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Frevert ML, Dannehl D, Jansen L, Hermann S, Schäffler H, Huwer S, Janni W, Juhasz-Böss I, Hartkopf AD, Taran FA. Feasibility of targeted therapies in the adjuvant setting of early breast cancer in men: real-world data from a population-based registry. Arch Gynecol Obstet 2024; 309:2811-2819. [PMID: 38472501 PMCID: PMC11147886 DOI: 10.1007/s00404-024-07405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/28/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Following the positive iDFS and OS results of the phase III clinical trials monarchE, NATALEE and OlympiA, new oral anticancer agents (the CDK4/6 inhibitors abemaciclib, ribociclib as well as the PARP inhibitor olaparib) have recently been introduced into the treatment of high-risk early breast cancer (eBC). However, only few male patients were included in these trials (0.4%, 0.6% and 0.3%, respectively). The objective of this real-world analysis was to determine the proportion of male patients with eBC fulfilling the clinical high-risk criteria of above-mentioned trials. PATIENTS AND METHODS We conducted a data inquiry and analysis with the Cancer Registry of Baden-Württemberg of men with breast cancer diagnosed between January 1, 2015 and December 31, 2021. Men with eBC were identified and the number of patients at clinical high-risk according to the inclusion criteria of monarchE, NATALEE and OlympiA was assessed. RESULTS Of 397 men with eBC, 354 (89.1%) had a HR + /Her2- and 4 (1.0%) a triple-negative subtype. 84 patients (21.2%) met the clinical high-risk criteria according to the monarchE, 189 (47.6%) those according to the NATALEE and 50 (12.6%) those according to the OlympiA trial. CONCLUSION In a large real-world sample, more men with eBC are at clinical high risk according to the inclusion criteria of monarchE, NATALEE and OlympiA than would be expected in women. This is most likely due to more advanced stages at initial diagnosis in men. To evaluate whether CDK4/6 and PARP inhibitors improve prognosis also in men should be the topic of future real- world analyses.
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Affiliation(s)
- M L Frevert
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - D Dannehl
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - L Jansen
- Epidemiological Cancer Registry of Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Hermann
- Epidemiological Cancer Registry of Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Schäffler
- Department of Obstetrics and Gynecology, University Clinic Ulm, Faculty of Medicine, University of Ulm, Ulm, Germany
| | - S Huwer
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - W Janni
- Department of Obstetrics and Gynecology, University Clinic Ulm, Faculty of Medicine, University of Ulm, Ulm, Germany
| | - I Juhasz-Böss
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - A D Hartkopf
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - F-A Taran
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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2
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Sanli AN, Tekcan Sanli DE, Altundag MK, Aydogan F. Is There a Survival Difference Between Male and Female Breast Cancer Subtypes According to the Prognostic Staging System? A Population-Based Cohort Study. Am Surg 2024; 90:788-799. [PMID: 37916470 DOI: 10.1177/00031348231212588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND In retrospective studies investigating the difference in survival by gender, there are conflicting results. It was aimed to compare overall survival (OS) and breast cancer-specific survival (BCSS) in male and female breast cancer subtypes according to the prognostic staging system. METHODS Overall survival rates and BCSS rates of patients diagnosed with breast cancer between 2010 and 2019 compared by gender for all cohorts, stages, and molecular subtypes using the SEER Database. The stage has been rearranged according to the eighth edition of the AJCC. RESULTS 364 039 patients were included in the study. .7% (n = 2503) of all breast cancers were male breast cancer. Overall survival (male: 5-year OS 73.9%, female = 5-year OS 86%) and BCSS rates (male: 5-year BCSS 78.9%, female = 5-year BCSS 94.7%) were significantly higher in females than in males for all cohorts. OS (male: 5-year OS 66.2% vs female: 5-year OS 88.3%), and BCSS (male: 5-year BCSS 88.4% vs female: 5-year 93.6%) rates were higher in hormone receptor (HR)-positive/Her2-negative female patients. Overall survival rate is higher in females in stage I (male: 5-year OS 81.5%, female: 5-year OS 92.8%), and BCSS rate is higher in stage I (male: 5-year BCSS 94.8%, female: 5-year BCSS 97.5%). Males have 2 times (HR = 2.023) higher overall mortality risk than females, but the risk of dying from breast cancer is only 1.6 times (HR = 1.596) higher. CONCLUSIONS Breast cancer-specific mortality is significantly higher in male breast cancers, especially in the early stage, and HR-positive subtype than females.
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Affiliation(s)
- Ahmet Necati Sanli
- Department of General Surgery, Abdulkadir Yuksel State Hospital, Gaziantep, Turkey
| | | | | | - Fatih Aydogan
- Breast Health Center, Memorial Bahcelievler Hospital, Istanbul, Turkey
- Department of General Surgery, Faculty of Medicine, Kırklareli University, Kırklareli, Turkey
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3
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Uddin MMN, Bekmukhametova A, Antony A, Barman SK, Houang J, Wu MJ, Hook JM, George L, Wuhrer R, Mawad D, Ta D, Ruprai H, Lauto A. Encapsulated Rose Bengal Enhances the Photodynamic Treatment of Triple-Negative Breast Cancer Cells. Molecules 2024; 29:546. [PMID: 38276623 PMCID: PMC10820979 DOI: 10.3390/molecules29020546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
Among breast cancer subtypes, triple-negative breast cancer stands out as the most aggressive, with patients facing a 40% mortality rate within the initial five years. The limited treatment options and unfavourable prognosis for triple-negative patients necessitate the development of novel therapeutic strategies. Photodynamic therapy (PDT) is an alternative treatment that can effectively target triple-negative neoplastic cells such as MDA-MB-231. In this in vitro study, we conducted a comparative analysis of the PDT killing rate of unbound Rose Bengal (RB) in solution versus RB-encapsulated chitosan nanoparticles to determine the most effective approach for inducing cytotoxicity at low laser powers (90 mW, 50 mW, 25 mW and 10 mW) and RB concentrations (50 µg/mL, 25 µg/mL, 10 µg/mL and 5 µg/mL). Intracellular singlet oxygen production and cell uptake were also determined for both treatment modalities. Dark toxicity was also assessed for normal breast cells. Despite the low laser power and concentration of nanoparticles (10 mW and 5 µg/mL), MDA-MB-231 cells experienced a substantial reduction in viability (8 ± 1%) compared to those treated with RB solution (38 ± 10%). RB nanoparticles demonstrated higher singlet oxygen production and greater uptake by cancer cells than RB solutions. Moreover, RB nanoparticles display strong cytocompatibility with normal breast cells (MCF-10A). The low activation threshold may be a crucial advantage for specifically targeting malignant cells in deep tissues.
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Affiliation(s)
- Mir Muhammad Nasir Uddin
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
- Department of Pharmacy, Faculty of Biological Sciences, University of Chittagong, Chittagong 4331, Bangladesh
| | | | - Anu Antony
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Shital K. Barman
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Jessica Houang
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Ming J. Wu
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - James M. Hook
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Laurel George
- Advanced Materials Characterisation Facility, Western Sydney University, Penrith, NSW 2750, Australia
| | - Richard Wuhrer
- Advanced Materials Characterisation Facility, Western Sydney University, Penrith, NSW 2750, Australia
| | - Damia Mawad
- School of Materials Science and Engineering and Australian Centre for NanoMedicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Daniel Ta
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Herleen Ruprai
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Antonio Lauto
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
- Biomedical Engineering & Neuroscience Research Group, The MARCS Institute, Western Sydney University, Penrith, NSW 2750, Australia
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Valentini V, Silvestri V, Bucalo A, Conti G, Karimi M, Di Francesco L, Pomati G, Mezi S, Cerbelli B, Pignataro MG, Nicolussi A, Coppa A, D’Amati G, Giannini G, Ottini L. Molecular profiling of male breast cancer by multigene panel testing: Implications for precision oncology. Front Oncol 2023; 12:1092201. [PMID: 36686738 PMCID: PMC9854133 DOI: 10.3389/fonc.2022.1092201] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Compared with breast cancer (BC) in women, BC in men is a rare disease with genetic and molecular peculiarities. Therapeutic approaches for male BC (MBC) are currently extrapolated from the clinical management of female BC, although the disease does not exactly overlap in males and females. Data on specific molecular biomarkers in MBC are lacking, cutting out male patients from more appropriate therapeutic strategies. Growing evidence indicates that Next Generation Sequencing (NGS) multigene panel testing can be used for the detection of predictive molecular biomarkers, including Tumor Mutational Burden (TMB) and Microsatellite Instability (MSI). Methods In this study, NGS multigene gene panel sequencing, targeting 1.94 Mb of the genome at 523 cancer-relevant genes (TruSight Oncology 500, Illumina), was used to identify and characterize somatic variants, Copy Number Variations (CNVs), TMB and MSI, in 15 Formalin-Fixed Paraffin-Embedded (FFPE) male breast cancer samples. Results and discussion A total of 40 pathogenic variants were detected in 24 genes. All MBC cases harbored at least one pathogenic variant. PIK3CA was the most frequently mutated gene, with six (40.0%) MBCs harboring targetable PIK3CA alterations. CNVs analysis showed copy number gains in 22 genes. No copy number losses were found. Specifically, 13 (86.7%) MBCs showed gene copy number gains. MYC was the most frequently amplified gene with eight (53.3%) MBCs showing a median fold-changes value of 1.9 (range 1.8-3.8). A median TMB value of 4.3 (range 0.8-12.3) mut/Mb was observed, with two (13%) MBCs showing high-TMB. The median percentage of MSI was 2.4% (range 0-17.6%), with two (13%) MBCs showing high-MSI. Overall, these results indicate that NGS multigene panel sequencing can provide a comprehensive molecular tumor profiling in MBC. The identification of targetable molecular alterations in more than 70% of MBCs suggests that the NGS approach may allow for the selection of MBC patients eligible for precision/targeted therapy.
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Affiliation(s)
- Virginia Valentini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Agostino Bucalo
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia Conti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Mina Karimi
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Linda Di Francesco
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia Pomati
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Silvia Mezi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Bruna Cerbelli
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Maria Gemma Pignataro
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Arianna Nicolussi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Anna Coppa
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia D’Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giannini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy,Istituto Pasteur-Fondazione Cenci Bolognetti, Rome, Italy
| | - Laura Ottini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy,*Correspondence: Laura Ottini,
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5
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Lee J, Lee KS, Sim SH, Chae H, Sohn J, Kim GM, Lee KH, Kang SH, Jung KH, Jeong JH, Byun JH, Koh SJ, Lee KE, Lim S, Kim HJ, Won HS, Park HS, Lee GJ, Hong S, Baek SK, Lee SI, Choi MY, Woo IS. Impacts of Subtype on Clinical Feature and Outcome of Male Breast Cancer: Multicenter Study in Korea (KCSG BR16-09). Cancer Res Treat 2023; 55:123-135. [PMID: 35344650 PMCID: PMC9873331 DOI: 10.4143/crt.2021.1561] [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: 12/05/2021] [Accepted: 03/23/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The treatment of male breast cancer (MBC) has been extrapolated from female breast cancer (FBC) because of its rarity despite their different clinicopathologic characteristics. We aimed to investigate the distribution of intrinsic subtypes based on immunohistochemistry, their clinical impact, and treatment pattern in clinical practice through a multicenter study in Korea. MATERIALS AND METHODS We retrospectively analyzed clinical data of 248 MBC patients from 18 institutions across the country from January 1995 to July 2016. RESULTS The median age of MBC patients was 63 years (range, 25 to 102 years). Among 148 intrinsic subtype classified patients, 61 (41.2%), 44 (29.7%), 29 (19.5%), and 14 (9.5%) were luminal A, luminal B, human epidermal growth factor receptor 2, and triple-negative breast cancer, respectively. Luminal A subtype showed trends for superior survival compared to other subtypes. Most hormone receptor-positive patients (166 patients, 82.6%) received adjuvant endocrine treatment. Five-year completion of adjuvant endocrine treatment was associated with superior disease-free survival (DFS) in patients classified with an intrinsic subtype (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.04 to 0.49; p=0.002) and in all patients (HR, 0.16; 95% CI, 0.05 to 0.54; p=0.003). CONCLUSION Distribution of subtypes of MBC was similar to FBC and luminal type A was most common. Overall survival tended to be improved for luminal A subtype, although there was no statistical significance. Completion of adjuvant endocrine treatment was associated with prolonged DFS in intrinsic subtype classified patients. MBC patients tended to receive less treatment. MBC patients should receive standard treatment according to guidelines as FBC patients.
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Affiliation(s)
- Jieun Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Keun Seok Lee
- Center for Breast Cancer, National Cancer Center, Goyang,
Korea
| | - Sung Hoon Sim
- Center for Breast Cancer, National Cancer Center, Goyang,
Korea
| | - Heejung Chae
- Center for Breast Cancer, National Cancer Center, Goyang,
Korea
| | - Joohyuk Sohn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, College of Medicine, Yonsei University, Seoul,
Korea
| | - Gun Min Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, College of Medicine, Yonsei University, Seoul,
Korea
| | - Kyung-Hee Lee
- Division of Oncology-Hematology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Su Hwan Kang
- Department of Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu,
Korea
| | - Kyung Hae Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jae-ho Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jae Ho Byun
- Division of Medical Oncology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Su-Jin Koh
- Department of Internal Medicine, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan,
Korea
| | - Kyoung Eun Lee
- Department of Hematology and Oncology, Ewha Womans University Hospital, Seoul,
Korea
| | - Seungtaek Lim
- Department of Hemato-Oncology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju,
Korea
| | - Hee Jun Kim
- Division of Hematology–Oncology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Hye Sung Won
- Division of Medical Oncology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Hyung Soon Park
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Guk Jin Lee
- Division of Medical Oncology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Soojung Hong
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang,
Korea
| | - Sun Kyung Baek
- Division of Hematology and Oncology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul,
Korea
| | - Soon Il Lee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan,
Korea
| | - Moon Young Choi
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan,
Korea
| | - In Sook Woo
- Division of Medical Oncology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
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6
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Lim JSH, Sim Y, Ngeow J, Yuen J, Tan VKM, Tan BKT, Yong WS, Wong CY, Lim SZ, Hamzah JLB, Tan SY, Wong FY, Madhukumar P. Male breast cancer: a Singapore perspective. ANZ J Surg 2022; 92:1440-1446. [PMID: 35470542 DOI: 10.1111/ans.17737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Male breast cancer (MBC) is rare, representing <1% of all breast cancers. Treatment recommendations have been extrapolated from trial data of female breast cancer patients. This study aims to report our institutional experience of MBC across a 20 year period, analyse the survival outcome and prognosis of this group against female breast cancer patients treated at the same centre. METHODS Clinical, histopathological, treatment and survival data of male and female breast cancer patients treated between Jan 1999 and July 2019 at Singapore General Hospital and National Cancer Centre Singapore were identified and analysed. RESULTS Fifty-seven male patients were identified. The median age at diagnosis was 63 years. Majority had invasive ductal carcinoma (86%) and presented at an early disease stage: 70.2% presented as Tis/T1/T2 and 49.1% had no axillary nodal involvement. 84.2% had a simple mastectomy with either a sentinel lymph node biopsy or axillary clearance. The median follow up was 5.69 years for males and 5.83 years for females. The median survival was 11.86 years for males and 16.3 years for females. At 5 years, overall survival (OS) was 69.9% (52.3-82.1%) and disease free survival (DFS) was 62.9% (44.9-76.5%) for males compared with OS 83.8% (83.21-84.39%) and DFS 74.5% (73.91-75.09%) for females. CONCLUSION MBC remains understudied. Our institutional data indicates that good long term survival in South-East Asian patients can be achieved with treatment protocols that are similar to female breast cancer. More prospective studies are required.
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Affiliation(s)
- Joshua S H Lim
- Department of General Surgery, Singapore General Hospital, Singapore
| | - Yirong Sim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Joanne Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Jeanette Yuen
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Veronique K M Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Benita Kiat Tee Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore.,Department of General Surgery, Sengkang General Hospital, Singapore
| | - Wei-Sean Yong
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Chow Yin Wong
- Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Sue Zann Lim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Julie Liana B Hamzah
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Si Ying Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre, Singapore
| | - Preetha Madhukumar
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
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7
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Hipp LE, Hulswit BB, Milliron KJ. Clinical Tools and Counseling Considerations for Breast Cancer Risk Assessment and Evaluation for Hereditary Cancer Risk. Best Pract Res Clin Obstet Gynaecol 2022; 82:12-29. [DOI: 10.1016/j.bpobgyn.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/28/2022]
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8
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Clinicopathologic characteristics and prognosis for male breast cancer compared to female breast cancer. Sci Rep 2022; 12:220. [PMID: 34997151 PMCID: PMC8741943 DOI: 10.1038/s41598-021-04342-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/17/2021] [Indexed: 12/22/2022] Open
Abstract
Male breast cancer (MBC) is rare. Due to limited information, MBC has always been understudied. We conducted a retrospective population-based cohort study using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. The clinical and biological features of female breast cancer (FBC) patients were compared with MBC patients. Cox regression models and competing risks analyses were used to identify risk factors associated with cancer-related survival in MBC and FBC groups. Results showed that MBC patients suffered from higher TNM stages, tumor grades, and a higher percentage of hormone receptor-positive tumors, compared with FBC patients (all p < 0.05). In addition, the breast tumor locations varied a lot between males and females (p < 0.05). FBC patients were associated with superior overall survival than MBC patients. Results from multivariate cox regression and competing risks analyses showed age, race, T, N, M-stages, tumor grades, estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) overexpression were independent prognosis factors in FBC patients (all p < 0.05). MBC patients had similar risk factors to FBC patients, but PR and HER-2 status did not independently influence survival (all p > 0.05). Tumor location was an independent prognostic factor for both gender groups.
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9
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Fentiman IS. Prognostic difficulties of men with breast cancer. Breast J 2021; 27:877-882. [PMID: 34652050 DOI: 10.1111/tbj.14297] [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: 07/26/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
Most adequately powered studies confirm a worse prognosis for males versus matched females with breast cancer. There is in-stage migration for stage I cancers with a different ratio of tumor/normal breast tissue in males. Younger men have a better prognosis, largely the result of increased morbidity in the elderly, exacerbated by smoking, low socioeconomic differences, and ethnic disparity. BRCA2 carriers with MBC have a worse outcome than noncarriers as do men with amplification of EMSY. Men with tumors having a high cytosol level of plasminogen activator inhibitor 1 (PAI-1) may have more invasive cancers leading to earlier spread and hence a worse outcome. PREDICT+ is a useful prognostic model for MBC and multigene testing enables more specific systemic therapies to be used.
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Affiliation(s)
- Ian S Fentiman
- Professor of Surgical Oncology, Research Oncology, Guy's Hospital, London, UK
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10
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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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11
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Breast Cancer and the Male-Female Divide: It's Even More Complicated. Clin Breast Cancer 2021; 22:e157. [PMID: 34389269 DOI: 10.1016/j.clbc.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/23/2021] [Indexed: 11/23/2022]
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12
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Zhang H, Lin W, Chen D, Wang K, Tu W, Lin H, Li K, Ye S, Guan T, Chen Y. Cardiovascular and Other Competing Causes of Death in Male Breast Cancer Patients: A Population-Based Epidemiologic Study. Clin Interv Aging 2021; 16:1393-1401. [PMID: 34321871 PMCID: PMC8312508 DOI: 10.2147/cia.s314689] [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: 04/08/2021] [Accepted: 06/30/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Male breast cancer (MBC) is a rare disease that tends to occur in elderly men. Little is known about the causes of death in MBC because of the small sample size of most studies. This study aimed to investigate the causes of death in MBC patients. Patients and Methods MBC patient data were obtained from the Surveillance, Epidemiology, and End Results database (1975-2016). Time trends of MBC mortality in the US population were analyzed using Joinpoint software. We calculated the proportion of each cause of death in the overall cohort and in different patient subgroups. Competing risk models were used to calculate cumulative mortality at different follow-up times. The risk of cardiovascular death (CVD) in MBC patients was compared to that of the age-matched general population by calculating standardized mortality ratio (SMR). Results In total, 6426 patients were included in the analysis. MBC mortality rate increased between 2004 and 2019 (annual percentage change=1.16, 95% confidence interval [CI]: 0.50, 1.80). There were 1757 patients (27.3%) who died of non-breast cancer causes. CVD was the leading cause of death in patients who were elderly or had localized disease. MBC patients had a 6.58-fold higher risk of CVD than the general population (SMR=6.58, 95% CI: 6.14, 7.05). Conclusion Non-breast cancer death accounts for the majority of deaths in MBC patients who are elderly or have localized cancer. Compared to the general population, MBC patients have an increased risk of CVD. These results highlight the importance of monitoring cardiovascular comorbidities in MBC patients.
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Affiliation(s)
- Hanbin Zhang
- Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Wenrui Lin
- Department of Clinical Medicine, The Sixth Clinical College of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Dongting Chen
- Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Kenie Wang
- The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, People's Republic of China
| | - Wei Tu
- Department of Oncology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Huiwen Lin
- Department of Oncology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Kun Li
- Department of Oncology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Shangzhu Ye
- Department of Ophthalmology and Otorhinolaryngology, Yangjiang Hospital of Traditional Chinese Medicine, Yangjiang, People's Republic of China
| | - Tianwang Guan
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Yuerong Chen
- Department of Oncology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
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13
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Yadav SK, Silwal S, Yadav S, Krishnamoorthy G, Chisti MM. A Systematic Comparison of Overall Survival Between Men and Women With Triple Negative Breast Cancer. Clin Breast Cancer 2021; 22:161-169. [PMID: 34419351 DOI: 10.1016/j.clbc.2021.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/03/2021] [Accepted: 07/02/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Triple-negative breast cancer (TNBC) in men is very rare. The clinical characteristics, prognostic factors, and overall survival of men with TNBC have not been characterized. METHODS The study population consisted of men and women with a diagnosis of stage I-III TNBC between 2010 and 2016 in the National Cancer Database. Baseline demographic and tumor characteristics between men and women were compared using Pearson's Chi-Square test for categorical variables and Mann-Whitney U test for continuous variables. Kaplan-Meier and multivariate Cox proportional hazards regression model was used to compare survival and identify prognostic factors. RESULTS A total of 311 men and 95,406 women with TNBC were included in the final analysis. The 3-year and 5-year overall survival was 74.8% and 68.8% in men, while it was 83.2% and 74.8% in women, respectively. In multivariate analysis, men were found to have a significantly worse overall survival compared to women (HR, 1.49, 95% CI, 1.19-1.86, P= .01). Older age at diagnosis, higher TNM stage, undergoing mastectomy and not undergoing chemotherapy or radiation were identified as independent negative prognostic factors in men with TNBC. CONCLUSION In one of the largest studies of men with TNBC, men were noted to have a poorer overall survival compared to women, despite adjusting for usual prognostic factors. Further research into differences in tumor biology, treatment patterns and compliance with therapy between men and women are needed to understand the underlying etiologies for the survival difference in TNBC.
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Affiliation(s)
| | - Swechchha Silwal
- Department of Internal Medicine/Transitional Year, Detroit Medical Center Sinai Grace Hospital, Detroit, MI
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14
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Management and outcomes of men diagnosed with primary breast cancer. Breast Cancer Res Treat 2021; 188:561-569. [PMID: 33830393 DOI: 10.1007/s10549-021-06174-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/03/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Fewer than 1% of all breast cancers occur in men. As a result, a distinct lack of data exists regarding the management and outcomes in this cohort. METHODS Any male patient with pathologically confirmed breast cancer diagnosed between August 2000 and October 2017 at either Massachusetts General Hospital or Brigham and Women's Hospital/Dana-Farber Cancer Institute and their affiliate satellite locations were included. Primary chart review was used to assess clinical and pathologic characteristics. Patient and treatment variables were reported via descriptive statistics. Local-regional failure (LRF), overall survival (OS), breast cancer-specific survival (BCSS), and disease-free survival (DFS) were estimated using the Kaplan-Meier method. RESULTS 100 patients were included in this study. Median follow-up was 112 months (range 1-220 months). Approximately 1/3 of patients experienced at least a 3-month delay to presentation. 83 patients ultimately underwent mastectomy as definitive surgical treatment. 46 patients received adjuvant radiation therapy, and 37 patients received chemotherapy. Of 82 hormone receptor-positive patients with invasive cancer, 94% (n = 77) received endocrine therapy. Of the fifty-eight patients who underwent genetic testing, 15 (26%) tested positive. The 5-year OS, BCSS, DFS, and LRF rates were 91.5%, 96.2%, 86%, and 4.8%, respectively. Delay to presentation was not associated with worse survival. CONCLUSIONS Male breast cancer remains a rare diagnosis. Despite this, the majority of patients in this study received standard of care therapy and experienced excellent oncologic outcomes. Penetration for genetic testing improved over time.
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15
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Carrasco C, Tittarelli A, Paillaleve N, Pozo MD, Rojas-Sepúlveda D, Barría O, Fluxá P, Hott M, Martin C, Quezada C, Salazar-Onfray F. The Evaluation of 17 Gastrointestinal Tumor Markers Reveals Prognosis Value for MUC6, CK17, and CD10 in Gallbladder-Cancer Patients. Diagnostics (Basel) 2021; 11:diagnostics11020153. [PMID: 33494186 PMCID: PMC7909765 DOI: 10.3390/diagnostics11020153] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 12/28/2022] Open
Abstract
Gallbladder cancer (GBC) is an aggressive and highly lethal disease with relatively low global incidence, but one that constitutes a major health problem in Asian and Latin American countries, particularly in Chile. The identification of new tumor-associated markers with potential prognosis value is required for GBC clinical practice. Using immunohistochemistry/tumor tissue microarray, we evaluated the expression of 17 gastrointestinal tumor-associated protein markers (CK7, CK17, CK19, CK20, CKLMW, CKHMW, MUC1, MUC2, MUC5AC, MUC6, CA125, CD10, CEA, vimentin, villin, claudin-4, and CDX2) in primary gallbladder adenocarcinomas from 180 Chilean patients and analyzed potential associations with their pathological and clinical characteristics. Younger female patients with well- to moderately differentiated tumors had a better prognosis than that of older female or male patients with tumors with a similar tumor differentiation grade. Among all analyzed markers, MUC6 expression was associated with better prognosis in patients with well- to moderately differentiated tumors, whereas CK17 or CD10 was associated with worse prognosis in patients with poorly differentiated tumors. In addition, the MUC6+CK17– expression pattern was strongly associated with better prognosis in patients with well- to moderately differentiated tumors, whereas patients with poorly differentiated tumors and with the CK17+CD10+ expression pattern showed worse prognosis. Our results suggest that tumor MUC6, CK17, and CD10 can be considered as potential prognosis markers for GBC.
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Affiliation(s)
- Cristian Carrasco
- Subdepartamento de Anatomía Patológica, Hospital Base de Valdivia, Valdivia 5090000, Chile; (N.P.); (M.D.P.)
- Correspondence: (C.C.); (F.S.-O.); Tel.: +56-63-2263301 (C.C.); +56-2-29786345 (F.S.-O.)
| | - Andrés Tittarelli
- Programa Institucional de Fomento a la Investigación, Desarrollo e Innovación, Universidad Tecnológica Metropolitana, Santiago 8940577, Chile;
| | - Natalia Paillaleve
- Subdepartamento de Anatomía Patológica, Hospital Base de Valdivia, Valdivia 5090000, Chile; (N.P.); (M.D.P.)
| | - Maeva Del Pozo
- Subdepartamento de Anatomía Patológica, Hospital Base de Valdivia, Valdivia 5090000, Chile; (N.P.); (M.D.P.)
| | - Daniel Rojas-Sepúlveda
- Millennium Institute on Immunology and Immunotherapy, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (D.R.-S.); (O.B.); (C.Q.)
- Disciplinary Program of Immunology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Omar Barría
- Millennium Institute on Immunology and Immunotherapy, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (D.R.-S.); (O.B.); (C.Q.)
- Disciplinary Program of Immunology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Paula Fluxá
- Departamento de Cirugía Oriente, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile;
| | - Melissa Hott
- Subdepartamento de Enfermedades Virales, Instituto de Salud Pública, Santiago 7780050, Chile;
| | - Carolina Martin
- Escuela de Tecnología Médica, Universidad Austral de Chile, Puerto Montt 5500000, Chile;
| | - Claudia Quezada
- Millennium Institute on Immunology and Immunotherapy, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (D.R.-S.); (O.B.); (C.Q.)
- Instituto de Bioquímica y Microbiología, Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Flavio Salazar-Onfray
- Millennium Institute on Immunology and Immunotherapy, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (D.R.-S.); (O.B.); (C.Q.)
- Disciplinary Program of Immunology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile
- Correspondence: (C.C.); (F.S.-O.); Tel.: +56-63-2263301 (C.C.); +56-2-29786345 (F.S.-O.)
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16
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Corrigan KL, Mainwaring W, Miller AB, Lin TA, Jethanandani A, Espinoza AF, Piotrowski M, Fuller CD, Stauder MC, Shaitelman SF, Perkins GH, Woodward WA, Giordano SH, Smith BD, Ludmir EB. Exclusion of Men from Randomized Phase III Breast Cancer Clinical Trials. Oncologist 2020; 25:e990-e992. [PMID: 32272505 PMCID: PMC7288651 DOI: 10.1634/theoncologist.2019-0871] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/20/2020] [Indexed: 11/17/2022] Open
Abstract
Male breast cancer treatment regimens are often extrapolated from female-based studies because of a paucity of literature analyzing male breast cancer. Using ClinicalTrials.gov, we analyzed breast cancer randomized clinical trials (RCTs) to determine which factors were associated with male-gender inclusion. Of 131 breast cancer RCTs identified, male patients represented 0.087% of the total study population, which is significantly less than the proportion of male patients with breast cancer in the U.S. (0.95%; p < .001). Twenty-seven trials included male patients (20.6%). Lower rates of male inclusion were seen in trials that randomized or mandated hormone therapy as part of the trial protocol compared with trials that did not randomize or mandate endocrine therapy (2.5% vs. 28.6% male inclusion; p < .001). It is imperative for breast cancer clinical trials to include men when allowable in order to improve generalizability and treatment decisions in male patients with breast cancer.
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Affiliation(s)
- Kelsey L. Corrigan
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | | | - Austin B. Miller
- Health Science Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - Timothy A. Lin
- The Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Amit Jethanandani
- The University of Tennessee Health Science CenterMemphisTennesseeUSA
| | | | - Matt Piotrowski
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - C. David Fuller
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - Michael C. Stauder
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - Simona F. Shaitelman
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - George H. Perkins
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - Wendy A. Woodward
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - Sharon H. Giordano
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - Benjamin D. Smith
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
| | - Ethan B. Ludmir
- MD Anderson Cancer Center, McGovern Medical School, University of TexasHoustonTexasUSA
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17
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Chaib M, Chauhan SC, Makowski L. Friend or Foe? Recent Strategies to Target Myeloid Cells in Cancer. Front Cell Dev Biol 2020; 8:351. [PMID: 32509781 PMCID: PMC7249856 DOI: 10.3389/fcell.2020.00351] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/21/2020] [Indexed: 12/12/2022] Open
Abstract
The tumor microenvironment (TME) is a complex network of epithelial and stromal cells, wherein stromal components provide support to tumor cells during all stages of tumorigenesis. Among these stromal cell populations are myeloid cells, which are comprised mainly of tumor-associated macrophages (TAM), dendritic cells (DC), myeloid-derived suppressor cells (MDSC), and tumor-associated neutrophils (TAN). Myeloid cells play a major role in tumor growth through nurturing cancer stem cells by providing growth factors and metabolites, increasing angiogenesis, as well as promoting immune evasion through the creation of an immune-suppressive microenvironment. Immunosuppression in the TME is achieved by preventing critical anti-tumor immune responses by natural killer and T cells within the primary tumor and in metastatic niches. Therapeutic success in targeting myeloid cells in malignancies may prove to be an effective strategy to overcome chemotherapy and immunotherapy limitations. Current therapeutic approaches to target myeloid cells in various cancers include inhibition of their recruitment, alteration of function, or functional re-education to an antitumor phenotype to overcome immunosuppression. In this review, we describe strategies to target TAMs and MDSCs, consisting of single agent therapies, nanoparticle-targeted approaches and combination therapies including chemotherapy and immunotherapy. We also summarize recent molecular targets that are specific to myeloid cell populations in the TME, while providing a critical review of the limitations of current strategies aimed at targeting a single subtype of the myeloid cell compartment. The goal of this review is to provide the reader with an understanding of the critical role of myeloid cells in the TME and current therapeutic approaches including ongoing or recently completed clinical trials.
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Affiliation(s)
- Mehdi Chaib
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Subhash C Chauhan
- South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, United States.,Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Liza Makowski
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, United States.,Division of Hematology Oncology, Department of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States.,Center for Cancer Research, The University of Tennessee Health Science Center, Memphis, TN, United States
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18
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Tedaldi G, Tebaldi M, Zampiga V, Cangini I, Pirini F, Ferracci E, Danesi R, Arcangeli V, Ravegnani M, Martinelli G, Falcini F, Ulivi P, Calistri D. Male Breast Cancer: Results of the Application of Multigene Panel Testing to an Italian Cohort of Patients. Diagnostics (Basel) 2020; 10:E269. [PMID: 32365798 PMCID: PMC7277207 DOI: 10.3390/diagnostics10050269] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 12/24/2022] Open
Abstract
Male breast cancer (MBC) is a rare tumor, accounting for less than 1% of all breast cancers. In MBC, genetic predisposition plays an important role; however, only a few studies have investigated in depth the role of genes other than BRCA1 and BRCA2. We performed a Next-Generation Sequencing (NGS) analysis with a panel of 94 cancer predisposition genes on germline DNA from an Italian case series of 70 patients with MBC. Moreover, we searched for large deletions/duplications of BRCA1/2 genes through the Multiplex Ligation-dependent Probe Amplification (MLPA) technique. Through the combination of NGS and MLPA, we identified three pathogenic variants in the BRCA1 gene and six in the BRCA2 gene. Besides these alterations, we found six additional pathogenic/likely-pathogenic variants in PALB2, CHEK2, ATM, RAD51C, BAP1 and EGFR genes. From our study, BRCA1 and BRCA2 emerge as the main genes associated with MBC risk, but also other genes seem to be associated with the disease. Indeed, some of these genes have already been implicated in female breast cancer predisposition, but others are known to be involved in other types of cancer. Consequently, our results suggest that novel genes could be involved in MBC susceptibility, shedding new light on their role in cancer development.
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Affiliation(s)
- Gianluca Tedaldi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (V.Z.); (I.C.); (F.P.); (E.F.); (D.C.)
| | - Michela Tebaldi
- Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Valentina Zampiga
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (V.Z.); (I.C.); (F.P.); (E.F.); (D.C.)
| | - Ilaria Cangini
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (V.Z.); (I.C.); (F.P.); (E.F.); (D.C.)
| | - Francesca Pirini
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (V.Z.); (I.C.); (F.P.); (E.F.); (D.C.)
| | - Elisa Ferracci
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (V.Z.); (I.C.); (F.P.); (E.F.); (D.C.)
| | - Rita Danesi
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (R.D.); (M.R.); (F.F.)
| | | | - Mila Ravegnani
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (R.D.); (M.R.); (F.F.)
| | - Giovanni Martinelli
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (R.D.); (M.R.); (F.F.)
| | - Paola Ulivi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (V.Z.); (I.C.); (F.P.); (E.F.); (D.C.)
| | - Daniele Calistri
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (V.Z.); (I.C.); (F.P.); (E.F.); (D.C.)
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19
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Dong M, Cioffi G, Wang J, Waite KA, Ostrom QT, Kruchko C, Lathia JD, Rubin JB, Berens ME, Connor J, Barnholtz-Sloan JS. Sex Differences in Cancer Incidence and Survival: A Pan-Cancer Analysis. Cancer Epidemiol Biomarkers Prev 2020; 29:1389-1397. [PMID: 32349967 DOI: 10.1158/1055-9965.epi-20-0036] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/01/2020] [Accepted: 04/24/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sex plays an important role in the incidence, prognosis, and mortality of cancers, but often is not considered in disease treatment. METHODS We quantified sex differences in cancer incidence using the United States Cancer Statistics (USCS) public use database and sex differences in cancer survival using Surveillance, Epidemiology, and End Results (SEER) public use data from 2001 to 2016. Age-adjusted male-to-female incidence rate ratios (IRR) with 95% confidence intervals (CI) were generated by primary cancer site, race, and age groups. In addition, age-adjusted hazard ratios with 95% CI by sex within site were generated. RESULTS In general, cancer incidence and overall survival were lower in males than females, with Kaposi sarcoma (IRR: 9.751; 95% CI, 9.287-10.242; P < 0.001) having highest male-to-female incidence, and thyroid cancers (HR, 1.774; 95% CI, 1.707-1.845) having largest male-to-female survival difference. Asian or Pacific Islanders had particularly high male-to-female incidence in larynx cancers (IRR: 8.199; 95% CI, 7.203-9.363; P < 0.001), relative to other races. Among primary brain tumors, germ cell tumors had the largest male-to-female incidence (IRR: 3.03; 95% CI, 2.798-3.284, P < 0.001). CONCLUSIONS Overall, incidence and survival of cancer vary significantly by sex, with males generally having lower incidence and survival compared with females. Male-to-female incidence differences were also noted across race and age groups. These results provide strong evidence that the fundamental biology of sex differences affects cancers of all types. IMPACT This study represents the most recent and comprehensive reporting of sex differences in cancer incidence and survival in the United States. Identifying disadvantaged groups is critical as it can provide useful information to improve cancer survival, as well as to better understand the etiology and pathogenesis of specific cancers.
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Affiliation(s)
| | - Gino Cioffi
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Cleveland Center for Health Outcomes Research (CCHOR), Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio.,Central Brain Tumor Registry of the United States (CBTRUS), Hinsdale, Illinois
| | - Jacqueline Wang
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Kristin A Waite
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Cleveland Center for Health Outcomes Research (CCHOR), Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio.,Central Brain Tumor Registry of the United States (CBTRUS), Hinsdale, Illinois
| | - Quinn T Ostrom
- Central Brain Tumor Registry of the United States (CBTRUS), Hinsdale, Illinois.,Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, Texas
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States (CBTRUS), Hinsdale, Illinois
| | - Justin D Lathia
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Joshua B Rubin
- Departments of Pediatrics and Neuroscience, Washington University School of Medicine, St. Louis, Missouri
| | - Michael E Berens
- Cancer and Cell Biology Division, Translational Genomics Research Institute (Tgen), Phoenix, Arizona
| | - James Connor
- Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio. .,Cleveland Center for Health Outcomes Research (CCHOR), Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio.,Central Brain Tumor Registry of the United States (CBTRUS), Hinsdale, Illinois.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Cleveland Institute for Computational Biology, Cleveland, Ohio.,Research Health Analytics and Informatics, University Hospitals Health System (UHHS), Cleveland, Ohio
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20
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Lee EG, Jung SY, Lim MC, Lim J, Kang HS, Lee S, Han JH, Jo H, Won YJ, Lee ES. Comparing the Characteristics and Outcomes of Male and Female Breast Cancer Patients in Korea: Korea Central Cancer Registry. Cancer Res Treat 2020; 52:739-746. [PMID: 32054149 PMCID: PMC7373857 DOI: 10.4143/crt.2019.639] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/12/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE This study aimed to determine the incidence of male breast cancer (MBC) and its survival outcomes in Korea, and to compare these results to those for female breast cancer (FBC). Materials and Methods We searched the Korea Central Cancer Registry and identified 227,122 breast cancer cases that were diagnosed between 1999 and 2016. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to sex, age, histological type, and cancer stage. RESULTS The 227,122 patients included 1,094 MBC cases and 226,028 FBC cases. Based on the age-standardized rate, the male: female ratio was 0.0055:1. The most common ages at diagnosis were 60-69 years for MBC and 40-49 years for FBC (p < 0.001). Male patients were less likely than female patients to receive adjuvant radiotherapy (7.5% vs. 21.8%, p < 0.001) or adjuvant chemotherapy (40.1% vs. 55.4%, p < 0.001). The 5-year OS rates after diagnosis were 88.8% for all patients, although it was significantly lower for MBC than for FBC (76.2% vs. 88.9%, p < 0.001). In both groups, older age (≥ 60 years) was associated with shorter survival. The 5-year OS rates for the invasive histological types were 75.8% for men and 89.0% for women. The 5-year OS rates in both groups decreased with increasing cancer stage. CONCLUSION MBC was diagnosed at older ages than FBC, and male patients were less likely to receive radiotherapy and chemotherapy. The survival outcomes were worse for MBC than for FBC, with even poorer outcomes related to older age, the inflammatory histological types, and advanced stage. It is important that clinicians recognize the differences between FBC and MBC when treating these patients.
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Affiliation(s)
- Eun-Gyeong Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Goyang, Korea.,Cancer Healthcare Research Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Myong Cheol Lim
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jiwon Lim
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Han-Sung Kang
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Seeyoun Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Jai Hong Han
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Heein Jo
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea.,Immunotherapeutics Branch, Research Institute, National Cancer Center, Goyang, Korea.,National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
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21
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Xie J, Ying YY, Xu B, Li Y, Zhang X, Li C. Metastasis pattern and prognosis of male breast cancer patients in US: a population-based study from SEER database. Ther Adv Med Oncol 2019; 11:1758835919889003. [PMID: 31798694 PMCID: PMC6859799 DOI: 10.1177/1758835919889003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/21/2019] [Indexed: 12/23/2022] Open
Abstract
Background The aims of this study were to analyze the metastasis pattern and prognosis of male breast cancer (MBC) and compare it with female breast cancer (FBC), and to determine the independent factors affecting the prognosis of MBC patients. Methods Metastatic MBC diagnosed in the Surveillance, Epidemiology and End results (SEER) database from 2010 to 2015 were selected. Chi-squared test was used to compare clinicopathological characteristics. Survival differences were compared by Kaplan-Meier analysis. Cox proportional hazard model was used to determine the prognostic factors affecting overall survival. Results A total of 2754 MBC patients were identified, of which 196 had distant metastasis. Compared with nonmetastatic MBC, metastatic MBC patients had a higher proportion of <60 years old and grade III-IV, and were more likely to receive chemotherapy and radiotherapy, while the proportion of surgery, central portion of the breast, and Her2-/HR+ was lower. Compared with metastatic FBC, metastatic MBC patients had a higher proportion of ⩾60 years old, central portion of the breast, surgery, simultaneous bone and lung metastasis, while the proportion of Her2+/HR-, triple negative, liver metastasis only, and simultaneous bone and liver metastasis was lower. MBC patients with lung alone, bone alone, and simultaneous lung and bone metastasis had a higher hazard ratio (2.41; 3.06; 2.52; p < 0.0001) compared with nonmetastatic patients. Conclusions Compared with nonmetastatic MBC patients, metastatic MBC patients had unique clinicopathological features, and were also different from metastatic FBC patients. However, there was no difference in prognosis between metastatic MBC and FBC patients. Distant metastasis was an independent risk factor for the prognosis of MBC patients.
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Affiliation(s)
- Jun Xie
- Department of Respiration, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Yao-Yu Ying
- Department of Epidemiology and Biostatistics, Soochow University, Suzhou, Jiangsu, China
| | - Bin Xu
- Department of Tumor Biological Treatment, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Yan Li
- Department of Respiration, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Xian Zhang
- Department of Respiration, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Chong Li
- Department of Respiration, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Juqian Road No.185, Changzhou 213000, China
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22
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Overall Survival of Men and Women With Breast Cancer According to Tumor Subtype: A Population-based Study. Am J Clin Oncol 2019; 42:215-220. [PMID: 30499840 DOI: 10.1097/coc.0000000000000497] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To analyze differences in overall survival (OS) between male breast cancer (MBC) and female breast cancer (FBC) according to tumor subtype compared with other factors. MATERIALS AND METHODS We evaluated men and women with breast cancer between 2010 and 2013 with known hormone receptor (HR) status and human epidermal growth factor receptor 2 (HER2) status reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results program. Patient characteristics were compared between groups. Univariate and multivariate analyses were performed to determine the effect of each variable on OS. Breast cancer-specific survival was a secondary endpoint. RESULTS We included 1187 MBC and 166,054 FBC. Median follow-up was 21 months (range, 1 to 48) for both groups. OS at 3 years for MBC and FBC was 85.6% and 90.4%, respectively (P=0.0002). MBC were more ductal, had higher grade, presented with more advanced stage and were often HR+/HER2- (each P<0.0001). MBC had worse OS than FBC in HR+/HER2- (Hazard ratio [HaR], 1.5; P=0.0005), HR+/HER2+ (HaR, 2.8; P<0.0001) and triple negative (HaR, 4.3; P<0.0001) (Pinteraction<0.02). MBC had significantly worse OS than FBC in stages I and II, but similar OS in stages III and IV (Pinteraction<0.01). In multivariate analysis, HR+/HER2+ was the only subtype with significant differences in OS between MBC and FBC (HaR, 2.0; P=0.002). CONCLUSIONS OS was significantly different in both groups. Men had worse OS in early stages while similar OS in stages III and IV. There were significant differences in OS according to tumor subtype; compared with women, men with HR+/HER2+ tumors had twice the risk of death.
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23
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Popa-Nimigean V, Ahmed M. Current state of surgical management for male breast cancer. Transl Cancer Res 2019; 8:S457-S462. [PMID: 35117123 PMCID: PMC8798217 DOI: 10.21037/tcr.2019.04.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 04/15/2019] [Indexed: 11/17/2022]
Abstract
Management guidelines for male breast cancer have long been extrapolated from those for female breast cancer, which are based on large, randomised-controlled trials. While there are no randomised-controlled trials for male breast cancer management mainly due to the rarity of the disease, the only type of evidence available comes from retrospective studies, subject to selection biases and small sample sizes. Male breast cancer, while similar to female breast cancer in many respects, has some important differences that can affect management choices. Most cancers are oestrogen and progesterone receptor positive, and usually more advanced at presentation than female breast cancer. This is likely due to less breast parenchyma in male patients and delay to diagnosis. The classical management option for male patients with breast cancer is mastectomy, due to small tumour-to-breast ratio and often central position of the tumour. Breast conserving surgery is still useful in selected cases and has similar outcomes when compared to mastectomies in these patients. For patients with clinically negative lymph nodes, sentinel lymph node biopsy offers the same prognosis as axillary lymph node dissection, but with less associated morbidity. Endocrine therapy is of particular use, due to high levels of receptor positivity. Adjuvant endocrine therapy seems to significantly improve overall survival of male patients with breast cancer and while no prospective evidence exists for neoadjuvant hormonal therapy, there is hope that this is a useful management option as well. Radiotherapy is also useful in an adjuvant setting, particularly when combined with endocrine therapy. Better identification of patients, less delay from presentation to diagnosis and more collaborative efforts are key in improving the management, prognosis and outcomes of patients with male breast cancer.
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Affiliation(s)
| | - Muneer Ahmed
- Division of Cancer Studies, King's College London, London WC2R 2LS, UK
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24
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Wang Y, Chen K, Yang Y, Tan L, Chen L, Zhu L, Su F, Liu X, Li S. Incidence and survival outcomes of early male breast cancer: a population-based comparison with early female breast cancer. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:536. [PMID: 31807518 DOI: 10.21037/atm.2019.10.04] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Male breast cancer (MBC) is a rare malignancy. We aimed to analyze the incidence trends, clinicopathological characteristics, and survival outcomes in early MBC comparison with early female breast cancer (FBC). Methods We included eligible MBC and FBC patients with stage I-II disease in the Surveillance, Epidemiology, and End Results (SEER) database from 2000-2015. Joinpoint regression was used to evaluate the trends in age-adjusted incidence. A one-to-four propensity score matching (PSM) analysis was performed to reduce bias in a retrospective study. Survival outcomes were evaluated using Kaplan-Meier analyses with the log-rank test and Cox proportional hazards regression analysis. Results Trends in the age-adjusted incidence rates of early MBC were stable [2000-2015, annual percentage change (APC) =0.50, 95% confidence interval (CI): -0.1 to 1.1, P=0.102]; however, the incidence of early FBC changed significantly over the time period (2000-2015, APC = 0.30, 95% CI: 0.0 to 0.6, P=0.045). In the matched cohort, unmarried status, higher grade, larger tumor size, and advanced lymph node (LN) status were associated with a higher risk of breast cancer death and death of any causes both in early MBC and FBC patients. The hormone receptor (HR) status was as a prognostic factor in FBC patients, but not in MBC. Early MBC had worse breast cancer-specific survival (BCSS) and overall survival (OS) than early FBC in stage I, stage II and HR-positive subgroup of patients. Conclusions The biological behavior, clinicopathological features, and clinical outcomes of early MBC are different from that of FBC. Further studies on individualized treatment approaches in MBC are needed.
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Affiliation(s)
- Yan Wang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Kai Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Yaping Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Luyuan Tan
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Lili Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Liling Zhu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Fengxi Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Xue Liu
- College of Basic Medicine, Jining Medical University, Jining 272067, China
| | - Shunrong Li
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
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25
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Cicekdal MB, Tuna BG, Charehsaz M, Cleary MP, Aydin A, Dogan S. Effects of long‐term intermittent versus chronic calorie restriction on oxidative stress in a mouse cancer model. IUBMB Life 2019; 71:1973-1985. [DOI: 10.1002/iub.2145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/22/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Munevver B. Cicekdal
- Department of Medical BiologyYeditepe University, School of Medicine Istanbul Turkey
| | - Bilge G. Tuna
- Department of BiophysicsYeditepe University, School of Medicine Istanbul Turkey
| | - Mohammad Charehsaz
- Department of Pharmaceutical ToxicologyYeditepe University, School of Pharmacy Istanbul Turkey
| | - Margot P. Cleary
- Hormel Institute Medical Research CenterUniversity of Minnesota Austin Minnesota
| | - Ahmet Aydin
- Department of Pharmaceutical ToxicologyYeditepe University, School of Pharmacy Istanbul Turkey
| | - Soner Dogan
- Department of Medical BiologyYeditepe University, School of Medicine Istanbul Turkey
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26
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André S, Pereira T, Silva F, Machado P, Vaz F, Aparício M, Silva GL, Pinto AE. Male breast cancer: Specific biological characteristics and survival in a Portuguese cohort. Mol Clin Oncol 2019; 10:644-654. [PMID: 31031981 PMCID: PMC6482395 DOI: 10.3892/mco.2019.1841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 03/29/2019] [Indexed: 12/12/2022] Open
Abstract
Male breast cancer (BC) represents an individual subtype of BC, with therapeutic procedures based on female BC therapy results. The present study evaluated the parameters currently used for the characterization and therapy of male BC, and their association with disease-free (DFS) and overall survival (OS), aiming to obtain a comprehensive basis to improve the personalized care of male BC. A total of 196 patients from March 1970 to March 2018 (mean follow-up, 84.9 months) were profiled, using clinicopathological review, molecular assessment [BRCA1/2, DNA repair associated (BRCA1/2) status, immunohistochemistry, fluorescence in situ hybridization and DNA flow cytometry] and Cox regression statistical analysis. The median age of patients was 66.5 years. At presentation, 39.2% of patients with invasive carcinomas were in anatomic stage (AS) I. Patients exhibited primarily invasive carcinomas of no special type, histological grade 2, estrogen receptor α-(ERα) and progesterone receptor (PR)-positive, receptor tyrosine kinase erbB-2-negative, high Ki-67, Luminal B-like and aneuploid tumors. A total of 13 of the 44 (29.5%) BRCA-evaluated patients exhibited BRCA2 mutations, significantly associated with family history (FH), bilaterality, high Ki-67 expression, absence of PR and Luminal B-like tumors. Bilaterality was associated with the occurrence of non-breast primary neoplasms (NBPN). The 5 and 10-year DFS rates, excluding patients with distant metastasis, NBPN and in situ carcinomas (n=145) were 65.9 and 58.2%, respectively, and the 5 and 10-year OS rates were 77.5 and 59.2%, respectively. In the univariate analysis, Luminal B-like subtype, BRCA2 mutations, high Ki-67 expression, and AS II and III were significantly associated with shorter DFS and OS. In addition, age >70 years was associated with low OS. In the multivariate analysis, FH, AS II and III, and Luminal B-like subtypes were associated with poorer OS. In conclusion, the data from the present study emphasize the high incidence of BRCA2 mutation in male BC, and its association with FH, bilaterality, high Ki-67 expression, negative PR expression and Luminal B-like subtypes, and with shorter DFS and OS in univariate analysis.
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Affiliation(s)
- Saudade André
- Department of Pathology, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Teresa Pereira
- Department of Pathology, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Fernanda Silva
- NOVA Medical School, NOVA University, 1169-056 Lisbon, Portugal
| | - Patrícia Machado
- Breast Cancer Risk Evaluation Clinic, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Fátima Vaz
- Breast Cancer Risk Evaluation Clinic, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Mariana Aparício
- Department of Mathematics of Higher Technical Institute, University of Lisbon, Portugal
| | - Giovani L. Silva
- Department of Mathematics of Higher Technical Institute, University of Lisbon, Portugal
- Statistics and Applications Center of University of Lisbon, 1049-001 Lisbon, Portugal
| | - António E. Pinto
- Department of Pathology, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
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27
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Dong D, Zhang G, Yang J, Zhao B, Wang S, Wang L, Zhang G, Shang P. The role of iron metabolism in cancer therapy focusing on tumor-associated macrophages. J Cell Physiol 2018; 234:8028-8039. [PMID: 30362549 DOI: 10.1002/jcp.27569] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/17/2018] [Indexed: 12/11/2022]
Abstract
Iron is an essential micronutrient in mammalian cells for basic processes such as DNA synthesis, cell cycle progression, and mitochondrial activity. Macrophages play a vital role in iron metabolism, which is tightly linked to their phagocytosis of senescent and death erythrocytes. It is now recognized that the polarization process of macrophages determines the expression profile of genes associated with iron metabolism. Although iron metabolism is strictly controlled by physiology, cancer has recently been connected with disordered iron metabolism. Moreover, in the environment of cancer, tumor-associated macrophages (TAMs) exhibit an iron release phenotype, which stimulates tumor cell survival and growth. Usually, the abundance of TAMs in the tumor is implicated in poor disease prognosis. Therefore, important attention has been drawn toward the development of tumor immunotherapies targeting these TAMs focussing on iron metabolism and reprogramming polarized phenotypes. Although further systematic research is still required, these efforts are almost certainly valuable in the search for new and effective cancer treatments.
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Affiliation(s)
- Dandan Dong
- School of Life Sciences, Northwestern Polytechnical University, Xi'an Shanxi, China.,Key Laboratory for Space Biosciences and Biotechnology, Xi'an Shanxi, China
| | - Gejing Zhang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an Shanxi, China.,Key Laboratory for Space Biosciences and Biotechnology, Xi'an Shanxi, China
| | - Jiancheng Yang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an Shanxi, China.,Key Laboratory for Space Biosciences and Biotechnology, Xi'an Shanxi, China
| | - Bin Zhao
- School of Life Sciences, Northwestern Polytechnical University, Xi'an Shanxi, China.,Key Laboratory for Space Biosciences and Biotechnology, Xi'an Shanxi, China
| | - Shenghang Wang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an Shanxi, China.,Key Laboratory for Space Biosciences and Biotechnology, Xi'an Shanxi, China
| | - Luyao Wang
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, China
| | - Ge Zhang
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, China
| | - Peng Shang
- Research & Development Institute in Shenzhen, Northwestern Polytechnical University, Shenzhen, China.,Key Laboratory for Space Biosciences and Biotechnology, Xi'an Shanxi, China
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28
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Li N, Wang X, Zhang H, Wang H. Young male breast cancer, a small crowd, the survival, and prognosis?: A population-based study. Medicine (Baltimore) 2018; 97:e12686. [PMID: 30290658 PMCID: PMC6200462 DOI: 10.1097/md.0000000000012686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Women diagnosed with breast cancer at young age often have poorprognoses. Yet, few studies have focused on the prognoses of young men with breast cancer. We therefore used Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 151 male patients with breast cancer aged <40 years between 1988 and 2012. Propensity score matching analysis was used to balance the clinical variables among different groups. Kaplan-Meier curves were applied to compare the survival differences. The subgroup variables on cancer-specific survival (CSS) and overall survival (OS) were analyzed by the Cox proportional hazard model. Results showed that male patients with breast cancer aged <40 had a significant OS benefit compared with those aged ≥40 years (P < .001). The significant difference of the CSS was not found (P > .05). Compared with the male patients with breast cancer aged ≥40, those aged <40 had significant OS benefit in most subgroups (P < .05). Compared with the female patients with breast cancer aged <40, the male patients with breast cancer aged <40 had worse OS and CSS benefit only in the subgroup with progesterone receptor and estrogen receptor positive (P < .05). In conclusion, we demonstrated that young male patients with breast cancer had better OS compared with elder male patients with breast cancer. However, the survival benefit was not found compared with young female patients with breast cancer.
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Affiliation(s)
- Naikun Li
- Department of Oncology, Central Hospital of Yidu affiliated to Weifang Medical College, Weifang
| | - Xiaohui Wang
- Research Service Office, Shandong Liaocheng People's Hospital
| | - Hongju Zhang
- Department of Oncology, Liaocheng Infectious Disease Hospital, Liaocheng
| | - Haiyong Wang
- Department of internal Medicine-Oncology, Shandong Cancer Hospital and Institute, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
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29
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Kehl KL, Niu J, Chavez-MacGregor M, Giordano SH. Hospitalization by cytotoxic chemotherapy regimen among older women with stage IV breast cancer. Cancer 2018; 124:4685-4691. [PMID: 30264853 DOI: 10.1002/cncr.31760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/19/2018] [Accepted: 08/13/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Older patients with cancer are at risk for increased side effects of treatment. Our goal was to inform treatment for older patients by analyzing the relationship between chemotherapy regimen and hospitalization among older women receiving palliative cytotoxic chemotherapy for breast cancer. METHOD We identified women aged 66-99 years with stage IV de novo breast cancer diagnosed between 2010 and 2013 who received any of the 10 most common cytotoxic chemotherapy-containing regimens in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. The primary outcome was hospitalization or death within 30 days of starting a new line of chemotherapy. Generalized linear mixed effects models with patient-specific random effects were used for multivariable analysis of the association between chemotherapy regimen and this outcome. Additional covariates included number of prior lines of therapy; time since diagnosis; hormone receptor and HER2 status; sites of metastatic disease; and age, race, and marital status. The unit of analysis was each new line of chemotherapy. RESULTS Of 972 lines of chemotherapy initiated among 693 patients, 188 (19%) were followed by hospitalization or death within 30 days. After adjustment, there was significant variation in this outcome by chemotherapy regimen (P = .03); compared with capecitabine, hospitalization/death rates were higher with cyclophosphamide + docetaxel (odds ratio [OR], 2.71; 95% confidence interval [CI], 1.31-5.59), cyclophosphamide + doxorubicin (OR, 2.45; 95% CI, 1.19-5.03), docetaxel (OR, 2.49; 95% CI, 1.19-5.21), and gemcitabine (OR, 3.51; 95% CI, 1.72-7.19). CONCLUSION Treatment regimen was associated with significant variation in 30-day hospitalization or death among older women receiving cytotoxic chemotherapy for stage IV de novo breast cancer.
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Affiliation(s)
- Kenneth L Kehl
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Jiangong Niu
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mariana Chavez-MacGregor
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sharon H Giordano
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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Liu N, Johnson KJ, Ma CX. Male Breast Cancer: An Updated Surveillance, Epidemiology, and End Results Data Analysis. Clin Breast Cancer 2018; 18:e997-e1002. [PMID: 30007834 DOI: 10.1016/j.clbc.2018.06.013] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/24/2018] [Accepted: 06/19/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Male breast cancer is rare and understudied compared with female breast cancer. A current comparison with female breast cancer could assist in bridging this gap. Although conflicting data have been reported on male and female survival outcomes, data from 1973 through 2005 in the Surveillance, Epidemiology, and End Results (SEER) program have demonstrated that the improvement in breast cancer survival in men has fallen behind that of women. As treatment for breast cancer has improved significantly, an updated analysis using a contemporary population is necessary. MATERIALS AND METHODS An analysis of SEER data from patients with a diagnosis of primary breast cancer from 2005 to 2010 were included. A Cox regression model was used to examine the association between sex and breast cancer mortality after controlling for prognostic factors, including age, race, marital status, disease stage, estrogen and progesterone receptor status, lymph node involvement, tumor grade, surgery, and geography. Subgroup analyses were performed by race and stage. RESULTS We included a total of 289,673 breast cancer cases (2054 men) with a diagnosis from 2005 to 2010. The 5-year survival rate for male patients was lower than that for female patients (82.8% vs. 88.5%). After controlling for other factors, the risk of death in men was 43% greater than that in women during the follow-up period (hazard ratio, 1.43; 95% confidence interval, 1.26-1.61). Similar results were noted in the race and stage subgroup analyses. CONCLUSION In recent years, male breast cancer patients have had worse survival outcomes compared with those of female patients.
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Affiliation(s)
- Ning Liu
- Washington University Brown School of Public Health, St. Louis, MO
| | - Kimberly J Johnson
- Washington University Brown School of Public Health, St. Louis, MO; Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Cynthia X Ma
- Washington University Brown School of Public Health, St. Louis, MO; Section of Medical Oncology, Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO.
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Altman AM, Kizy S, Yuan J, Denbo JW, Jensen EH, Hui JYC, Tuttle TM, Marmor S. Distribution of 21-Gene Recurrence Scores in Male Breast Cancer in the United States. Ann Surg Oncol 2018; 25:2296-2302. [PMID: 29907942 DOI: 10.1245/s10434-018-6566-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND The 21-gene recurrence score (RS) is a RT-PCR assay estimating risk of distant recurrence in estrogen receptor positive (ER+), human epidermal growth factor receptor 2 negative (HER2) breast cancer (BC). Studies validating RS are limited to women. Our objective was to assess RS distribution and factors associated with high-risk RS in male BC. METHODS Using the Surveillance, Epidemiology, and End Results database, we identified men and women with ER+/HER2- BC from 2010 to 2013. Patients were categorized into risk groups using the traditional and the Trial Assigning Individualized Options for Treatment (TAILORx) cutoffs. Multivariable logistic regression determined factors associated with testing and high-risk TAILORx RS. RESULTS We identified 1388 men and 154,196 women with ER+/HER2- BC. Twenty-five percent of men and 30% of women had RS testing. Mean age of tested men was 63; most were white (81%), had grade I or II tumors (67%), and had stage I or II (95%) BC. Factors associated with increased RS testing were younger age, recent year of diagnosis, lymph node negativity, and lower-stage tumors (p ≤ 0.05). By TAILORx, 21% of men had high-risk RS compared with 14% of tested women. Men with grade III and PR negative tumors were more likely to have a high-risk RS (p ≤ 0.05). Chemotherapy utilization was correlated with RS. CONCLUSIONS Using a large population-based dataset, we found that compared with women, men were significantly more likely to have high-risk RS. Grade III and PR-negative BC were significantly associated with high-risk RS. Higher RS in men correlated with increased chemotherapy utilization.
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Affiliation(s)
- Ariella M Altman
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Scott Kizy
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jianling Yuan
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Jason W Denbo
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Eric H Jensen
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jane Y C Hui
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Todd M Tuttle
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Schelomo Marmor
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
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Massarweh SA, Sledge GW, Miller DP, McCullough D, Petkov VI, Shak S. Molecular Characterization and Mortality From Breast Cancer in Men. J Clin Oncol 2018; 36:1396-1404. [PMID: 29584547 DOI: 10.1200/jco.2017.76.8861] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Limited data exist on the molecular biology, treatment, and outcomes of breast cancer in men, and much of our understanding in this area remains largely an extrapolation from data in women with breast cancer. Materials and Methods We studied men and women with hormone receptor-positive breast cancer and the 21-gene Breast Recurrence Score (RS) results. Differences in clinical characteristics and gene expression were determined, and distribution of RS results was correlated with 5-year breast cancer-specific survival (BCSS) and overall survival. Results There were 3,806 men and 571,115 women. Men were older than women (mean age, 64.2 v 59.1 years; P < .001). RS < 18 predominated in both genders, but RS ≥ 31 was more frequent in men (12.4% v 7.4%; P < .001), as were very low scores (RS < 11; 33.8% v 22.1%; P < .001). Mean gene expression was higher in men for the estrogen receptor (ER), proliferation, and invasion groups. ER was lowest and progesterone receptor was highest in women younger than 50 years of age, with a progressive increase in ER with age. Men younger than 50 years of age had slightly lower ER and progesterone receptor compared with older men. Survival data were available from SEER for 322 men and 55,842 women. Five-year BCSS was 99.0% (95% CI, 99.3% to 99.9%) and 95.9% (95% CI, 87.6% to 98.7%) for men with RS < 18 and RS 18-30, respectively, and for women, it was 99.5% (95% CI, 99.4% to 99.6%) and 98.6% (95% CI, 98.4% to 98.8%), respectively. RS ≥ 31 was associated with an 81.0% 5-year BCSS in men (95% CI, 53.3% to 93.2%) and 94.9% 5-year BCSS (95% CI, 93.9% to 95.7%) in women. Five-year BCSS and overall survival were lower in men than in women. Conclusion This study reveals some distinctive biologic features of breast cancer in men and an important prognostic role for RS testing in both men and women.
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Affiliation(s)
- Suleiman Alfred Massarweh
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - George W Sledge
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Dave P Miller
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Debbie McCullough
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Valentina I Petkov
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
| | - Steven Shak
- Suleiman Alfred Massarweh and George W. Sledge, Stanford University School of Medicine and Stanford Cancer Institute, Stanford; Dave P. Miller, Debbie McCullough, and Steven Shak, Genomic Health, Redwood City, CA; and Valentina I. Petkov, National Cancer Institute, Bethesda, MD
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Zhang J, Zhang Y, Zhang Z. Association of rs2279744 and rs117039649 promoter polymorphism with the risk of gynecological cancer: A meta-analysis of case-control studies. Medicine (Baltimore) 2018; 97:e9554. [PMID: 29480845 PMCID: PMC5943879 DOI: 10.1097/md.0000000000009554] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Increasing evidence has suggested that rs2279744 is associated with rs117039649 polymorphism, which can increase the risk of gynecological cancers, including cervical, ovarian, breast, and endometrial cancer. The results are inconsistent so that we performed a meta-analysis of current literature to clarify the impacts of these polymorphisms on gynecological cancer. METHODS Eligible articles were identified through an exhaustive search of relevant databases including PubMed, Embase, Web of science, Springer Link, Chinese National Knowledge Infrastructure (CNKI), and Weipu database for the period up to July 2016. Data about the association between single nucleotide polymorphisms (SNPs) and cancer risk were refined from the selected articles as well as other information about cases and controls, and all of them were extracted by 2 independent researchers and pooled odds ratio with 95% confidence interval was calculated. RESULTS This analysis included 24 articles, 27 case-control studies of rs2279744 polymorphism and 3 case-control studies of rs117039649 polymorphism. Significant association with the risk of gynecological cancer was observed for both SNPs. Subgroup analysis by ethnicity and cancer type (cervical, ovarian, breast, and endometrial) also showed a positive relationship between rs2279744 polymorphism and gynecological cancer risk in Caucasian; and there was also a notable association between rs2279744 polymorphism and cervical cancer. CONCLUSIONS We found that rs2279744 (SNP309) and rs117039649 (SNP285) were both associated with the risk of gynecological cancers. Subgroup analysis showed that rs2279744 (SNP309) was associated with the risk of gynecological cancers in Caucasian and Asian according to the ethnicity and cancer type, especially for endometrial cancer.
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Eom HJ, Ko BS, Song IH, Gong G, Kim HH. Ectopic Male Breast Cancer in the Perineum: A Case Report. J Breast Cancer 2017; 20:404-407. [PMID: 29285047 PMCID: PMC5744002 DOI: 10.4048/jbc.2017.20.4.404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/23/2017] [Indexed: 11/30/2022] Open
Abstract
Ectopic breast tissue and male breast cancer are both very rare diseases with only a few reports in the literature. Here, we present the first case of ectopic male breast cancer in the perineum. The patient was a 70-year-old man with a palpable mass in the perineum. A wide local excision and inguinal lymph node dissection revealed invasive breast carcinoma of no special type involving the skin and subcutis, and inguinal lymph node metastases. Immunohistochemical staining showed that the tumor cells were strongly positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2. Moreover, no p53 overexpression was observed. Herein, the clinical and pathologic features, as well as a review of ectopic male breast cancer are discussed.
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Affiliation(s)
- Hye-Joung Eom
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom Seok Ko
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Hye Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gyungyub Gong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hak Hee Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jung M, Weigert A, Mertens C, Rehwald C, Brüne B. Iron Handling in Tumor-Associated Macrophages-Is There a New Role for Lipocalin-2? Front Immunol 2017; 8:1171. [PMID: 28979267 PMCID: PMC5611490 DOI: 10.3389/fimmu.2017.01171] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 09/04/2017] [Indexed: 12/18/2022] Open
Abstract
Carcinogenesis is a multistep process. Besides somatic mutations in tumor cells, stroma-associated immunity is a major regulator of tumor growth. Tumor cells produce and secrete diverse mediators to create a local microenvironment that supports their own survival and growth. It is becoming apparent that iron acquisition, storage, and release in tumor cells is different from healthy counterparts. It is also appreciated that macrophages in the tumor microenvironment acquire a tumor-supportive, anti-inflammatory phenotype that promotes tumor cell proliferation, angiogenesis, and metastasis. Apparently, this behavior is attributed, at least in part, to the ability of macrophages to support tumor cells with iron. Polarization of macrophages by apoptotic tumor cells shifts the profile of genes involved in iron metabolism from an iron sequestering to an iron-release phenotype. Iron release from macrophages is supposed to be facilitated by ferroportin. However, lipid mediators such as sphingosine-1-phosphate, released form apoptotic tumor cells, upregulate lipocalin-2 (Lcn-2) in macrophages. This protein is known to bind siderophore-complexed iron and thus, may participate in iron transport in the tumor microenvironment. We describe how macrophages handle iron in the tumor microenvironment, discuss the relevance of an iron-release macrophage phenotype for tumor progression, and propose a new role for Lcn-2 in tumor-associated macrophages.
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Affiliation(s)
- Michaela Jung
- Faculty of Medicine, Institute of Biochemistry I, Goethe University Frankfurt, Frankfurt, Germany
| | - Andreas Weigert
- Faculty of Medicine, Institute of Biochemistry I, Goethe University Frankfurt, Frankfurt, Germany
| | - Christina Mertens
- Faculty of Medicine, Institute of Biochemistry I, Goethe University Frankfurt, Frankfurt, Germany.,Faculty 15, Biological Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Claudia Rehwald
- Faculty of Medicine, Institute of Biochemistry I, Goethe University Frankfurt, Frankfurt, Germany
| | - Bernhard Brüne
- Faculty of Medicine, Institute of Biochemistry I, Goethe University Frankfurt, Frankfurt, Germany.,Project Group Translational Medicine and Pharmacology TMP, Fraunhofer Institute for Molecular Biology and Applied Ecology, IME, Frankfurt, Germany
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36
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Commentary on: Men and women show similar survival rates after breast cancer. J Cancer Res Clin Oncol 2017; 143:1621. [DOI: 10.1007/s00432-017-2443-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 05/18/2017] [Indexed: 10/19/2022]
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Abstract
BACKGROUND The local-regional management of female breast cancer has been extensively investigated worldwide. The optimal approach for males diagnosed with breast cancer is less clear. We have analyzed the treatment of male breast cancer using a population-based national registry to determine the impact of surgery and radiation therapy on survival. MATERIALS AND METHODS The Surveillance Epidemiology and End Results (SEER) database was queried to identify males with invasive ductal carcinoma of the breast who underwent primary surgical resection (radical mastectomy, modified radical mastectomy, total mastectomy, or segmental) for the years 1983 to 2002. Demographic, clinical, and pathologic data were culled and analyzed to determine the impact of radiation therapy (RT) following resection. Survival rates were estimated using the Kaplan-Meier method and significance was determined using the log-rank test (P<0.05). Multivariate analysis with the Cox proportional hazards model was performed to determine factors significant for overall (OS) and cause-specific survival (CSS). RESULTS A total of 1337 patients met the eligibility criteria and were analyzed. Median follow-up was 7.3 years (range, 1 mo to 25 y). Most men underwent modified radical mastectomy (n=1062) with a minority undergoing segmental (n=113). About 329 men received postoperative external beam RT. The median rates of OS and CSS for all men were 10.5 years and not yet reached, respectively. The surgical procedure did not significantly associate with OS or CSS. By stage, RT was associated with improved OS for stage I (P=0.03). There was a trend for improved survival with stage II (P=0.21) and III (P=0.15). RT was not associated with improved CSS by stage. RT improved rates of OS and CSS in N2 patients without reaching statistical significance (P=0.10 and 0.22). On multivariate analysis, advancing age, stage and grade, and no postoperative RT predicted for worse OS. However, when controlled for those with known hormone receptor status (n=978), only the factors of advancing age, stage, grade, and hormone receptor negativity predicted for worse OS. Advancing age, stage, and grade were the only predictors of CSS irrespective of the cohort analyzed. CONCLUSIONS The primary surgical procedure did not ultimately influence OS or CSS in this population-based registry of males with breast cancer. A statistically nonsignificant improvement with postoperative RT was observed in men with lymph node involvement, larger tumor size, or higher stage. When controlled for age, stage, and grade in multivariate analysis, postoperative RT predicted for improved OS but not CSS. These data suggest a beneficial effect of RT in the postoperative setting. A prospective study is necessary to further elucidate appropriate treatment strategies for men with breast cancer.
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Yu XF, Wang C, Chen B, Liang CL, Chen DB, Yu Y, Yang HJ. The effect of adjuvant chemotherapy in male breast cancer: 134 cases from a retrospective study. ESMO Open 2017; 2:e000134. [PMID: 28761739 PMCID: PMC5519781 DOI: 10.1136/esmoopen-2016-000134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 12/31/2016] [Accepted: 01/02/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Male breast cancer (BC) is a kind of rare tumour. There were few researches concerning the effect of chemotherapy for it. The purpose of this study is to estimate the value of chemotherapy on prognosis in male BC. PATIENTS AND METHODS Complete clinical and pathological information of male BC were collected from January 1990 to January 2008 in Zhejiang Cancer Hospital in China. 134 cases of male BC were included for analysis and separated into two groups based on receiving chemotherapy or not receiving chemotherapy. The disease-free survival (DFS) and overall survival (OS) between chemotherapy group and non-chemotherapy group were compared with Kaplan-Meier survival curve. Stratified analysis was used to evaluate the strength of the association between chemotherapy and each risk factor. Multivariate analysis was conducted by using COX proportional hazard regression model. RESULTS There were 58.21% (78/134) cases who underwent chemotherapy and 41.79% (56/134) cases without chemotherapy. There were 20 cases (25.64%) with recurrence/metastasis in patients with chemotherapy and six cases (10.71%) in patients without chemotherapy. The mean DFS time of male BC with chemotherapy and non-chemotherapy is 150.87 and 154.13 months, respectively (χ2=3.825, p=0.050). The mean OS time of male BC with chemotherapy and non-chemotherapy is 155.33 and 154.26 months, respectively (χ2=2.542, p=0.111). COX proportional hazard regression model showed that the two groups had similar DFS (HR=0.386, p=0.165), while chemotherapy might be a protective fact on OS (HR=0.140, p=0.026). CONCLUSION The utility of chemotherapy should be considered in the high risk level of recurrence/metastasis in male BC.
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Affiliation(s)
- Xing-Fei Yu
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Chen Wang
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Bo Chen
- Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Chen-Lu Liang
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Dao-Bao Chen
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Yang Yu
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Hong-Jian Yang
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
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Oliveira LLD, Aguiar SSD, Bender PFM, Bergmann A, Thuler LCS. Men Have a Higher Incidence of Seroma after Breast Cancer
Surgery. Asian Pac J Cancer Prev 2017; 18:1423-1427. [PMID: 28612597 PMCID: PMC5555557 DOI: 10.22034/apjcp.2017.18.5.1423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background and Objectives: Male breast cancer (MBC) is rare. While surgical treatment may result in several complications in women, little is known about how it affects men. The objective of this study was to compare the incidence of postoperative wound complications between men and women after breast cancer surgery. Methods: This cohort study included all male patients enrolled for breast cancer surgical treatment at the Brazilian National Cancer Institute, between 1999 and 2013. Each was matched with three female breast cancer patients. Parameters analyzed were necrosis, seroma and infection. Odds ratios (OR) were generated and statistical significance was considered at p<0.05. Results: We included in this study 71 men and 213 women with an average age of 63.5 (±12.0). The incidences of complications in men and women were: necrosis, 32.8% and 37.8% (p=0.477); seroma, 80.6% and 59.4% (p=0.003); and surgical site infection, 14.8% and 18.2% (p=0.54). After adjustment, men had a 3 times greater risk of developing seroma compared to women (OR=3.0; IC95%=1.4-6.4; p=0.004). No statistically significant differences was detected in the incidences of wound infection and necrosis. Conclusion: Men have a greater risk of developing seroma after surgery for breast cancer than women, whereas infection and necrosis occur at similar frequencies in both genders.
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Ottini L, Capalbo C. Male Breast Cancer. Breast Cancer 2017. [DOI: 10.1007/978-3-319-48848-6_63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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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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Abstract
Male breast cancer is a rare disease, accounting for only 1% of breast cancer diagnoses in the USA. The current literature suggests that genetic factors including BRCA2 mutations, family history, age, androgen/estrogen imbalance, and environmental exposures may predispose to male breast cancer. In this manuscript, we will review known and possible risk factors for male breast cancer, as well as describe the clinical patterns of the disease.
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Affiliation(s)
- Raina M Ferzoco
- Department of Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
| | - Kathryn J Ruddy
- Department of Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
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Popovic DS, Popovic LS. Obesity and breast cancer - Association even more relevant in males? Eur J Intern Med 2016; 29:e11-2. [PMID: 26703430 DOI: 10.1016/j.ejim.2015.11.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 11/27/2015] [Indexed: 11/22/2022]
Affiliation(s)
- Djordje S Popovic
- Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of Vojvodina, Medical Faculty, University of Novi Sad, Serbia.
| | - Lazar S Popovic
- Clinic for Medical Oncology, Institute for Oncology of Vojvodina, Sremska Kamenica, Medical Faculty, University of Novi Sad, Serbia
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Choi MY, Lee SK, Lee JE, Park HS, Lim ST, Jung Y, Ko BK, Nam SJ. Characterization of Korean Male Breast Cancer Using an Online Nationwide Breast-Cancer Database: Matched-Pair Analysis of Patients With Female Breast Cancer. Medicine (Baltimore) 2016; 95:e3299. [PMID: 27100414 PMCID: PMC4845818 DOI: 10.1097/md.0000000000003299] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to review the characteristics and the survival rate in male breast cancer (MBC) patients in Korea over a 31-year period. Additionally, we analyzed the overall survival (OS) rate of a group of MBC matched to females with breast cancer. We retrospectively analyzed the data from 400 Korean patients who were treated for MBC from 1978 to 2009. Patient demographics and clinical information were routinely documented throughout the study period. Survival and prognostic factors were evaluated. Each MBC patient was matched with 5 female breast cancer (FBC) patients based on 7 characteristics and we compared the OS rates between the 2 groups. For MBC cases, the median follow-up was 72 months and the 5-year OS rate was 85.9%. In univariate analyses, the prognostic factors influencing OS were age (more than 60 years, P <0.001), tumor size (>2 cm, P = 0.007), and having a negative progesterone receptor (PR) status (P = 0.042). Only the age (P = 0.028) and tumor size (P = 0.024) were significant prognostic factors for OS in multivariate analysis. After matching, we had 260 male patients matched to 1300 female patients for analysis. Compared with cases among females, the rate of mastectomy was higher among MBC cases and tumors, which were almost invasive ductal carcinomas (IDCs), were more likely to be located in the central part of the breast. For MBC cases, the percentage of adjuvant radiation therapy was low compared with female cases. The primary hormone therapy agent used was tamoxifen. The 5-year OS rates were similar in MBC compared with FBC (91.0% vs. 92.6%, P = 0.300). We found that only the age (more than 60 years) and tumor size were independent prognostic factors of survival in MBC. The prognosis for MBC is similar to that for FBC given similar stage and hormone-receptor status.
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Affiliation(s)
- Min-Young Choi
- From the Division of Breast and Endocrine Surgery (M-YC), Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine; Division of Breast and Endocrine Surgery (SKL, JEL, SJN), Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Department of Surgery (HSP), Yonsei University College of Medicine, Seoul; Department of Surgery (STL), St. Vincent's Hospital, The Catholic University of Korea; Department of Surgery (YJ), Ajou University School of Medicine, Suwon; and Department of Surgery (BKK), Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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45
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Park SY, Chae SY, Park JO, Lee KJ, Park G. Gold-conjugated resveratrol nanoparticles attenuate the invasion and MMP-9 and COX-2 expression in breast cancer cells. Oncol Rep 2016; 35:3248-56. [PMID: 27035791 DOI: 10.3892/or.2016.4716] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/26/2016] [Indexed: 11/06/2022] Open
Abstract
Gold nanoparticles (AuNPs) with antitumorigenic effects obstruct the initiation, development and progression of tumors via the regulation of various processes, such as proliferation and apoptosis. However, the effects of AuNPs on breast cancer metastasis have not been well studied, and their response to 12-O-tetradecanoylphorbol-13-acetate (TPA) stimulation remains unclear. Therefore, we synthesized resveratrol-capped gold nanoparticles (Rev-AuNPs) using green nanotechnology and investigated their potential anti-invasive properties in human breast cancer cells in response to TPA stimulation. The Rev-AuNPs formed spherical nanoparticles of 22.28±2.98 nm in diameter. Next, we found that non-cytotoxic concentrations of Rev-AuNPs significantly suppressed the TPA-induced migration and invasion abilities of breast cancer cells. Rev-AuNPs suppressed TPA-induced enzymatic activity and the expression of matrix metalloproteinase (MMP)-9 and cyclooxygenase-2 (COX-2). Furthermore, Rev-AuNP treatment remarkably downregulated TPA-induced nuclear translocation and transcriptional activation of nuclear transcription factor-κB (NF-κB) and activator protein-1 (AP-1). Rev-AuNPs reduced the phosphorylation of phosphoinositide 3-kinase/Akt (PI3K/Akt) and extracellular signal-regulated kinase (ERK)1/2 signaling, but did not affect the phosphorylation of Jun N-terminal kinase (JNK) or p38 MAPK in the TPA-stimulated breast cancer cells. Notably, Rev-AuNPs generally showed better anti-invasive activity than resveratrol without cytotoxicity. The inhibitory effect of Rev-AuNPs on MMP-9, COX-2, NF-κB, AP-1, PI3K/Akt and ERK activation was stronger than that of resveratrol for the same concentrations. We also demonstrated that Rev-AuNPs induced heme oxygenase-1 (HO-1) expression and that the inhibition of MMP-9 and COX-2 expression and MMP-9 enzymatic activity of Rev-AuNPs were abrogated by siRNA knockdown of HO-1 expression. Our findings revealed that the anti-invasive effects of Rev-AuNPs in response to TPA-stimulation were mediated by the suppression of MMP-9, COX-2, NF-κB, AP-1, PI3K/Akt and ERK and/or the activation of HO-1 signaling cascades. This novel finding emphasizes the pharmacological ability of Rev-AuNPs to treat breast cancer metastasis.
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Affiliation(s)
- Sun Young Park
- Bio-IT Fusion Technology Research Institute, Pusan National University, Busan 609-735, Republic of Korea
| | - Seon Yeong Chae
- Department of Nano Fusion Technology, Graduate School, Pusan National University, Busan 609-735, Republic of Korea
| | - Jin Oh Park
- Department of Nano Fusion Technology, Graduate School, Pusan National University, Busan 609-735, Republic of Korea
| | - Kyu Jin Lee
- Department of Nano Fusion Technology, Graduate School, Pusan National University, Busan 609-735, Republic of Korea
| | - Geuntae Park
- Department of Nano Fusion Technology, Graduate School, Pusan National University, Busan 609-735, Republic of Korea
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Kehl KL, Shen C, Litton JK, Arun B, Giordano SH. Rates of BRCA1/2 mutation testing among young survivors of breast cancer. Breast Cancer Res Treat 2016; 155:165-73. [PMID: 26706041 PMCID: PMC5521172 DOI: 10.1007/s10549-015-3658-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/08/2015] [Indexed: 02/07/2023]
Abstract
Guidelines in the United States recommend consideration of testing for mutations in the BRCA1 and BRCA2 genes for women diagnosed with breast cancer under age 45. Identification of mutations among survivors has implications for secondary prevention and familial risk reduction. Although only 10 % of breast cancers are diagnosed under age 45, there are approximately 2.8 million breast cancer survivors in the United States, such that the young survivor population likely numbers in the hundreds of thousands. However, little is known about genetic testing rates in this population. We assessed trends in BRCA1/2 testing among breast cancer survivors who were under age 45 at diagnosis and were treated from 2005 to 2012. Using insurance claims from a national database (MarketScan), we identified incident breast cancer cases among (1) women aged ≤40 and (2) women aged 41-45. We measured BRCA1/2 testing using Kaplan-Meier analysis and Cox proportional hazards models. Among 26,985 patients analyzed, BRCA1/2 testing rates increased with each year of diagnosis from 2005 to 2012 (P < 0.001). However, among women treated in earlier years, testing rates did not approach those of patients treated later, even after extended follow-up (median time from surgery to testing among patients treated in 2005, not reached; median time to testing among patients treated in 2012, 0.2 months for women aged ≤40 and 1.0 month for women aged 41-45). Women aged 41-45 had lower rates than women aged ≤40 throughout the analysis period (P < 0.001 for each year). BRCA1/2 testing rates among young women with incident breast cancer increased substantially in the last decade. However, most survivors treated in earlier years have never been tested. Our results demonstrate a need to better incorporate genetic counseling into survivorship and primary care for this population.
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Affiliation(s)
- Kenneth L Kehl
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 463, Houston, TX, 77030, USA.
| | - Chan Shen
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer K Litton
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Banu Arun
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sharon H Giordano
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Ferzoco RM, Ruddy KJ. Optimal delivery of male breast cancer follow-up care: improving outcomes. BREAST CANCER-TARGETS AND THERAPY 2015; 7:371-9. [PMID: 26648754 PMCID: PMC4664432 DOI: 10.2147/bctt.s75630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Male breast cancer is a rare disease. There are limited data to inform optimal treatment and follow-up strategies in this population. Currently, most follow-up guidelines are drawn from the vast literature on female breast cancer, despite the fact that male breast cancer has unique biological characteristics. In this review, we discuss clinical characteristics of male breast cancer as well as current best practices for long-term care with a focus on surveillance, screening, and treatment-related symptom management in male breast cancer survivors.
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Zhu J, Davis CT, Silberman S, Spector N, Zhang T. A role for the androgen receptor in the treatment of male breast cancer. Crit Rev Oncol Hematol 2015; 98:358-63. [PMID: 26669267 DOI: 10.1016/j.critrevonc.2015.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/30/2015] [Accepted: 11/19/2015] [Indexed: 11/19/2022] Open
Abstract
Male breast cancer (BC) is relatively rare, making up less than 1% of all breast cancer cases in the United States. Treatment guidelines for male BC are derived from studies on the treatment of female BC, and are based molecular and clinical characteristics, such as hormone receptor positivity. For female estrogen receptor positive (ER+) breast cancers, the standard of care includes three classes of endocrine therapies: selective estrogen receptor modulators, aromatase inhibitors, and pure anti-estrogens. In contrast to female ER+ breast cancers, there is less known about the optimal treatment for male ER+ BC. Furthermore, in contrast to ER, less is known about the role of the androgen receptor (AR) in male and female BC. We report here the treatment of a 28-year-old man with metastatic AR+, ER+ breast cancer otherwise refractory to chemotherapy, who has had a durable clinical response to hormonal suppression with the combination of aromatase inhibition (Letrozole) in conjunction with a GnRH agonist (Leuprolide).
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Affiliation(s)
- Jason Zhu
- Department of Medicine, Duke University Medical Center, Durham, NC 27710, United States
| | - Carter T Davis
- Duke Cancer Institute, Division of Medical Oncology, Department of Medicine, Duke University Medical Center, DUMC 3841, Durham, NC 27710, United States
| | - Sandra Silberman
- Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States
| | - Neil Spector
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, United States
| | - Tian Zhang
- Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, DUMC 103861, Durham, NC 27710, United States.
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Breast cancer risk factors. MENOPAUSE REVIEW 2015; 14:196-202. [PMID: 26528110 PMCID: PMC4612558 DOI: 10.5114/pm.2015.54346] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 07/03/2015] [Accepted: 07/16/2015] [Indexed: 12/13/2022]
Abstract
Breast cancer is the most frequently diagnosed neoplastic disease in women around menopause often leading to a significant reduction of these women's ability to function normally in everyday life. The increased breast cancer incidence observed in epidemiological studies in a group of women actively participating in social and professional life implicates the necessity of conducting multidirectional studies in order to identify risk factors associated with the occurrence of this type of neoplasm. Taking the possibility of influencing the neoplastic transformation process in individuals as a criterion, all the risk factors initiating the process can be divided into two groups. The first group would include inherent factors such as age, sex, race, genetic makeup promoting familial occurrence of the neoplastic disease or the occurrence of benign proliferative lesions of the mammary gland. They all constitute independent parameters and do not undergo simple modification in the course of an individual's life. The second group would include extrinsic factors conditioned by lifestyle, diet or long-term medical intervention such as using oral hormonal contraceptives or hormonal replacement therapy and their influence on the neoplastic process may be modified to a certain degree. Identification of modifiable factors may contribute to development of prevention strategies decreasing breast cancer incidence.
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Wang H, Wang B, Zhu W, Yang Z. Lentivirus-Mediated Knockdown of Myosin VI Inhibits Cell Proliferation of Breast Cancer Cell. Cancer Biother Radiopharm 2015; 30:330-5. [PMID: 26407123 DOI: 10.1089/cbr.2014.1759] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Myosin VI (MYO6) is a unique member of the myosin superfamily, and almost no experimental studies link MYO6 to tumorigenesis of breast cancer. However, previous microarray data demonstrated that MYO6 was frequently overexpressed in breast cancer tissues. In this study, to further develop its role in breast cancer, endogenous expression of MYO6 was significantly inhibited in breast cancer ZR-75-30 and MDA-MB-231 cells using lentivirus-mediated RNA interference. Quantitative polymerase chain reaction and western blot were applied to detect the expression level of MYO6. Cell viability of both cell lines was measured by methylthiazol tetrazolium and colony formation assays. Besides, cell cycle assay was utilized to acquire the distribution information of cell phase. The results demonstrated that knockdown of MYO6 markedly reduced cell viability and colony formation, as well as suppressed cell cycle progression in breast cancer cells. The results suggested that MYO6 played a vital role in breast cancer cells and might provide useful information for diagnosis and therapy of human breast cancer in future.
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Affiliation(s)
- Hong Wang
- 1 Department of General Surgery, Zhongshan Hospital, Fudan University , Shanghai, China
| | - Biyun Wang
- 2 Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wei Zhu
- 1 Department of General Surgery, Zhongshan Hospital, Fudan University , Shanghai, China
| | - Ziang Yang
- 1 Department of General Surgery, Zhongshan Hospital, Fudan University , Shanghai, China
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