICE This study reports that men are presenting more frequently to the clinic with breast cancer, both as an initial cancer and as a second cancer following an earlier malignancy. We also report the novel observation that men who survive lymphoma are at increased risk of developing a subsequent breast cancer. Further work is needed to better understand possible treatment or biologic causes of this association. More immediately, these findings suggest the need for heightened vigilance for male breast cancer overall and, in particular, for male lymphoma survivors.
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Affiliation(s)
- Deborah E Farr
- Division of Surgical Oncology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Alexandra Thomas
- Department of Internal Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Seema Ahsan Khan
- Department of Surgery, Feinberg School of Medicine of Northwestern University, Chicago, Illinois, USA
| | - Mary C Schroeder
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA
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Bender PFM, de Oliveira LL, Costa CR, de Aguiar SS, Bergmann A, Thuler LCS. Men and women show similar survival rates after breast cancer. J Cancer Res Clin Oncol 2016; 143:563-571. [PMID: 27933394 DOI: 10.1007/s00432-016-2311-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 11/23/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the disease-free survival (DFS) and overall survival (OS) rates of men and women undergoing treatment for breast cancer. METHODS A retrospective cohort study of patients with breast cancer diagnosed and treated at the Cancer Hospital III of the National Cancer Institute of Brazil, Rio de Janeiro, Brazil, between 1999 and 2013. Male breast cancer cases were matched for age, year of diagnosis, and clinical staging to three female cases (1:3). Patient characteristics were abstracted from hospital records and medical charts. Cases were analyzed using descriptive statistics, and comparisons between the genders were performed using Kaplan-Meier curves and Cox regression analysis with 95% confidence intervals. RESULTS The study population comprised 98 men and 294 women. There were significant differences (p < 0.05) between the genders for marital status, alcohol consumption, smoking, presence of hypertension and other comorbidities, histological type of tumor, expression of estrogen receptors, progesterone receptors, human epidermal growth factor receptor-type 2, type of breast surgery, neoadjuvant chemotherapy, adjuvant radiotherapy, and use of palliative bisphosphonate therapy. Five- and 10-year DFS rates were, respectively, 80.0 and 51.4% for men and 71.4 and 63.5% for women (p = 0.245), and 5- and 10-year OS rates were, respectively, 65.0 and 47.5% for men and 56.5 and 41.4% for women (p = 0.221). CONCLUSION There was no significant difference in prognosis (DFS and OS rates) between the genders, but significant differences in sociodemographic and clinical characteristics were detected between male and female breast cancer cases.
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Affiliation(s)
| | | | | | | | - Anke Bergmann
- Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Luiz Claudio Santos Thuler
- Brazilian National Cancer Institute (INCA) and Federal University of Rio de Janeiro State (UNIRIO), Rua André Cavalcanti, 37/2nd floor - Centro, Rio de Janeiro, RJ, 20231-050, Brazil.
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Flaherty DC, Bawa R, Burton C, Goldfarb M. Breast Cancer in Male Adolescents and Young Adults. Ann Surg Oncol 2016; 24:84-90. [DOI: 10.1245/s10434-016-5586-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Indexed: 11/18/2022]
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Gargiulo P, Pensabene M, Milano M, Arpino G, Giuliano M, Forestieri V, Condello C, Lauria R, De Placido S. Long-term survival and BRCA status in male breast cancer: a retrospective single-center analysis. BMC Cancer 2016; 16:375. [PMID: 27377827 PMCID: PMC4932666 DOI: 10.1186/s12885-016-2414-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 06/28/2016] [Indexed: 11/17/2022] Open
Abstract
Background Male breast cancer (MBC) is rare. Given the paucity of randomized trials, treatment is generally extrapolated from female breast cancer guidelines. Methods This is a retrospective analysis of all male patients presenting with MBC at the Department of Oncology at University Federico II of Naples between January 1989 and January 2014. We recorded the following data: baseline characteristics (age, height, weight, body mass index, risk factors, family history), tumor characteristics (side affected, stage, histotype, hormonal and HER2 status, and Ki-67 expression), treatment (type of surgery, chemotherapy, endocrine therapy, and/or radiotherapy), BRCA1/2 mutation status (if available), other tumors, and long-term survival. Results Forty-seven patients were analyzed. Median age was 62.0 [55.0–72.0]. Among risk factors, obesity and family history of breast cancer were associated with 21 % and 30 % of MBC cases, respectively. The majority of tumors were diagnosed at an early stage: stage I (34.0 %) and stage II (44.7 %). Infiltrating ductal carcinoma was the most frequent histologic subtype (95.8 %). Hormone receptors were generally positive (88.4 % of cases were Estrogen receptor [ER] positive and 81.4 % Progesteron receptor [PgR] positive). Human epidermal growth factor receptor 2 (HER2) was positive in 26.8 % of cases; 7.0 % of MBCs were triple negative. The tumor had high proliferation index (Ki67 ≥ 20 %) in 64.7 %. Surgery was predominantly mastectomy (85.1 %), whereas quadrantectomy was performed in 14.9 % of patients. Adjuvant chemotherapy was administered to 70.7 % of patients, endocrine therapy to 90.2 %, trastuzumab to 16.7 % and radiotherapy to 32.6 %. BRCA status was available for 17 patients: 10 wild-type, 1 BRCA1 carrier, 5 BRCA2 carriers, 1 unknown variant sequence. The overall estimated long-term survival was about 90 % at 5 years, 80 % at 10 years and 70 % at 20 years. Patients carrying a BRCA mutation had a significantly lower survival than patients with wild-type BRCA (p = 0.04). Conclusions Long-term survival was high in MBC patients referred to our clinical unit. Survival was poorer in BRCA-mutated patients than in patients with wild-type BRCA.
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Affiliation(s)
- Piera Gargiulo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Matilde Pensabene
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Monica Milano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.,Lester and Sue Smith Breast Center at Baylor College of Medicine, Houston, Tx, USA
| | - Valeria Forestieri
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Caterina Condello
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Rossella Lauria
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
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He DX, Ma X. Clinical utility of letrozole in the treatment of breast cancer: a Chinese perspective. Onco Targets Ther 2016; 9:1077-84. [PMID: 27042100 PMCID: PMC4780194 DOI: 10.2147/ott.s81087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The incidence rate of breast cancers in People’s Republic of China has increased in the last decade, and many cases are responsive to hormone therapies. The third-generation aromatase inhibitor letrozole inhibits estrogen production, and is more efficacious than the estrogen receptor inhibitor tamoxifen. In recent years, letrozole has been widely used to treat postmenopausal breast cancers in People’s Republic of China. Also, metastatic, premenopausal, and male breast cancers have been effectively treated by a combination of letrozole with cytotoxic, radiation, or other therapies. In this review, we provide a perspective and summary of recent advances in the use of letrozole for breast cancer in Chinese patients.
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Affiliation(s)
- Dong-Xu He
- National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Xin Ma
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi, People's Republic of China
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23
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Zaenger D, Rabatic BM, Dasher B, Mourad WF. Is Breast Conserving Therapy a Safe Modality for Early-Stage Male Breast Cancer? Clin Breast Cancer 2016; 16:101-4. [DOI: 10.1016/j.clbc.2015.11.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 11/10/2015] [Indexed: 11/28/2022]
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Grundy A, Harris SA, Demers PA, Johnson KC, Agnew DA, Villeneuve PJ. Occupational exposure to magnetic fields and breast cancer among Canadian men. Cancer Med 2016; 5:586-96. [PMID: 26792203 PMCID: PMC4799956 DOI: 10.1002/cam4.581] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 10/01/2015] [Accepted: 10/15/2015] [Indexed: 01/13/2023] Open
Abstract
Occupational magnetic field (MF) exposure has been suggested as a risk factor for breast cancer in both men and women. Due to the rarity of this disease in men, most epidemiologic studies investigating this relationship have been limited by small sample sizes. Herein, associations of several measures of occupational MF exposure with breast cancer in men were investigated using data from the population-based case-control component of the Canadian National Enhanced Cancer Surveillance System. Lifetime job histories were provided by 115 cases and 570 controls. Average MF exposure of individual jobs was classified into three categories (<0.3, 0.3 to <0.6, or ≥0.6 μT) through expert blinded review of participant's lifetime occupational histories. The impact of highest average and cumulative MF exposure, as well as exposure duration and specific exposure-time windows, on cancer risk was examined using logistic regression. The proportion of cases (25%) with a highest average exposure of ≥0.3 μT was higher than among controls (22%). We found an elevated risk of breast cancer in men who were exposed to ≥0.6 μT (odds ratio [OR] = 1.80, 95% CI = 0.82-3.95) when compared to those with exposures <0.3 μT. Those exposed to occupational MF fields for at least 30 years had a nearly threefold increase in risk of breast cancer (OR = 2.77, 95% CI = 0.98-7.82) when compared to those with background levels of exposure. Findings for the other time-related MF variables were inconsistent. Our analysis, in one of the largest case-control studies of breast cancer in men conducted to date, provides limited support for the hypothesis that exposure to MF increases the risk breast cancer in men.
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Affiliation(s)
- Anne Grundy
- Department of Cancer Epidemiology and Prevention ResearchAlberta Health Services – Cancer Control AlbertaCalgaryAlbertaCanada
| | - Shelley A. Harris
- Prevention and Cancer ControlCancer Care OntarioTorontoOntarioCanada
- Occupational Cancer Research CenterCancer Care OntarioTorontoOntarioCanada
- Division of Occupational and Environmental HealthDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Division of EpidemiologyDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Paul A. Demers
- Occupational Cancer Research CenterCancer Care OntarioTorontoOntarioCanada
- Division of Occupational and Environmental HealthDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Kenneth C. Johnson
- Department of Epidemiology and Community MedicineUniversity of OttawaOttawaOntarioCanada
| | - David A. Agnew
- University of Ontario Institute of TechnologyOshawaOntarioCanada
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Male breast cancer, clinical presentation, diagnosis and treatment: Twenty years of experience in our Breast Unit. Int J Surg Case Rep 2016; 20S:8-11. [PMID: 26994487 PMCID: PMC4883054 DOI: 10.1016/j.ijscr.2016.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Male breast cancer (MBC) is a rare disease representing less than 1% of all malignancies in men andonly 1% of all incident breast cancers. Management consisted especially of radical mastectomy; followed by adjuvant radiotherapy and hormonal therapy with or without chemotherapy. Future research for better understanding of this disease at national or international level are needed to improve the management and prognosis of male patients.
Background The male breast cancer (MBC) is a rare and represents less than 1% of all malignancies in men and only 1% of all breast cancers incident. We illustrate the experience of our team about the clinico-pathological characteristics, treatment and prognostic factors of patients treated over a period of twenty years . Results Forty-seven patients were collected 1995–2014 at the Breast Unit of the Hospital of Terni, Italy. The average age was 67 years and the median time to diagnosis from the onset of symptoms was 16 months. The main clinical complaint was sub areolar swelling in 36, 76% of cases. Most patients have come to our attention with advanced disease. The histology of about ninety percent of the tumors were invasive ductal carcinoma. Management consisted mainly of radical mastectomy; followed by adjuvant radiotherapy and hormonal therapy with or without chemotherapy. The median follow-up was 38 months. The evolution has been characterized by local recurrences; in eight cases (17% of all patients). Metastasis occurred in 15 cases (32% of all patients). The site of bone metastases was in eight cases; lung in four cases; liver in three cases; liver and skin in one case and pleura and skin in one case. Conclusion The male breast cancer has many similarities to breast cancer in women, but there are distinct functions that need to be appreciated. Future research for a better understanding of the disease should provide a better account of genetic and epigenetic characteristics of these forms; but, above all, epidemiological and biological cohorts numerically more consistent.
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Yalaza M, İnan A, Bozer M. Male Breast Cancer. THE JOURNAL OF BREAST HEALTH 2016; 12:1-8. [PMID: 28331724 DOI: 10.5152/tjbh.2015.2711] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/03/2015] [Indexed: 12/24/2022]
Abstract
Male breast cancer (MBC) is a rare disease, accounting for less than 1% of all breast cancer diagnoses worldwide. Although breast carcinomas share certain characteristics in both genders, there are notable differences. Most studies on men with breast cancer are very small. Thus, most data on male breast cancer are derived from studies on females. However, when a number of these small studies are grouped together, we can learn more from them. This review emphasizes the incidence, etiology, clinical features, diagnosis, treatment, pathology, survival, and prognostic factors related to MBC.
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Affiliation(s)
- Metin Yalaza
- Clinic of Surgical Oncology, Konya Training and Research Hospital, Konya, Turkey
| | - Aydın İnan
- Department of General Surgery, Turgut Özal University Faculty of Medicine, Ankara, Turkey
| | - Mikdat Bozer
- Department of General Surgery, Division of Surgical Oncology, Fatih University Faculty of Medicine, İstanbul, Turkey
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Humphries MP, Jordan VC, Speirs V. Obesity and male breast cancer: provocative parallels? BMC Med 2015; 13:134. [PMID: 26044503 PMCID: PMC4457166 DOI: 10.1186/s12916-015-0380-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/19/2015] [Indexed: 01/17/2023] Open
Abstract
While rare compared to female breast cancer the incidence of male breast cancer (MBC) has increased in the last few decades. Without comprehensive epidemiological studies, the explanation for the increased incidence of MBC can only be speculated. Nevertheless, one of the most worrying global public health issues is the exponential rise in the number of overweight and obese people, especially in the developed world. Although obesity is not considered an established risk factor for MBC, studies have shown increased incidence among obese individuals. With this observation in mind, this article highlights the correlation between the increased incidence of MBC and the current trends in obesity as a growing problem in the 21(st) century, including how this may impact treatment. With MBC becoming more prominent we put forward the notion that, not only is obesity a risk factor for MBC, but that increasing obesity trends are a contributing factor to its increased incidence.
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Affiliation(s)
- Matthew P Humphries
- Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital, Leeds, LS9 7TF, UK.
| | - V Craig Jordan
- Department of Breast Medical Oncology and Molecular and Cellular Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Valerie Speirs
- Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital, Leeds, LS9 7TF, UK.
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Abstract
PURPOSE To describe the clinical-epidemiological features of male patients with breast cancer in Brazil. METHODS Data from male patients with breast cancer treated from 2000 through 2009 were obtained from the Brazilian Hospital Cancer Register databases. Descriptive statistics were performed. RESULTS A total of 1189 male patients were included. The mean age at diagnosis was 59.6 years (± 13.6). Tumours were categorised as clinical stage I (14.3%), stage II (38.3%), stage III (34.1%) and stage IV (13.3%). The most frequent histological type was invasive ductal carcinoma (83.7%). The first course treatment (alone or combined) consisted of chemotherapy in 53.2%, surgery in 49.2, radiation therapy in 36.8 and hormonal therapy in 21.0%; 3.4% of cases did not receive treatment. Treatment modality varies according to the tumor-node-metastasis (TNM) stage. The inadequate response rate was 15.9%, and 7.4% of patients died after the first course of treatment. Adequate response according to the first-course cancer treatment, after adjusted for clinical stage, was associated with being Caucasian (odds ratio (OR) = 2.50; 95% confidence interval (95% CI): 1.35-4.65) and submitted to chemotherapy (OR = 0.46; 95% CI: 0.28-0.74). CONCLUSIONS Male breast cancer diagnosis is often made in the advanced stage. Consequently, patients were subjected to more aggressive treatments, with poorer clinical response.
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MESH Headings
- Adult
- Aged
- Antineoplastic Agents/therapeutic use
- Brazil/epidemiology
- Breast Neoplasms, Male/epidemiology
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/therapy
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Radiotherapy
- Registries
- Surgical Procedures, Operative
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Affiliation(s)
- Luiz Claudio Santos Thuler
- Clinical Research and Technology Incorporation Coordination by Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) , Rio de Janeiro (RJ) , Brazil
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Li G, Zhong X, Yao J, Chen J, Wang M, Liu H, Yang S. Secretory breast carcinoma in a 41-year-old man with long-term follow-up: a special report. Future Oncol 2015; 11:1767-73. [PMID: 26075445 DOI: 10.2217/fon.15.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Secretory breast carcinoma (SBC) is a rare tumor that is particularly rare in male adults. To our knowledge, only 28 previous male cases of secretory breast carcinoma have been reported. We present a case of secretory breast carcinoma that has the longest duration of symptoms (40 years) in a male individual until now. Typically, the clinical features and treatment of male SBC are similar with female SBC. The ETV6–NTRK3 fusion gene is a specific genetic alteration in SBC. When compared to other types of male breast cancer, patients with male secretory breast cancer are much younger, and have a lower rate of estrogen/progesterone hormone receptor positivity. Modified radical mastectomy has been favored as a therapeutic approach in all female SBC, male SBC and other types of male breast cancer.
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Affiliation(s)
- Guanqiao Li
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Xiaojie Zhong
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Jia Yao
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Jimin Chen
- Department of Pathology, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Mei Wang
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Haiying Liu
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Shiping Yang
- Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China
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Leporati P, Fonte R, de Martinis L, Zambelli A, Magri F, Pavesi L, Rotondi M, Chiovato L. A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression. BMC Cancer 2015; 15:397. [PMID: 25962899 PMCID: PMC4436112 DOI: 10.1186/s12885-015-1400-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 04/29/2015] [Indexed: 12/04/2022] Open
Abstract
Background Acromegaly is a rare disease associated with an increased risk of developing cancer. Case presentation We report the case of a 72-year-old man who was diagnosed with acromegaly (IGF-1 770 ng/ml) and breast cancer. Four years before he suffered from a colon-rectal cancer. Pituitary surgery and octreotide-LAR treatment failed to control acromegaly. Normalization of IGF-1 (97 ng/ml) was obtained with pegvisomant therapy. Four years after breast cancer surgery, 2 pulmonary metastases were detected at chest CT. The patient was started on anastrozole, but, contrary to medical advice, he stopped pegvisomant treatment (IGF-I 453 ng/ml). Four months later, chest CT revealed an increase in size of the metastatic lesion of the left lung. The patient was shifted from anastrozole to tamoxifen and was restarted on pegvisomant, with normalization of serum IGF-1 levels (90 ng/ml). Four months later, a reduction in size of the metastatic lesion of the left lung was detected by CT. Subsequent CT scans throughout a 24-month follow-up showed a further reduction in size and then a stabilization of the metastasis. Conclusions This is the first report of a male patient with acromegaly and breast cancer. The clinical course of breast cancer was closely related to the metabolic control of acromegaly. The rapid progression of metastatic lesion was temporally related to stopping pegvisomant treatment and paralleled a rise in serum IGF-1 levels. Normalization of IGF-1 after re-starting pegvisomant impressively reduced the progression of metastatic breast lesions. Control of acromegaly is mandatory in acromegalic patients with cancer.
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Affiliation(s)
- Paola Leporati
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100, Pavia, Italy.
| | - Rodolfo Fonte
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100, Pavia, Italy.
| | - Luca de Martinis
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100, Pavia, Italy.
| | - Alberto Zambelli
- Unit of Medical Oncology, Fondazione Salvatore Maugeri I.R.C.C.S., 27100, Pavia, Italy.
| | - Flavia Magri
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100, Pavia, Italy.
| | - Lorenzo Pavesi
- Unit of Medical Oncology, Fondazione Salvatore Maugeri I.R.C.C.S., 27100, Pavia, Italy.
| | - Mario Rotondi
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100, Pavia, Italy.
| | - Luca Chiovato
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100, Pavia, Italy.
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Sineshaw HM, Freedman RA, Ward EM, Flanders WD, Jemal A. Black/White Disparities in Receipt of Treatment and Survival Among Men With Early-Stage Breast Cancer. J Clin Oncol 2015; 33:2337-44. [PMID: 25940726 DOI: 10.1200/jco.2014.60.5584] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To examine the extent of black/white disparities in receipt of treatment and survival for early-stage breast cancer in men age 18 to 64 and ≥ 65 years. PATIENTS AND METHODS We identified 725 non-Hispanic black (black) and 5,247 non-Hispanic white (white) men diagnosed with early-stage breast cancer from 2004 to 2011 in the National Cancer Data Base. We used multivariable logistic regression and calculated standardized risk ratios to predict receipt of treatment and a proportional hazards model to estimate overall hazard ratios (HRs) in black versus white men age 18 to 64 and ≥ 65 years, separately. RESULTS Receipt of treatment was remarkably similar between blacks and whites in both age groups. Black and white older men had lower receipt of chemotherapy (39.2% and 42.0%, respectively) compared with younger patients (76.7% and 79.3%, respectively). Younger black men had a 76% higher risk of death than younger white men after adjustment for clinical factors only (HR, 1.76; 95% CI, 1.11 to 2.78), but this difference significantly diminished after subsequent adjustment for insurance and income (HR, 1.37; 95% CI, 0.83 to 2.24). In those age ≥ 65 years, the excess risk of death in blacks versus whites was nonsignificant and not affected by adjustment for covariates. CONCLUSION The excess risk of death in black versus white men diagnosed with early-stage breast cancer was largely confined to those age 18 to 64 years and became nonsignificant after adjustment for differences in insurance and income. These findings suggest the importance of improving access to care in reducing racial disparities in male breast cancer mortality.
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Affiliation(s)
- Helmneh M Sineshaw
- Helmneh M. Sineshaw, Elizabeth M. Ward, W. Dana Flanders, and Ahmedin Jemal, American Cancer Society; W. Dana Flanders, Rollins School of Public Health, Emory University, Atlanta, GA; and Rachel A. Freedman, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA.
| | - Rachel A Freedman
- Helmneh M. Sineshaw, Elizabeth M. Ward, W. Dana Flanders, and Ahmedin Jemal, American Cancer Society; W. Dana Flanders, Rollins School of Public Health, Emory University, Atlanta, GA; and Rachel A. Freedman, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
| | - Elizabeth M Ward
- Helmneh M. Sineshaw, Elizabeth M. Ward, W. Dana Flanders, and Ahmedin Jemal, American Cancer Society; W. Dana Flanders, Rollins School of Public Health, Emory University, Atlanta, GA; and Rachel A. Freedman, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
| | - W Dana Flanders
- Helmneh M. Sineshaw, Elizabeth M. Ward, W. Dana Flanders, and Ahmedin Jemal, American Cancer Society; W. Dana Flanders, Rollins School of Public Health, Emory University, Atlanta, GA; and Rachel A. Freedman, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
| | - Ahmedin Jemal
- Helmneh M. Sineshaw, Elizabeth M. Ward, W. Dana Flanders, and Ahmedin Jemal, American Cancer Society; W. Dana Flanders, Rollins School of Public Health, Emory University, Atlanta, GA; and Rachel A. Freedman, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
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Cerebral Metastasis from Breast Cancer in a Male Patient with HIV. Case Rep Neurol Med 2015; 2015:482839. [PMID: 25694836 PMCID: PMC4324742 DOI: 10.1155/2015/482839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/30/2014] [Indexed: 11/17/2022] Open
Abstract
Context. Breast cancer (BC) in men is a rare condition, corresponding to 1% of all neoplasms in this gender. Some studies show that up to 93% of BC cases in men are advanced disease. If its occurrence constitutes an uncommon fact, the appearance of a metastasis to the central nervous system (CNS) is extremely rare. The objective of the present study is to present the case of a male patient, bearer of HIV infection, who presented with BC and later metastasis to the CNS. We also include a brief review of the literature. Case Report. We describe a case of a male patient, 59 years old, with HIV infection and a history of BC treated 4 years earlier, which progressed into headache and vertigo. Neuroimaging exams showed lesions suggestive of cerebral metastasis and a stereotaxic biopsy confirmed BC metastasis. Conclusion. Breast cancer in men with metastasis to the CNS is a rare condition and similar reports were not found in the available databases. It should be pointed out that even though rare, it should be considered among the differential diagnoses for SNC metastases in men, although HIV infection favors the appearance of some types of cancer.
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Tang P, Yang S, Zhong X, Yao J, Zhang Y, Dong H, Li G. Breast adenoid cystic carcinoma in a 19-year-old man: a case report and review of the literature. World J Surg Oncol 2015; 13:19. [PMID: 25885366 PMCID: PMC4329652 DOI: 10.1186/s12957-015-0442-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 01/07/2015] [Indexed: 12/27/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) of the breast is very rare in males. There have been only eight previous articles published on breast ACC in males. Here, we will report on the first case of this type of tumor in the Chinese province of Hainan. The patient was a 19-year-old male, and he underwent a radical mastectomy (RM) with axillary lymph node dissection. The histopathological examination specimen revealed that surgical margins were negative; none of the 41 axillary lymph nodes excised were positive for malignancy. The patient is alive and well 67 months after radical mastectomy. In the present study, we discuss the diagnosis and treatment options for male breast ACC based on previous English publications.
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Affiliation(s)
- Peng Tang
- Department of Breast surgery, Hainan Province People's Hospital, NO.19, Xiuhua Road, Xiuying District, Haikou, Hainan, 570311, China.
| | - Shiping Yang
- Department of Radiation Oncology, Hainan Province People's Hospital, NO.19, Xiuhua Road, Xiuying District, Haikou, Hainan, 570311, China.
| | - Xiaojie Zhong
- Department of Breast surgery, Hainan Province People's Hospital, NO.19, Xiuhua Road, Xiuying District, Haikou, Hainan, 570311, China.
| | - Jia Yao
- Department of Breast surgery, Hainan Province People's Hospital, NO.19, Xiuhua Road, Xiuying District, Haikou, Hainan, 570311, China.
| | - Yu Zhang
- Department of Breast surgery, Hainan Province People's Hospital, NO.19, Xiuhua Road, Xiuying District, Haikou, Hainan, 570311, China.
| | - Huaying Dong
- Department of Breast surgery, Hainan Province People's Hospital, NO.19, Xiuhua Road, Xiuying District, Haikou, Hainan, 570311, China.
| | - Guanqiao Li
- Department of Breast surgery, Hainan Province People's Hospital, NO.19, Xiuhua Road, Xiuying District, Haikou, Hainan, 570311, China.
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Sipetic-Grujicic SB, Murtezani ZH, Neskovic-Konstatinovic ZB, Marinkovic JM, Kovcin VN, Andric ZG, Kostic SV, Ratkov IS, Maksimovic JM. Multivariate analysis of prognostic factors in male breast cancer in Serbia. Asian Pac J Cancer Prev 2015; 15:3233-8. [PMID: 24815476 DOI: 10.7314/apjcp.2014.15.7.3233] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. MATERIALS AND METHODS In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. RESULTS The mean age at diagnosis with breast cancer was 64.3±10.5 years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibited stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ≤2 cm, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. CONCLUSIONS Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.
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Huang DP, Ye XH, Jin C. Successful use of bevacizumb and paclitaxel in a male breast cancer with liver metastases. Int J Clin Exp Med 2014; 7:3076-3079. [PMID: 25356184 PMCID: PMC4211834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 08/26/2014] [Indexed: 06/04/2023]
Abstract
Breast cancer in men is a rare cancer manifestation. In this article we report a case of male breast cancer with liver metastases, which showed a good response to a combined treatment of bevacizumb and paclitaxel, suggesting a useful option for the first-line treatment of patients with recurrent HER2-negative male breast cancer. And further assessment in a randomized clinical trial is needed.
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Affiliation(s)
- Du-Ping Huang
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, China
| | - Xiao-He Ye
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, China
| | - Chun Jin
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, China
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Kipling M, Ralph JEM, Callanan K. Psychological impact of male breast disorders: literature review and survey results. ACTA ACUST UNITED AC 2014; 9:29-33. [PMID: 24803884 DOI: 10.1159/000358751] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Referrals of men to breast assessment clinics are increasing. While most of the men will have benign disease, some of them will have breast cancer. Whichever pathology they have, men should be offered a service tailored to their needs, rather than being 'shoehorned' into a service designed to care for women. This paper explores the psychological impact on men of their condition and of attending a breast assessment clinic. METHODS The literature regarding male experience of breast problems is reviewed, and screening for psychological morbidity is discussed. Results of a survey regarding an all-male breast assessment clinic are reported, with a plan for future research. RESULTS Many of the 78 men surveyed described negative feelings relating to their condition although they did not want to be seen in an all-male breast assessment clinic if that meant a longer wait. Men reported feelings of anxiety, embarrassment, emasculation and even depression regarding their condition. CONCLUSIONS Men are distressed by gynaecomastia and need psychological support for any breast-related presentation. More formalised research into this area is needed, although the men's distress does not translate into the desire to attend an all-male assessment clinic if this means a longer wait before being seen.
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Affiliation(s)
- Mike Kipling
- Breast Unit, University Hospital of North Durham (UHND), Durham, UK
| | - Jane E M Ralph
- Breast Unit, University Hospital of North Durham (UHND), Durham, UK
| | - Keith Callanan
- Breast Unit, University Hospital of North Durham (UHND), Durham, UK
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Kwong A, Chau WW, Mang OWK, Wong CHN, Suen DTK, Leung R, Wong K, Lee A, Shea C, Morse E, Law SCK. Male Breast Cancer: A Population-Based Comparison with Female Breast Cancer in Hong Kong, Southern China: 1997–2006. Ann Surg Oncol 2013; 21:1246-53. [DOI: 10.1245/s10434-013-3377-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Indexed: 12/22/2022]
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Eggemann H, Ignatov A, Stabenow R, von Minckwitz G, Röhl FW, Hass P, Costa SD. Male breast cancer: 20-year survival data for post-mastectomy radiotherapy. ACTA ACUST UNITED AC 2013; 8:270-5. [PMID: 24132074 DOI: 10.1159/000354122] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The goal of this population-based study was to determine the impact of post-mastectomy radiation therapy on long-term overall survival (OS) of male patients with breast cancer. PATIENTS AND METHODS We investigated 20-year OS rates of 664 patients diagnosed with primary stage I-III breast cancer in former East Germany between 1970 and 1989. Patients had a radical mastectomy with axillary lymph node dissection without systemic adjuvant therapy. RESULTS Median follow-up time was 26.2 years (range 19-38 years). 52.4% of the patients had post-mastectomy radiotherapy. Radiotherapy showed different effects in each stage group after 20 years. Whereas there was an OS trend for radiotherapy to harm patients with stage I disease (hazard ratio (HR) 1.45; 95% confidence interval (CI) 0.98-2.15; p = 0.065), radiotherapy showed no benefit in patients with stage II disease (HR 0.82; 95% CI 0.62-1.1; p = 0.15). There was a significant survival benefit for patients with stage III disease receiving radiotherapy (HR 0.60; 95% CI 0.41-0.88; p = 0.008). CONCLUSION Post-mastectomy radiotherapy is associated with longer OS in male patients with stage III breast cancer. Male breast cancer patients at stages I and II do not seem to benefit from radiotherapy, but obsolete irradiation techniques might explain adverse long-term effects in earlier stages.
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Affiliation(s)
- Holm Eggemann
- University Women's Clinic, Otto von Guericke University, Magdeburg, Berlin
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Chen X, Liu X, Zhang L, Li S, Shi Y, Tong Z. Poorer survival of male breast cancer compared with female breast cancer patients may be due to biological differences. Jpn J Clin Oncol 2013; 43:954-63. [PMID: 23935206 DOI: 10.1093/jjco/hyt116] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The objective of the study was to compare disease-free survival and overall survival in a group of matched males and females with breast cancer, and to analyze possible treatment- and gender-related differences. METHODS We retrospectively analyzed the data of 150 operable male breast cancer patients treated in our hospital from December 1980 to June 2012. Each male breast cancer patient recorded in the database was matched with two female breast cancer patients of equal stage. Prognosis in terms of disease-free survival and overall survival was evaluated. RESULTS The mean age at diagnosis was 58.6 ± 9.7 years for males and 57.2 ± 10.3 years for females. The median follow-up was 69 months for males and 81 months for females. Significant differences were identified for tumor location, hormone receptor status, molecular subtypes and hormone therapy between the two groups. Monofactorial analysis demonstrated that tumor size, lymph node state, American Joint Committee on Cancer stage, molecular subtypes and adjuvant chemotherapy treatment were prognostic factors in male breast cancer patients. The 5- and 10-year disease-free survival rates were 65.6 and 40.1% for males, and 74.9 and 51.5% for females, respectively. The 5- and 10-year overall survival rates were 72.9 and 53.9% for males, and 83.2 and 68.5% for females, respectively. There was significantly difference in disease-free survival and overall survival between the two matched groups (P = 0.002). CONCLUSIONS Male breast cancer patients had inferior outcome despite of equal stage in comparison with matched female breast cancer patients, which demonstrates that biological differences may contribute to the worse prognosis.
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Affiliation(s)
- Xingyu Chen
- *Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin 300060, China.
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Firmin-Lefebvre D, Misery L. [Male breast diseases]. Ann Dermatol Venereol 2013; 140:436-43. [PMID: 23773741 DOI: 10.1016/j.annder.2013.04.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 02/27/2013] [Accepted: 04/08/2013] [Indexed: 12/07/2022]
Abstract
Because andrology is relatively undeveloped in France, the dermatologist is often the doctor first consulted for diseases of the nipple in men. All dermatological diseases can in fact occur at this site. There are some specific nipple diseases such as gynaecomastia, congenital abnormalities, hyperplasia, benign tumours and breast cancer. All clinical examinations and laboratory examinations should focus on diagnosis of this type of cancer and its elimination.
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Affiliation(s)
- D Firmin-Lefebvre
- Service de dermatologie, CHU de Brest, 2, avenue Foch, 29200 Brest, France
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Malignant fibrous histiocytoma of the breast in young male patient: a case report and a review of the literature. Case Rep Oncol Med 2013; 2013:524305. [PMID: 23573437 PMCID: PMC3612459 DOI: 10.1155/2013/524305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 02/20/2013] [Indexed: 11/22/2022] Open
Abstract
Malignant Fibrous Histiocytoma (MFH) is a fairly common tumor in the deep soft tissues: the most frequent primary sites are the lower (49%) and upper (19%) limbs, but it has been reported even in the retroperitoneum and abdomen (16%), while localization in the breast is extremely rare (1-2). Breast cancer is rarely seen in males, accounts for approximately 1% of all breast cancer, and the breast sarcomas constitute less than 1% of breast tumors in both sexes. In the review of the literature, this is the third male and first young male with MFH. Here, we present a 37-years-old male patient who is diagnosed to have malignant fibrous histiocytoma in a variant of pleomorphic fusiform cell localized in the left breast. Following the wide local excision, the patient was given an adjuvant 50 Gy of external radiotherapy. He remained alive and well after 42 months of followup. We believe that reporting such few cases would contribute to forming treatment algorithms of rare tumors.
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Selcukbiricik F, Tural D, Aydoğan F, Beşe N, Büyükünal E, Serdengeçti S. Male breast cancer: 37-year data study at a single experience center in Turkey. J Breast Cancer 2013; 16:60-5. [PMID: 23593083 PMCID: PMC3625771 DOI: 10.4048/jbc.2013.16.1.60] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 01/31/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate the effects of prognostic factors on the overall survival (OS) and locoregional control (LC) among male breast cancer (MBC) patients treated at Cerrahpasa Medical School Hospital, along with a review of the related literature. METHODS The data of 86 patients treated for MBC from 1973 to 2010 are retrospectively reviewed. Patient demographics and clinical information, including the date of diagnosis, treatment, clinical course, and the date and causes of death are routinely recorded. RESULTS Median follow-up was 66 months. Isolated local-regional recurrence and distant metastases were observed in 15 (17.4%) and 24 (34.1%) of the cases, respectively. The 5-year OS rate was 65.8%; the disease-free survival rate was 72.4%, and the LC rate was 89.7%. The prognostic factors influencing local relapse were the T stage (p=0.002) and the chest wall muscular invasion (p=0.027) in the univariate analysis. The prognostic factors influencing OS were the presence of a positive axillary lymph node (p=0.001) and the T stage (p=0.001) in the univariate analysis. The T stage (p=0.008) and node (N) stage (p=0.038) were significant prognostic factors for OS in the multivariate analyses. Also, the T stage (p=0.034) was found to be significant for LC. CONCLUSION We found that only the tumor size and lymph node status were independent prognostic factors for survival. In addition, only the tumor size was an independent prognostic factor for locoregional relapse. Modified radical mastectomy and conservative surgical procedures had similar outcomes for LC.
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Miscellaneous syndromes and their management: occult breast cancer, breast cancer in pregnancy, male breast cancer, surgery in stage IV disease. Surg Clin North Am 2013; 93:519-31. [PMID: 23464700 DOI: 10.1016/j.suc.2012.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Surgical therapy for occult breast cancer has traditionally centered on mastectomy; however, breast conservation with whole breast radiotherapy followed by axillary lymph node dissection has shown equivalent results. Patients with breast cancer in pregnancy can be safely and effectively treated; given a patient's pregnancy trimester and stage of breast cancer, a clinician must be able to guide therapy accordingly. Male breast cancer risk factors show strong association with BRCA2 mutations, as well as Klinefelter syndrome. Several retrospective trials of surgical therapy in stage IV breast cancer have associated a survival advantage with primary site tumor extirpation.
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Ruddy KJ, Winer EP. Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship. Ann Oncol 2013; 24:1434-43. [PMID: 23425944 DOI: 10.1093/annonc/mdt025] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The causes, optimal treatments, and medical/psychosocial sequelae of breast cancer in men are poorly understood. DESIGN A systematic review of the English language literature was conducted to identify studies relevant to male breast cancer between 1987 and 2012 and including at least 20 patients. Searches were carried out on PubMed using the title terms 'male breast cancer' or 'male breast carcinoma'. RESULTS Relevant published data regarding risk factors, biological characteristics, presentation and prognosis, appropriate evaluation and treatment, and survivorship issues in male breast cancer patients are presented. BRCA2 mutations, age, conditions that alter the estrogen/androgen ratio, and radiation are proven risk factors. Disease biology is distinct in men, but diagnostic approaches and treatments for men are generally extrapolated from those in women due to inadequate research in men. Survivorship issues in men may include sexual and hormonal side-effects of endocrine therapies as well as unique psychosocial impacts of the disease. CONCLUSION Further research is needed to address gaps in knowledge pertaining to care of male breast cancer patients and survivors.
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Affiliation(s)
- K J Ruddy
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
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Eggemann H, Ignatov A, Smith BJ, Altmann U, von Minckwitz G, Röhl FW, Jahn M, Costa SD. Adjuvant therapy with tamoxifen compared to aromatase inhibitors for 257 male breast cancer patients. Breast Cancer Res Treat 2012; 137:465-70. [PMID: 23224235 DOI: 10.1007/s10549-012-2355-3] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 11/22/2012] [Indexed: 12/18/2022]
Abstract
To determine the impact of adjuvant treatment with tamoxifen and aromatase inhibitors (AI) on the survival of men with breast cancer. We analyzed 257 male patients with hormone-receptor-positive breast cancer from numerous German population-based cancer registries treated with tamoxifen (N = 207) or aromatase inhibitors (N = 50). The median follow-up was 42.2 (range 2-115) months. Median age at diagnosis was 68 (range 36-91) years. Thirty-seven (17.9 %) patients treated with tamoxifen and 16 (32.0 %) patients treated with AI died (log rank p = 0.007). After the adjustment for the patient's age, tumor size, node status, and tumor grading, the AI treatment was linked to a 1.5-fold increase in risk of mortality compared to tamoxifen (HR 1.55; 95 % CI: 1.13-2.13; p = 0.007). The overall survival in male breast cancer was significantly better after adjuvant treatment with tamoxifen compared to an aromatase inhibitor. Tamoxifen should be considered as the treatment of choice for hormone-receptor-positive male breast cancer.
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Affiliation(s)
- Holm Eggemann
- University Women's Clinic, Otto-von-Guericke University, Gerhart-Hauptmann Str. 35, 39108, Magdeburg, Germany.
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Tural D, Selçukbiricik F, Aydoğan F, Beşe N, Yetmen O, Ilvan Ş, Büyükünal E, Serdengeçti S. Male breast cancers behave differently in elderly patients. Jpn J Clin Oncol 2012; 43:22-7. [PMID: 23159765 DOI: 10.1093/jjco/hys193] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate tumor characteristics, management and survival in elderly male breast cancer patients in comparison with younger men. METHODS We reviewed medical records of 99 male breast cancer patients between 1972 and 2011. The median age of the patients was 64.5 years. Patient characteristics including clinicopathologic factors, treatment modalities, survival and prognostic factors were evaluated. Patients were subdivided into two groups according to their age (young, <65 years; old, ≥ 65 years) and compared based on these factors. RESULTS Elderly male breast cancer patients had larger tumors in more advanced stages at the time of diagnosis compared with younger patients. In spite of the larger tumors at presentation, older patients had tumors with more favorable biological characteristics, such as higher ratio of estrogen and progesterone receptor expression. Ten-year cancer-specific survival for older patients was 49.2% compared with 55.8% in younger men (P = 0.8). Prognostic factors influencing overall survival in univariate analysis were: the presence of metastatic axillary lymph nodes (P = 0.0001), T stage (P = 0.001) and age ≥ 65 years. Multivariate analysis indicated T stage (P = 0.008) and N stage (P = 0.038) as the significant negative prognostic factors for overall survival. Although surgery, radiotherapy and hormone therapy were equally utilized in old and young patients, old patients were less likely to receive adjuvant chemotherapy. CONCLUSIONS Our study demonstrated the differences in the clinical and biological characteristics of male breast cancer according to the age of the patients.
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Affiliation(s)
- Deniz Tural
- Istanbul University Cerrahpasa Medical Faculty, Department of Internal Medicine, Division of Medical Oncology, 34098 Istanbul, Turkey.
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Constantinou C, Fentiman IS. Diagnosis and treatment of male breast cancer. BREAST CANCER MANAGEMENT 2012. [DOI: 10.2217/bmt.12.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Male breast cancer (MBC) accounts for <1% of mammary neoplasia and because of its rarity, diagnosis and treatment is based on breast cancer in women. The PubMed database was searched for all English language articles from 1993 to May 2012. Search terms included: male breast cancer, diagnosis, treatment and management. Although rare, MBC incidence is rising. Risk factors include hormonal imbalance, Klinefelter’s syndrome, exposure to radiation and BRCA2 mutations. Clinical evaluation combined with fine-needle aspiration/core biopsy usually suffices for diagnosis, but mammography can be helpful. Modified radical mastectomy was the standard treatment; total mastectomy and sentinel node biopsy is now the treatment of choice in node-negative cases. Tamoxifen is the mainstay of adjuvant hormonal therapy, but a role for aromatase inhibitors is emerging. Given the low incidence of MBC, worldwide studies are needed to improve management and prognosis.
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Affiliation(s)
- Chloe Constantinou
- Research Oncology, 3rd Floor Bermondsey Wing, Guy’s Hospital, London SE1 9RT, UK
| | - Ian S Fentiman
- Research Oncology, 3rd Floor Bermondsey Wing, Guy’s Hospital, London SE1 9RT, UK
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Ahmed A, Ukwenya Y, Abdullahi A, Muhammad I. Management and outcomes of male breast cancer in zaria, Nigeria. Int J Breast Cancer 2012; 2012:845143. [PMID: 22991670 PMCID: PMC3443591 DOI: 10.1155/2012/845143] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 07/02/2012] [Accepted: 07/17/2012] [Indexed: 11/17/2022] Open
Abstract
Male breast cancer is an uncommon disease accounting for only 1% of all breast cancers. We present the evaluation, treatment and outcome of male patients seen with breast cancer in our institution. Male patients that had histological diagnosis of breast cancer from 2001 to 2010 were retrospectively evaluated. After evaluation patients were treated with modified radical mastectomy. Combination chemotherapy was given to patients with positive axillary lymph nodes. Radiotherapy and hormonal therapy were also employed. There were 57 male patients with breast cancer which accounted for 9% of all breast cancers seen during the study period. Their mean age was 59 ± 2.3 years. The mean tumor diameter was 13 ± 2.5 cm. Fifty three (93%) patients presented with advanced disease including 15 with distant metastasis. Four patients with stage II disease were treated with modified radical mastectomy, chemotherapy and tamoxifen. Of the 30 patients with sage III disease that had modified radical mastectomy, complete axillary clearance and tumor free margins were achieved in 25. Overall 21 (36.8%) patients were tumor free at one year. Overall 5-year survival was 22.8%. In conclusion, male patients with breast cancer present with advanced disease which is associated with poor outcome of treatment.
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Affiliation(s)
- Adamu Ahmed
- Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Yahaya Ukwenya
- Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Adamu Abdullahi
- Department of Radiation Oncology, Ahmadu Bello University Teaching Hospital, 810001 Zaria, Nigeria
| | - Iliyasu Muhammad
- Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Sandhu NP, Bride MBM, Dilaveri CA, Neal L, Farley DR, Loprinzi CL, Wahner-Roedler DL, Ghosh K. Male breast cancer. JOURNAL OF MEN'S HEALTH 2012. [DOI: 10.1016/j.jomh.2012.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Shah S, Bhattacharyya S, Gupta A, Ghosh A, Basak S. Male breast cancer: a clinicopathologic study of 42 patients in eastern India. Indian J Surg Oncol 2012; 3:245-9. [PMID: 23997516 DOI: 10.1007/s13193-012-0163-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 06/05/2012] [Indexed: 01/21/2023] Open
Abstract
Retrospective review of presentation, treatment and outcome of male breast cancer in a tertiary cancer centre in eastern India. Data of 42 male breast cancer (MBC) patients, who presented between April, 2001 and March, 2008 were collected from institute records with respect to epidemiological characteristics, clinical and pathological parameters, treatment pattern and outcome. This series includes 42 patients with mean age of 56 years (range 31-78 years). MBC represented 1.1 % of all breast cancer. History of lump in the breast with duration ranging from 1 month to 4 years was the most common clinical presentation (80.95 %). Histopathology found infiltrating ductal carcinoma in 35 (83.33 %), followed by papillary carcinoma in 3 (7.14 %), undifferentiated carcinoma in 2 (4.76 %), mucinous carcinoma in 1 (2.38 %) and myxofibrosarcoma in 1 (2.38 %) patient. Hormone receptor (HR) study was performed on 29 patients. Twenty six (89.7 %) patients were hormone receptor positive in that 8 (27.6 %) were ER positive and 18 (62.1 %) were ER and PR positive. 3 (10.3 %) were hormone receptor negative.Axillary lymph node dissection was performed on 30 patients. Of those, 60 % were found to be positive (pN+) and 40 % were negative (pN-). Of the patients with invasive carcinoma 2.86 % were pathologic stage I, 37.14 % stage II, 42.86 % stage III and 17.14 % stage IV. Of the 35 treated patients, total 30 (85.71 %) patients underwent surgery. The surgery consisted of a modified radical mastectomy (MRM) 24 (80 %), radical mastectomy according to Halsted (RM) 6 (20 %). Adjuvant therapy i.e. Chemotherapy and Radiotherapy was administered to the patient based upon their stage. The standard treatment for all HR positive patients was administration of tamoxifen. Based upon the follow-up information (ranging from 17 month to 136 months), 4 (14.28 %) patients developed local recurrence over 4 to 26 months (mean17.5 months) and 5 patients developed distant metastasis over 24 to132 months (mean 78 months). Disease specific survival varied from 4 months to 132 months, with a mean of 56.75 months. Thirteen out of 28 evaluable patients (46.43 %) were disease free at 5 years. Male Breast cancer is a rare disease often ignored in the community, because of which it is seeks medical attention at advanced stage. Majority of MBC are found to be HR positive, hence hormonal therapy should to be strongly considered and multicentric prospective studies are needed to improve outcome.
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Affiliation(s)
- Sumit Shah
- Department of surgical oncology, Cancer Centre Welfare Home & Research Institute, M.G. Road, Thakurpukur, Kolkata 700063 India
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