Objective： To study the biological characteristics, the therapeutic procedure and the prognosis of male breast cancer. Methods： 34 patients with male breast cancer were retrospectively analyzed, who were diagnosed a...Objective： To study the biological characteristics, the therapeutic procedure and the prognosis of male breast cancer. Methods： 34 patients with male breast cancer were retrospectively analyzed, who were diagnosed and treated in the First Hospital of Jilin University between 1980 and March 2005. Results： Clinical TNM stage of the patients were stage Ⅰ, 6 patients, stage Ⅱ, 24 patients and stage Ⅲ, 4 patients＇. Positive lymph nodes were found in 35.3% of the patients. All these patients received modified radical mastectomy. The 5-year survival rate was 65.3%. Postoperation recurrence rate was 11.8%. Conclusions： Patients with male breast cancer should receive surgical treatment, assisted with adjuvant treatment, such as radiotherapy, chemotherapy, endocrine therapy and so on. TNM stage and expression of hormone receptor may be the main factors affecting the prognosis.展开更多
Expression of oncogene and anti-oncogene products in 12 cases of male breast carcinoma was studied.Positive staining was seen in 6 cases for c-myc,6 cases for EGFR.4 cases for c-erbB-2 cases for N-ras,5 cases for Rb a...Expression of oncogene and anti-oncogene products in 12 cases of male breast carcinoma was studied.Positive staining was seen in 6 cases for c-myc,6 cases for EGFR.4 cases for c-erbB-2 cases for N-ras,5 cases for Rb and 3 cases for P53.One case was positive and 4 cases were negative for all above mentioned oncogene and antioncogene products.In addition,Cathepsin D(Cath-D),ER.PR,AR.PCNA and AgNOR were also assayed.In all the cases showed c-erbB-2 or P53 positive were Cath-D positive.The significance of expression of c-erbB-2,c-myc,Cath-D,ER and PR in male breast carcinoma was emphatically discussed.展开更多
Objective:Male breast cancer(MBC) represents < 1% of all breast cancers.Hormone receptors and Her-2/neu status are established prognostic factors in female breast cancer but not yet studied enough in male breast ca...Objective:Male breast cancer(MBC) represents < 1% of all breast cancers.Hormone receptors and Her-2/neu status are established prognostic factors in female breast cancer but not yet studied enough in male breast cancer.The aim of the study was to verify the clinico-pathologic profile of male patients with breast cancer including analysis of hormone receptors and Her-2/neu state and its impact on survival rate.Methods:This is a retrospective study carried on a total of 123 male patients presented to the National Cancer Institute(NCI),Cairo University,Egypt-with breast carcinoma from January 1999 to December 2009.Results:The patients had a median age of 58(ranged from 29-92) years.About 39.8% of the patients presented with T4 lesion.At presentation,12.2% of the cases had metastasis with bone represented 86.7% of metastatic sites.About 92.7% of patients were subjected to modified radical mastectomy and radical mastectomy.Invasive duct carcinoma reported in 91.1%,and 76.4% of the patients had grade II pathology.Hormone profile was reported in 74% of the patients with 71.4% positive ER and 69.2% positive PR.Among 57 cases tested for Her-2/neu,10.5% were positive.Luminal A was the most common subtype detected in male breast carcinoma patients constituting 66.7%.Comparison with female patients with breast carcinoma revealed some differences regarding stage,hormone profile,Her-2/neu status and breast cancer subtypes.Chemotherapy as adjuvant,neo-adjuvant and metastatic was given for 73.1%,17.3% and 9.6% of the cases,with 83% of them had an anthracyclin-containing regimen.Sixty-nine patients received radiation treatment,65.2% and 34.8% of them with adjuvant and palliative aim,respectively.Dose of adjuvant radiotherapy had a median value of 4410(3400-5000) cGy.Adjuvant hormonal treatment(Tamoxafin) was given for 47 patients all of them with ER and/or PR positive for a median period of 33.5(4-60) months.The 5-year overall survival(OS),loco-regional control(LRC),metastasis-free survival(MFS) rates were 63%,68%,and 62%,respectively.Axillary lymph node metastasis and advanced tumor stage significantly worsen all survival rates.While,higher grade was associated with a poor overall survival,this was not reflected on LRC and MFS rates.Adjuvant radiotherapy and chemotherapy had significantly improved all survival rates.Conclusion:Some gender differences were detected regarding stage,hormone profile,Her-2 state,and tumor subtypes.展开更多
Background:?Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases;hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-nega...Background:?Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases;hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-negative and human epithelial growth factor Receptor type 2-positive breast cancer is?extremely low among male breast cancer.?A patient with advanced HER2 type breast cancer, a rare male breast cancer, was successfully treated with pertuzumab, trastuzumab, and eribulin therapy. Case Presentation:?A 75-?year-old man presented to our hospital with induration of the right anterior chest and lymphoedema of the right upper limb. Based on the results of core needle biopsy, he was diagnosed with HER2 type invasive ductal carcinoma associated with bone metastasis (stage IV). Chemotherapy with pertuzumab, trastuzumab, and eribulin was started. The drugs were remarkably effective, and his lymphoedema tended to improve.?Conclusion:?We reported a successful case of chemotherapy and targeted therapy for a rare male breast cancer of HER2 positive and hormone negative type.展开更多
Objective: To review presentation, diagnosis, treatment and prognosis of male breast cancer. Method: A systematic review of the English language literature between 1990 and 2013 was conducted to identify studies relev...Objective: To review presentation, diagnosis, treatment and prognosis of male breast cancer. Method: A systematic review of the English language literature between 1990 and 2013 was conducted to identify studies relevant to the objective. Searches were carried out on the database PubMed, by using the title term “male breast cancer”. Results: The majority of male patients present with a painless, firm, subareolar lump. Experience of male breast imaging is good but limited. However, there is no definitive therapeutic algorithm. Men are often treated with mastectomy instead of breast conserving surgery and mostly tamoxifen is used as an adjuvant therapy. The most important prognostic factors are tumor size and lymph node status in the armpit. Conclusion: More increased awareness and further research are needed to improve the diagnosis and treatment of this disease.展开更多
Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of...Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lomé. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.展开更多
Aims: Male breast cancer represents - mor aggressiveness and drug resistance. CSCs are characterized by CD44 and/or ALDH1 expression. In this study, we investigated their expression in male breast cancer. Method: Two ...Aims: Male breast cancer represents - mor aggressiveness and drug resistance. CSCs are characterized by CD44 and/or ALDH1 expression. In this study, we investigated their expression in male breast cancer. Method: Two in situ ductal carcinoma (DCIS) and 18 invasive duc- tal carcinoma (IDC) male breast cancer cases were studied with Jefferson IRB approval. Membrane staining of CD44 was scored by the percentage of positivity. Cytoplasmic expression of ALDH1 was considered positive. Results: Ten cases had high CD44 expression, which were all IDC. Both DCIS and in situ component of IDC were CD44 low. ALDH1 was only positive in 15 IDCs. ALDH1+ cells were mostly in the invasive component. Both DCIS cases were negative for ALDH1. Among the 15 ALDH1+ IDCs, five with only invasive component had a higher percentage (aver- age 4.4%) of positive cells compared to the other eight with in situ components (average 2.0%). Metastatic cells in sen- tinel lymph nodes had a similar expression pattern of CD44 and ALDH1 as their primary tumor. Conclusion: CD44 and ALDH1 are expressed in male breast cancers and they are overexpressed in invasive cancer compared to carcinoma in situ. These findings suggest that CSCs play an important role in the progression to invasive carcinoma.展开更多
Objective: To describe the radiological and histological aspects of breast nodules among men in our practice setting. Methodology: This is a descriptive and retrospective study conducted from January 2014 to October 2...Objective: To describe the radiological and histological aspects of breast nodules among men in our practice setting. Methodology: This is a descriptive and retrospective study conducted from January 2014 to October 2017. The study included male patients with breast nodules classified ACR3, 4 or 5 after a mammographic and ultrasound scan. These lesions were explored through an ultrasound-guided breast microbiopsy. The following are the variables collected: age, family history of breast cancer, medical history, ACR classification, nodule size, and anatomopathologic diagnosis. Results: 13 breast nodules were explored among 13 male subjects. Mammography and breast ultrasound enabled to identify one ACR3 lesion, 10 ACR4 lesions and 2 ACR5 lesions. The average age was 56.53 ± 14.63 years and the average size of the nodules 28.91 ± 13.62 mm. As for histology, there were seven malignant tumors and six benign tumors. The average age of patients with malignancy was 61.45 ± 13.62 years. The malignant nodules average size was 29.45 ± 12.54 mm. Malignant tumors exclusively consisted of invasive breast carcinomas while Benign ones consisted of dystrophic and inflammatory lesions. Conclusion: Most often Breast lesions among men had an indeterminate appearance on imaging and were predominantly malignant in histopathology.展开更多
Introduction: Male breast cancer is rare;representing 1% of breast cancers and less than 1% of all male neoplasia worldwide. We here analyzed the clinical, histological, therapeutic and prognostic characteristics of m...Introduction: Male breast cancer is rare;representing 1% of breast cancers and less than 1% of all male neoplasia worldwide. We here analyzed the clinical, histological, therapeutic and prognostic characteristics of male breast cancer in Bamako, Mali. Patients and methods: A retrospective descriptive study was conducted on 14 male patients with breast cancer who visited two university hospitals in Bamako (Hospital Gabriel TOURE and Hospital du Point G) in Mali, from January 2005 to December 2018. Results: Male breast cancer represented 0.63% of all breast cancers and 0.23% of all male cancers. The following was observed: the mean age of 53 years (range: 23 - 82);a family history of cancer in 2;breast pain in 9;the average time to consultation of 8 years (6 - 24);gynecomastia found in 1;the tumor palpable in all 14 (size of 5 cm [3 - 10]);ulceration in 5. The most common histological type was non-specific infiltrating carcinoma with 92.8%. SBR II grade was found in 78.5% of cases. Of 8 patients with immunohistochemistry, hormone receptor positive was in 13 and Her2 positive was in 5. Metastases were found in 4, 2 pulmonary and 2 hepatic. Treatment: Neoadjuvant chemotherapy in 21.4%;radical surgery in 13 cases;surgery + radiotherapy in 2;surgery + hormonal therapy in 4. After an average follow-up of 36 months, 1 patient developed a lung metastasis and another patient had a lymph node recurrence. Conclusion: Male breast cancer was detected at relatively later stages. Physicians must be aware of this condition.展开更多
Backgroud It is not clear if there is a difference in prognosis between male breast cancer （MBC） and female breast cancer （FBC） patients. The aim of this study was to compare the prognosis of MBC and FBC patients ...Backgroud It is not clear if there is a difference in prognosis between male breast cancer （MBC） and female breast cancer （FBC） patients. The aim of this study was to compare the prognosis of MBC and FBC patients in China and the prognosis of MBC and their corresponding postmenopausal FBC patients.Methods Thirty-five MBC patients who were treated at the Sun Yat-sen University Cancer Center between 1969 and 2004 were enrolled in the study. Seventy FBC patients who were matched with the MBC patients for TNM stage, year of diagnosis, and age at diagnosis were simultaneously enrolled in the study. A second group comprising 18 MBC patients and their corresponding 36 matched postmenopausal FBC patients were also enrolled. The whole group and the postmenopausal groups were compared for five- and ten-year survivals. Results All the factors that could potentially affect prognosis were comparable among the groups except more FBC than MBC patients underwent endocrine therapy and a modified radical mastectomy. The 5- and 10-year survivals in the whole group were 81.6% and 60.3% for men and 90.7% and 73.5% for women （P=0.02）. The 5- and 10-year survival in the postmenopausal group was 82.5% and 100% for men and 66.0% and 85.9% for women （P=0.159）.Conclusions Chinese FBC patients had a better prognosis than Chinese MBC patients. However, MBC patients and their corresponding postmenopausal FBC patients had a similar prognosis.展开更多
Objective： Male breast cancer （MBC） is a rare disease, and studies to compare the prognosis between the MBC and female breast cancer （FBC） available now were case-control studies and population-based studies, how...Objective： Male breast cancer （MBC） is a rare disease, and studies to compare the prognosis between the MBC and female breast cancer （FBC） available now were case-control studies and population-based studies, however, with controversial outcomes. To further investigate whether sex affects the prognosis of breast cancer, we performed a meta-analysis based on all the peered papers. Methods： The PubMed database was screened. Subsequently, the hazard ratios （HRs） for overall survival （OS） and disease special survival （DSS）, were pooled using the Review Manager 5.0 package. Results： This study comprised of 254 MBC and 733 FBC patients enrolled in six case-control studies. There was no statistically significant heterogeneity among the trials for either outcome variable. The pooled HR showed that there was no significant difference in 5-year or 10-year DSS （HR： 1.25, 95% CI： 0.76-2.08; HR： 1.04, 95% CI： 0.68-1.5g） and 5-year or 10-year OS （HR： 0.76, 95% CI： 0.51-1.14; HR： 0.74, 95% CI： 0.54-1.02） between MBCs and FBCs. Conclusion： MBC and FBC with similar prognosis are found in this meta-analysis based on only case-control studies which matched main potential prognostic factors such as age, clinical stage, and time at diagnosis.展开更多
Objective:The extremely low incidence of male breast cancer (MBC) leads to lack of prospective randomized phase III studies worldwide. Especially in China,all studies on Chinese patients with MBC were based on small s...Objective:The extremely low incidence of male breast cancer (MBC) leads to lack of prospective randomized phase III studies worldwide. Especially in China,all studies on Chinese patients with MBC were based on small sample size and single institute experience. The aim of this study was to provide overall view of characteristics of Chinese patients with MBC by means of summarizing all related papers published in Chinese journals. Methods: An online search was made in CBM,VIP,CNKI,and CBA databases to find all published articles of interest on Chinese patients with MBC. And eight subjects including the proportion of MBC in all breast cancer,age,tumor location,clinical stages,pathological subtypes,treatment modalities,ER/PR expression,and 5-year survival rate were selected to calculate the proportion and their 95% interval confidence. Results: There were 122 papers with 2584 patients enrolled. The basic features of Chinese patients with MBC included:(1) MBC only with a proportion of 1.06% of all the breast cancer; (2) The mean age at diagnosis was 57.6 years old; (3) Tumor mainly located in the areolar region (74.83%) with obvious nipple and/or skin involvement; (4) Nearly 62.62% patients were in early stage before accepting treatment; (5) Infiltrating ductal carcinoma accounted for 79.05% of all pathological subtypes; (6) ER/PR expression rate was 65.86%; (7) Radical resection was up to 86.06% in all surgical modalities; (8) The 5-year survival rate was 57.33%. Conclusion: The results showed in this study were an overall view of Chinese patients with MBC whose characteristics were similar to that reported in the West. Though this study provided a little bit stronger confidence than a single study collected in this paper,studies with more powerful evidence are urgently demanding in China.展开更多
BACKGROUND Breast cancer(BC)frequency in males is extremely low and tumor features vary from its female counterpart.Breast cancer clinical and pathological features differ by race in women.Tumor infiltrating lymphocyt...BACKGROUND Breast cancer(BC)frequency in males is extremely low and tumor features vary from its female counterpart.Breast cancer clinical and pathological features differ by race in women.Tumor infiltrating lymphocyte(TIL)levels,mismatch repair(MMR)protein loss,androgen receptor(AR)expression,and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC.There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC.AIM To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population.METHODS This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018.Standard pathological features,TIL levels,MMR proteins,AR immunohistochemistry staining,and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material.Percentage of AR and estrogen receptor(ER)positive cells was additionally calculated by software after slide scanning.Statistical analyses included association tests,intraclass correlation test and Kaplan Meier overall survival curves.RESULTS The median age was 63 years and most cases were ER-positive(85.7%),HER2 negative(87.2%),Luminal-A phenotype(60%)and clinical stage II(41.5%)among our male breast tumors.Median TIL was 10%and higher levels tended to be associated with Luminal-B phenotype and higher grade.AR-positive was found in 85.3%and was correlated with ER(intraclass index of 0.835,P<0.001).Loss of MMR proteins was found in 15.4%and PIK3CA mutation(H1047R)in 14.3%(belonged to the Luminal-A phenotype).Loss of MMR proteins was associated with AR-negative(P=0.018)but not with ER(P=0.43)or TIL(P=0.84).Early stages(P<0.001)and lower grade(P=0.006)were associated with longer overall survival.ER status,phenotype,AR status,TIL level,MMR protein loss nor PIK3CA mutation was not associated with survival(P>0.05).CONCLUSION Male BC is usually ER and AR positive,and Luminal-A.MMR loss and PIK3CA mutations are infrequent.Stage and grade predicted overall survival in our South American country population.展开更多
Background: Carcinoma of the male breast is relatively a rare disease accounting for about 1% of all cancer in men. Its treatments are based mainly on those of Female Breast Cancer (BCF). Materials and Methods: This i...Background: Carcinoma of the male breast is relatively a rare disease accounting for about 1% of all cancer in men. Its treatments are based mainly on those of Female Breast Cancer (BCF). Materials and Methods: This is a single institution retrospective study including all presenting to the NCI, Cairo University with Breast Cancer in a Male (BCM) in the last 11 years between Jan. 2005 until Jan. 2016. Data were collected from patient’s files from the statistical department then analyzed. Aims: To study the clinico-pathological characteristics, the presentation, workup, surgical approaches and postoperative complications and outcome of management, with addressing similarities and difference from BCF. Results: 64 patients were included in this cohort. The mean age was 58.6 & the median age was 59 years (range: 31 - 87 years). The main presenting symptomatology was retroareolar breast lump (50 cases, 78.1%). Most of our cases were advanced;22 cases (34.3%) were stage III & 16 cases (25%) were stage IV. Surgery was performed for 50 patients;MRM for 26 cases (40.6%), RM for 18 cases (28.1%) & toilet mastectomy for 6 cases (9.3%). Primary closure was feasible in 34 patients (68%) while 16 cases (32%) required reconstruction by local or pedicled flaps. Tamoxifen is the most important non-surgical treatment. It was given to all our cases (64 cases, 100%) either postoperatively as adjuvant management (36 cases, 56.2%) or as palliation for metastatic disease (28 cases, 43.8%). Chemotherapy was given to 32 patients (100%) as an adjuvant for 24 cases (75%) and as a palliation for 8 cases (25%). Radiotherapy was given to 26 patients (100%) as adjuvant therapy for 20 cases (76.9%) and as a palliation for 6 cases (23.1%). The only significant factor determining the overall 5 years survival was the stage of the disease. LN status & surgery type were of border line significance (better survival with negative LN & with MRM). The 5-year Overall Survival (OS) & Disease Free Survival (DFS) for the whole group were 66% & 52% respectively. Within the DFS there was no significant variable;however, the stage and type of surgery were of borderline significance, with better survival with early stage disease (I & II) and with MRM (both were 61%). Conclusion: BCM has many similarities to BCF, but it harbours many different genetic and pathologic features. They obtain similar prognostic factors and similar stage-for-stage survival. They are always advanced to T4 stage rapidly due to the lack of breast parenchyma with higher ER expression in BCM than BCF patients.展开更多
Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed ...Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.展开更多
Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented...Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors(both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical(non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; p T3(10 cm), p N0(0/15), M0,R0; Oncotype DX Recurrence Score indicated low risk(RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.展开更多
Background: It is estimated that 2240 males in the United States will develop invasive breast cancer (BC) in 2013, resulting in 410 deaths. Overall, male breast cancers (MBCs) are diagnosed with larger tumor size, mor...Background: It is estimated that 2240 males in the United States will develop invasive breast cancer (BC) in 2013, resulting in 410 deaths. Overall, male breast cancers (MBCs) are diagnosed with larger tumor size, more frequent lymphatic invasion, and advanced tumor stage compared to their female counterparts. Several risk factors have been elucidated for the development of MBC, and this paper aims to critically review the existing literature on at-risk populations and provide screening recommendations. Methods: A comprehensive search for all published studies on populations at risk for MBC using PubMed, EBSCOhost, and Google Scholar was performed (1982- 2013). The search focused specifically on genetic and epidemiologic risk factors, and screening for MBC. Keywords searched included “male breast cancer risk factors”, “male breast cancer epidemiology”, and “male breast cancer genetics”. A total of 34 studies involving 4,865,819 patients were identified. Results: Five studies (N = 327,667) focused primarily on family history of breast cancer as a risk factor for MBC. 15% - 20% of men with BC have a family history of breast or ovarian cancer, and a family history of BC among first-degree relatives confers a 2-to 3-fold increase in MBC risk (odds ratio = 3.3). Seventeen studies (N = 5451) analyzed associations between several heritable genes and MBC. Lifetime MBC risk among BRCA1 mutation carriers is 1% - 5%, while MBC risk in BRCA2 mutation carriers is higher and varies between 4% - 40%. Less clear associations between MBC and PALB2, Androgen Receptor gene, CYP17, and CHEK2 mutations have also been documented. Five studies (N = 16,667) have addressed occupational risk factors for MBC. An 8-fold increase in MBC is reported in males working in the cosmetic cream manufacturing, and the motor vehicle industries. A meta-analysis of 18 trials also identified electromagnetic field exposure as a potential MBC risk, though causation remains undocumented. Eleven studies (N = 4,843,598) analyzed the role of abnormalities in the androgen-to-estrogen ratio as a risk factor for MBC. Conditions associated with increased MBC risk include Klinefelter’s syndrome (relative risk, RR = 29.64), obesity (RR = 1.98), orchitis/epididymitis (RR = 1.84), and gynecomastia (RR = 5.86). Conclusion: Routine screening for MBC should be considered in all high risk male populations, including those with a prior history of breast carcinoma, a strong family history of BC (defined as an affected mother or sister), a positive BRCA2 mutation status (regardless of family history), and men diagnosed with Klinefelter’s syndrome, or those in the chemical or motor vehicle industries. Genetic testing for BRCA2 should be recommended for all MBC patients. Increased public and physician education on MBC is necessary to raise awareness about this rare disease and the need for screening of at-risk populations.展开更多
目的探讨常规超声联合弹性超声在男性乳腺癌中的预测价值。方法纳入男性乳腺肿瘤患者105例,共108个病灶(良性肿块53个,恶性肿块55个)。对乳腺肿块行常规超声及弹性超声检查,应用单因素及多因素Logistic回归分析男性乳腺癌的独立预测因...目的探讨常规超声联合弹性超声在男性乳腺癌中的预测价值。方法纳入男性乳腺肿瘤患者105例,共108个病灶(良性肿块53个,恶性肿块55个)。对乳腺肿块行常规超声及弹性超声检查,应用单因素及多因素Logistic回归分析男性乳腺癌的独立预测因子。将差异有统计学意义的常规超声参数纳入二维超声模型,通过Logistic回归算法联合弹性评分和二维超声模型建立联合模型,并对两种模型的诊断效能进行评估对比。结果患者年龄(P=0.0001)、肿块血流(P=0.0023)、方位(P=0.0075)、弹性评分(P=0.0002)是男性乳腺癌的独立预测因子。联合模型和二维超声模型的曲线下面积(area under the curve,AUC)分别为0.911和0.855,两者比较差异有统计学意义(P=0.0311)。决策曲线分析(decision curve analysis,DCA)结果表明,联合模型在临床上具有较强的实用性。结论弹性评分是男性乳腺癌的独立预测因子,常规超声联合弹性超声可提高男性乳腺癌的诊断效能。展开更多
目的探究男性乳腺癌(male breast cancer,MBC)患者的预后因素,构建MBC患者生存预后列线图并预测3年和5年生存率。方法纳入监测、流行病学和最终结果(Surveillance,Epidemiology,and End Results,SEER)癌症登记数据库的MBC患者,同时纳入...目的探究男性乳腺癌(male breast cancer,MBC)患者的预后因素,构建MBC患者生存预后列线图并预测3年和5年生存率。方法纳入监测、流行病学和最终结果(Surveillance,Epidemiology,and End Results,SEER)癌症登记数据库的MBC患者,同时纳入川北医学院附属医院、遂宁市中心医院和德阳市人民医院的MBC患者,获取患者完整的临床基线资料及生存信息。以SEER数据库中患者数据作为训练集,3家医院中的患者数据作为验证集,通过单因素和多因素Cox回归分析确定与总生存期(overall survival,OS)相关的独立预后因素,并构建预测MBC患者3年及5年生存率的列线图,运用校准曲线、一致性指数(CI)、受试者工作特征曲线(ROC)和决策分析曲线来评估模型的准确程度和实际应用价值。结果共纳入3387名MBC患者,其中训练集3307例,验证集80例。通过对训练集进行单因素和多因素Cox回归分析后发现,诊断年龄、组织学分级、T分期、N分期、M分期、孕激素受体状态、手术、化疗和放疗是影响MBC患者OS的独立预后因素。将这些因素纳入并构建列线图模型并进行验证,训练集CI为0.711,验证集CI为0.787。训练集中,3年OS的AUC为0.744,5年OS的AUC为0.720;验证集中,3年OS的AUC为0.835,5年OS的AUC为0.858。ROC曲线表明模型区分能力较好,校准曲线显示模型预测性能良好,决策分析曲线表明模型的临床应用价值较高。结论开发的列线图为预测MBC患者的预后提供了一种可靠且实用的方法,有助于个性化治疗决策,改善患者的治疗效果。展开更多
基金This work was supported by a grant from Canada International Development Agency (CIDA) (No. PSCLU 010-282/19156).
文摘Objective： To study the biological characteristics, the therapeutic procedure and the prognosis of male breast cancer. Methods： 34 patients with male breast cancer were retrospectively analyzed, who were diagnosed and treated in the First Hospital of Jilin University between 1980 and March 2005. Results： Clinical TNM stage of the patients were stage Ⅰ, 6 patients, stage Ⅱ, 24 patients and stage Ⅲ, 4 patients＇. Positive lymph nodes were found in 35.3% of the patients. All these patients received modified radical mastectomy. The 5-year survival rate was 65.3%. Postoperation recurrence rate was 11.8%. Conclusions： Patients with male breast cancer should receive surgical treatment, assisted with adjuvant treatment, such as radiotherapy, chemotherapy, endocrine therapy and so on. TNM stage and expression of hormone receptor may be the main factors affecting the prognosis.
文摘Expression of oncogene and anti-oncogene products in 12 cases of male breast carcinoma was studied.Positive staining was seen in 6 cases for c-myc,6 cases for EGFR.4 cases for c-erbB-2 cases for N-ras,5 cases for Rb and 3 cases for P53.One case was positive and 4 cases were negative for all above mentioned oncogene and antioncogene products.In addition,Cathepsin D(Cath-D),ER.PR,AR.PCNA and AgNOR were also assayed.In all the cases showed c-erbB-2 or P53 positive were Cath-D positive.The significance of expression of c-erbB-2,c-myc,Cath-D,ER and PR in male breast carcinoma was emphatically discussed.
文摘Objective:Male breast cancer(MBC) represents < 1% of all breast cancers.Hormone receptors and Her-2/neu status are established prognostic factors in female breast cancer but not yet studied enough in male breast cancer.The aim of the study was to verify the clinico-pathologic profile of male patients with breast cancer including analysis of hormone receptors and Her-2/neu state and its impact on survival rate.Methods:This is a retrospective study carried on a total of 123 male patients presented to the National Cancer Institute(NCI),Cairo University,Egypt-with breast carcinoma from January 1999 to December 2009.Results:The patients had a median age of 58(ranged from 29-92) years.About 39.8% of the patients presented with T4 lesion.At presentation,12.2% of the cases had metastasis with bone represented 86.7% of metastatic sites.About 92.7% of patients were subjected to modified radical mastectomy and radical mastectomy.Invasive duct carcinoma reported in 91.1%,and 76.4% of the patients had grade II pathology.Hormone profile was reported in 74% of the patients with 71.4% positive ER and 69.2% positive PR.Among 57 cases tested for Her-2/neu,10.5% were positive.Luminal A was the most common subtype detected in male breast carcinoma patients constituting 66.7%.Comparison with female patients with breast carcinoma revealed some differences regarding stage,hormone profile,Her-2/neu status and breast cancer subtypes.Chemotherapy as adjuvant,neo-adjuvant and metastatic was given for 73.1%,17.3% and 9.6% of the cases,with 83% of them had an anthracyclin-containing regimen.Sixty-nine patients received radiation treatment,65.2% and 34.8% of them with adjuvant and palliative aim,respectively.Dose of adjuvant radiotherapy had a median value of 4410(3400-5000) cGy.Adjuvant hormonal treatment(Tamoxafin) was given for 47 patients all of them with ER and/or PR positive for a median period of 33.5(4-60) months.The 5-year overall survival(OS),loco-regional control(LRC),metastasis-free survival(MFS) rates were 63%,68%,and 62%,respectively.Axillary lymph node metastasis and advanced tumor stage significantly worsen all survival rates.While,higher grade was associated with a poor overall survival,this was not reflected on LRC and MFS rates.Adjuvant radiotherapy and chemotherapy had significantly improved all survival rates.Conclusion:Some gender differences were detected regarding stage,hormone profile,Her-2 state,and tumor subtypes.
文摘Background:?Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases;hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-negative and human epithelial growth factor Receptor type 2-positive breast cancer is?extremely low among male breast cancer.?A patient with advanced HER2 type breast cancer, a rare male breast cancer, was successfully treated with pertuzumab, trastuzumab, and eribulin therapy. Case Presentation:?A 75-?year-old man presented to our hospital with induration of the right anterior chest and lymphoedema of the right upper limb. Based on the results of core needle biopsy, he was diagnosed with HER2 type invasive ductal carcinoma associated with bone metastasis (stage IV). Chemotherapy with pertuzumab, trastuzumab, and eribulin was started. The drugs were remarkably effective, and his lymphoedema tended to improve.?Conclusion:?We reported a successful case of chemotherapy and targeted therapy for a rare male breast cancer of HER2 positive and hormone negative type.
文摘Objective: To review presentation, diagnosis, treatment and prognosis of male breast cancer. Method: A systematic review of the English language literature between 1990 and 2013 was conducted to identify studies relevant to the objective. Searches were carried out on the database PubMed, by using the title term “male breast cancer”. Results: The majority of male patients present with a painless, firm, subareolar lump. Experience of male breast imaging is good but limited. However, there is no definitive therapeutic algorithm. Men are often treated with mastectomy instead of breast conserving surgery and mostly tamoxifen is used as an adjuvant therapy. The most important prognostic factors are tumor size and lymph node status in the armpit. Conclusion: More increased awareness and further research are needed to improve the diagnosis and treatment of this disease.
文摘Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lomé. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.
文摘Aims: Male breast cancer represents - mor aggressiveness and drug resistance. CSCs are characterized by CD44 and/or ALDH1 expression. In this study, we investigated their expression in male breast cancer. Method: Two in situ ductal carcinoma (DCIS) and 18 invasive duc- tal carcinoma (IDC) male breast cancer cases were studied with Jefferson IRB approval. Membrane staining of CD44 was scored by the percentage of positivity. Cytoplasmic expression of ALDH1 was considered positive. Results: Ten cases had high CD44 expression, which were all IDC. Both DCIS and in situ component of IDC were CD44 low. ALDH1 was only positive in 15 IDCs. ALDH1+ cells were mostly in the invasive component. Both DCIS cases were negative for ALDH1. Among the 15 ALDH1+ IDCs, five with only invasive component had a higher percentage (aver- age 4.4%) of positive cells compared to the other eight with in situ components (average 2.0%). Metastatic cells in sen- tinel lymph nodes had a similar expression pattern of CD44 and ALDH1 as their primary tumor. Conclusion: CD44 and ALDH1 are expressed in male breast cancers and they are overexpressed in invasive cancer compared to carcinoma in situ. These findings suggest that CSCs play an important role in the progression to invasive carcinoma.
文摘Objective: To describe the radiological and histological aspects of breast nodules among men in our practice setting. Methodology: This is a descriptive and retrospective study conducted from January 2014 to October 2017. The study included male patients with breast nodules classified ACR3, 4 or 5 after a mammographic and ultrasound scan. These lesions were explored through an ultrasound-guided breast microbiopsy. The following are the variables collected: age, family history of breast cancer, medical history, ACR classification, nodule size, and anatomopathologic diagnosis. Results: 13 breast nodules were explored among 13 male subjects. Mammography and breast ultrasound enabled to identify one ACR3 lesion, 10 ACR4 lesions and 2 ACR5 lesions. The average age was 56.53 ± 14.63 years and the average size of the nodules 28.91 ± 13.62 mm. As for histology, there were seven malignant tumors and six benign tumors. The average age of patients with malignancy was 61.45 ± 13.62 years. The malignant nodules average size was 29.45 ± 12.54 mm. Malignant tumors exclusively consisted of invasive breast carcinomas while Benign ones consisted of dystrophic and inflammatory lesions. Conclusion: Most often Breast lesions among men had an indeterminate appearance on imaging and were predominantly malignant in histopathology.
文摘Introduction: Male breast cancer is rare;representing 1% of breast cancers and less than 1% of all male neoplasia worldwide. We here analyzed the clinical, histological, therapeutic and prognostic characteristics of male breast cancer in Bamako, Mali. Patients and methods: A retrospective descriptive study was conducted on 14 male patients with breast cancer who visited two university hospitals in Bamako (Hospital Gabriel TOURE and Hospital du Point G) in Mali, from January 2005 to December 2018. Results: Male breast cancer represented 0.63% of all breast cancers and 0.23% of all male cancers. The following was observed: the mean age of 53 years (range: 23 - 82);a family history of cancer in 2;breast pain in 9;the average time to consultation of 8 years (6 - 24);gynecomastia found in 1;the tumor palpable in all 14 (size of 5 cm [3 - 10]);ulceration in 5. The most common histological type was non-specific infiltrating carcinoma with 92.8%. SBR II grade was found in 78.5% of cases. Of 8 patients with immunohistochemistry, hormone receptor positive was in 13 and Her2 positive was in 5. Metastases were found in 4, 2 pulmonary and 2 hepatic. Treatment: Neoadjuvant chemotherapy in 21.4%;radical surgery in 13 cases;surgery + radiotherapy in 2;surgery + hormonal therapy in 4. After an average follow-up of 36 months, 1 patient developed a lung metastasis and another patient had a lymph node recurrence. Conclusion: Male breast cancer was detected at relatively later stages. Physicians must be aware of this condition.
文摘Backgroud It is not clear if there is a difference in prognosis between male breast cancer （MBC） and female breast cancer （FBC） patients. The aim of this study was to compare the prognosis of MBC and FBC patients in China and the prognosis of MBC and their corresponding postmenopausal FBC patients.Methods Thirty-five MBC patients who were treated at the Sun Yat-sen University Cancer Center between 1969 and 2004 were enrolled in the study. Seventy FBC patients who were matched with the MBC patients for TNM stage, year of diagnosis, and age at diagnosis were simultaneously enrolled in the study. A second group comprising 18 MBC patients and their corresponding 36 matched postmenopausal FBC patients were also enrolled. The whole group and the postmenopausal groups were compared for five- and ten-year survivals. Results All the factors that could potentially affect prognosis were comparable among the groups except more FBC than MBC patients underwent endocrine therapy and a modified radical mastectomy. The 5- and 10-year survivals in the whole group were 81.6% and 60.3% for men and 90.7% and 73.5% for women （P=0.02）. The 5- and 10-year survival in the postmenopausal group was 82.5% and 100% for men and 66.0% and 85.9% for women （P=0.159）.Conclusions Chinese FBC patients had a better prognosis than Chinese MBC patients. However, MBC patients and their corresponding postmenopausal FBC patients had a similar prognosis.
基金Supported by a grant from the Major Science and Technology Project of "National Significant New Drug Creation" (No. 2008ZX09312-002)
文摘Objective： Male breast cancer （MBC） is a rare disease, and studies to compare the prognosis between the MBC and female breast cancer （FBC） available now were case-control studies and population-based studies, however, with controversial outcomes. To further investigate whether sex affects the prognosis of breast cancer, we performed a meta-analysis based on all the peered papers. Methods： The PubMed database was screened. Subsequently, the hazard ratios （HRs） for overall survival （OS） and disease special survival （DSS）, were pooled using the Review Manager 5.0 package. Results： This study comprised of 254 MBC and 733 FBC patients enrolled in six case-control studies. There was no statistically significant heterogeneity among the trials for either outcome variable. The pooled HR showed that there was no significant difference in 5-year or 10-year DSS （HR： 1.25, 95% CI： 0.76-2.08; HR： 1.04, 95% CI： 0.68-1.5g） and 5-year or 10-year OS （HR： 0.76, 95% CI： 0.51-1.14; HR： 0.74, 95% CI： 0.54-1.02） between MBCs and FBCs. Conclusion： MBC and FBC with similar prognosis are found in this meta-analysis based on only case-control studies which matched main potential prognostic factors such as age, clinical stage, and time at diagnosis.
文摘Objective:The extremely low incidence of male breast cancer (MBC) leads to lack of prospective randomized phase III studies worldwide. Especially in China,all studies on Chinese patients with MBC were based on small sample size and single institute experience. The aim of this study was to provide overall view of characteristics of Chinese patients with MBC by means of summarizing all related papers published in Chinese journals. Methods: An online search was made in CBM,VIP,CNKI,and CBA databases to find all published articles of interest on Chinese patients with MBC. And eight subjects including the proportion of MBC in all breast cancer,age,tumor location,clinical stages,pathological subtypes,treatment modalities,ER/PR expression,and 5-year survival rate were selected to calculate the proportion and their 95% interval confidence. Results: There were 122 papers with 2584 patients enrolled. The basic features of Chinese patients with MBC included:(1) MBC only with a proportion of 1.06% of all the breast cancer; (2) The mean age at diagnosis was 57.6 years old; (3) Tumor mainly located in the areolar region (74.83%) with obvious nipple and/or skin involvement; (4) Nearly 62.62% patients were in early stage before accepting treatment; (5) Infiltrating ductal carcinoma accounted for 79.05% of all pathological subtypes; (6) ER/PR expression rate was 65.86%; (7) Radical resection was up to 86.06% in all surgical modalities; (8) The 5-year survival rate was 57.33%. Conclusion: The results showed in this study were an overall view of Chinese patients with MBC whose characteristics were similar to that reported in the West. Though this study provided a little bit stronger confidence than a single study collected in this paper,studies with more powerful evidence are urgently demanding in China.
基金the Consejo Nacional de Ciencia,Tecnologia e Innovacion Tecnologica,No.198-2015-FONDECYT.
文摘BACKGROUND Breast cancer(BC)frequency in males is extremely low and tumor features vary from its female counterpart.Breast cancer clinical and pathological features differ by race in women.Tumor infiltrating lymphocyte(TIL)levels,mismatch repair(MMR)protein loss,androgen receptor(AR)expression,and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC.There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC.AIM To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population.METHODS This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018.Standard pathological features,TIL levels,MMR proteins,AR immunohistochemistry staining,and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material.Percentage of AR and estrogen receptor(ER)positive cells was additionally calculated by software after slide scanning.Statistical analyses included association tests,intraclass correlation test and Kaplan Meier overall survival curves.RESULTS The median age was 63 years and most cases were ER-positive(85.7%),HER2 negative(87.2%),Luminal-A phenotype(60%)and clinical stage II(41.5%)among our male breast tumors.Median TIL was 10%and higher levels tended to be associated with Luminal-B phenotype and higher grade.AR-positive was found in 85.3%and was correlated with ER(intraclass index of 0.835,P<0.001).Loss of MMR proteins was found in 15.4%and PIK3CA mutation(H1047R)in 14.3%(belonged to the Luminal-A phenotype).Loss of MMR proteins was associated with AR-negative(P=0.018)but not with ER(P=0.43)or TIL(P=0.84).Early stages(P<0.001)and lower grade(P=0.006)were associated with longer overall survival.ER status,phenotype,AR status,TIL level,MMR protein loss nor PIK3CA mutation was not associated with survival(P>0.05).CONCLUSION Male BC is usually ER and AR positive,and Luminal-A.MMR loss and PIK3CA mutations are infrequent.Stage and grade predicted overall survival in our South American country population.
文摘Background: Carcinoma of the male breast is relatively a rare disease accounting for about 1% of all cancer in men. Its treatments are based mainly on those of Female Breast Cancer (BCF). Materials and Methods: This is a single institution retrospective study including all presenting to the NCI, Cairo University with Breast Cancer in a Male (BCM) in the last 11 years between Jan. 2005 until Jan. 2016. Data were collected from patient’s files from the statistical department then analyzed. Aims: To study the clinico-pathological characteristics, the presentation, workup, surgical approaches and postoperative complications and outcome of management, with addressing similarities and difference from BCF. Results: 64 patients were included in this cohort. The mean age was 58.6 & the median age was 59 years (range: 31 - 87 years). The main presenting symptomatology was retroareolar breast lump (50 cases, 78.1%). Most of our cases were advanced;22 cases (34.3%) were stage III & 16 cases (25%) were stage IV. Surgery was performed for 50 patients;MRM for 26 cases (40.6%), RM for 18 cases (28.1%) & toilet mastectomy for 6 cases (9.3%). Primary closure was feasible in 34 patients (68%) while 16 cases (32%) required reconstruction by local or pedicled flaps. Tamoxifen is the most important non-surgical treatment. It was given to all our cases (64 cases, 100%) either postoperatively as adjuvant management (36 cases, 56.2%) or as palliation for metastatic disease (28 cases, 43.8%). Chemotherapy was given to 32 patients (100%) as an adjuvant for 24 cases (75%) and as a palliation for 8 cases (25%). Radiotherapy was given to 26 patients (100%) as adjuvant therapy for 20 cases (76.9%) and as a palliation for 6 cases (23.1%). The only significant factor determining the overall 5 years survival was the stage of the disease. LN status & surgery type were of border line significance (better survival with negative LN & with MRM). The 5-year Overall Survival (OS) & Disease Free Survival (DFS) for the whole group were 66% & 52% respectively. Within the DFS there was no significant variable;however, the stage and type of surgery were of borderline significance, with better survival with early stage disease (I & II) and with MRM (both were 61%). Conclusion: BCM has many similarities to BCF, but it harbours many different genetic and pathologic features. They obtain similar prognostic factors and similar stage-for-stage survival. They are always advanced to T4 stage rapidly due to the lack of breast parenchyma with higher ER expression in BCM than BCF patients.
基金ACKNOWLEDGMENTS This study was supported by the National Natural Science Foundation of China （Grants 81472683 and 81202275）, Tianjin Natural Science fund （Grant 13JCQNJC 11000） and Research Seed Foundation of Tianjin Medical University Gancer Hospital and Institute （Grant 1421）.
文摘Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.
文摘Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors(both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical(non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; p T3(10 cm), p N0(0/15), M0,R0; Oncotype DX Recurrence Score indicated low risk(RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.
文摘Background: It is estimated that 2240 males in the United States will develop invasive breast cancer (BC) in 2013, resulting in 410 deaths. Overall, male breast cancers (MBCs) are diagnosed with larger tumor size, more frequent lymphatic invasion, and advanced tumor stage compared to their female counterparts. Several risk factors have been elucidated for the development of MBC, and this paper aims to critically review the existing literature on at-risk populations and provide screening recommendations. Methods: A comprehensive search for all published studies on populations at risk for MBC using PubMed, EBSCOhost, and Google Scholar was performed (1982- 2013). The search focused specifically on genetic and epidemiologic risk factors, and screening for MBC. Keywords searched included “male breast cancer risk factors”, “male breast cancer epidemiology”, and “male breast cancer genetics”. A total of 34 studies involving 4,865,819 patients were identified. Results: Five studies (N = 327,667) focused primarily on family history of breast cancer as a risk factor for MBC. 15% - 20% of men with BC have a family history of breast or ovarian cancer, and a family history of BC among first-degree relatives confers a 2-to 3-fold increase in MBC risk (odds ratio = 3.3). Seventeen studies (N = 5451) analyzed associations between several heritable genes and MBC. Lifetime MBC risk among BRCA1 mutation carriers is 1% - 5%, while MBC risk in BRCA2 mutation carriers is higher and varies between 4% - 40%. Less clear associations between MBC and PALB2, Androgen Receptor gene, CYP17, and CHEK2 mutations have also been documented. Five studies (N = 16,667) have addressed occupational risk factors for MBC. An 8-fold increase in MBC is reported in males working in the cosmetic cream manufacturing, and the motor vehicle industries. A meta-analysis of 18 trials also identified electromagnetic field exposure as a potential MBC risk, though causation remains undocumented. Eleven studies (N = 4,843,598) analyzed the role of abnormalities in the androgen-to-estrogen ratio as a risk factor for MBC. Conditions associated with increased MBC risk include Klinefelter’s syndrome (relative risk, RR = 29.64), obesity (RR = 1.98), orchitis/epididymitis (RR = 1.84), and gynecomastia (RR = 5.86). Conclusion: Routine screening for MBC should be considered in all high risk male populations, including those with a prior history of breast carcinoma, a strong family history of BC (defined as an affected mother or sister), a positive BRCA2 mutation status (regardless of family history), and men diagnosed with Klinefelter’s syndrome, or those in the chemical or motor vehicle industries. Genetic testing for BRCA2 should be recommended for all MBC patients. Increased public and physician education on MBC is necessary to raise awareness about this rare disease and the need for screening of at-risk populations.
文摘目的探讨常规超声联合弹性超声在男性乳腺癌中的预测价值。方法纳入男性乳腺肿瘤患者105例,共108个病灶(良性肿块53个,恶性肿块55个)。对乳腺肿块行常规超声及弹性超声检查,应用单因素及多因素Logistic回归分析男性乳腺癌的独立预测因子。将差异有统计学意义的常规超声参数纳入二维超声模型,通过Logistic回归算法联合弹性评分和二维超声模型建立联合模型,并对两种模型的诊断效能进行评估对比。结果患者年龄(P=0.0001)、肿块血流(P=0.0023)、方位(P=0.0075)、弹性评分(P=0.0002)是男性乳腺癌的独立预测因子。联合模型和二维超声模型的曲线下面积(area under the curve,AUC)分别为0.911和0.855,两者比较差异有统计学意义(P=0.0311)。决策曲线分析(decision curve analysis,DCA)结果表明,联合模型在临床上具有较强的实用性。结论弹性评分是男性乳腺癌的独立预测因子,常规超声联合弹性超声可提高男性乳腺癌的诊断效能。
文摘目的探究男性乳腺癌(male breast cancer,MBC)患者的预后因素,构建MBC患者生存预后列线图并预测3年和5年生存率。方法纳入监测、流行病学和最终结果(Surveillance,Epidemiology,and End Results,SEER)癌症登记数据库的MBC患者,同时纳入川北医学院附属医院、遂宁市中心医院和德阳市人民医院的MBC患者,获取患者完整的临床基线资料及生存信息。以SEER数据库中患者数据作为训练集,3家医院中的患者数据作为验证集,通过单因素和多因素Cox回归分析确定与总生存期(overall survival,OS)相关的独立预后因素,并构建预测MBC患者3年及5年生存率的列线图,运用校准曲线、一致性指数(CI)、受试者工作特征曲线(ROC)和决策分析曲线来评估模型的准确程度和实际应用价值。结果共纳入3387名MBC患者,其中训练集3307例,验证集80例。通过对训练集进行单因素和多因素Cox回归分析后发现,诊断年龄、组织学分级、T分期、N分期、M分期、孕激素受体状态、手术、化疗和放疗是影响MBC患者OS的独立预后因素。将这些因素纳入并构建列线图模型并进行验证,训练集CI为0.711,验证集CI为0.787。训练集中,3年OS的AUC为0.744,5年OS的AUC为0.720;验证集中,3年OS的AUC为0.835,5年OS的AUC为0.858。ROC曲线表明模型区分能力较好,校准曲线显示模型预测性能良好,决策分析曲线表明模型的临床应用价值较高。结论开发的列线图为预测MBC患者的预后提供了一种可靠且实用的方法,有助于个性化治疗决策,改善患者的治疗效果。
