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1.
Am J Mens Health ; 18(5): 15579883241284981, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39365001

RESUMEN

Breast cancer is rare in men and is managed using strategies similar to those for breast cancer in women. This study retrospectively analyzed the clinicopathological features, treatment, and survival of male breast cancer (MBC). A total of 66 patients with MBC admitted into Xijing Hospital from August 2006 to March 2024 were reviewed. Data were collected from patients' hospital records and breast cancer database of Xijing Hospital. The incidence of MBC tended to increase from 2018, with affected individuals being older than those with female breast cancer (FBC). The most common histological type of MBC was invasive carcinoma, with positive hormone receptor status. A total of 62 (93.9%) patients with MBC underwent modified radical mastectomy. Chemotherapy was administered to 39 (59.1%) patients, while endocrine therapy was received by 14 patients (21.2%) and radiotherapy by nine patients (13.6%). Survival analysis indicated that the median overall survival (OS) of patients with MBC was 46.7 months (0.9-184.8 months). As of the latest data, 58 patients (87.9%) with MBC are alive. Factors significantly associated with survival included age (χ2 = 3.856, p = .050), estrogen receptor (χ2 = 10.427, p = .005), molecular types (χ2 = 10.641, p = .031), P63 (χ2 = 2.631, p < .001), and endocrine therapy (χ2 = 31.167, p < .001). These findings provide valuable insights into MBC within the Chinese population and serve as a reference for the standard treatment of MBC.


Asunto(s)
Neoplasias de la Mama Masculina , Humanos , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/mortalidad , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Pronóstico , Anciano , Adulto , China , Anciano de 80 o más Años , Análisis de Supervivencia
2.
Asian Pac J Cancer Prev ; 25(9): 3199-3207, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-39342599

RESUMEN

BACKGROUND: HER2-positive male breast cancer (MBC) is a rare condition that has a poor prognosis. The purpose of this study was to establish a nomogram model for predicting the prognosis of HER2-positive MBC patients. METHODS: 240 HER2-positive MBC patients from 2004 to 2015 were retrieved from the surveillance, epidemiology, and end results (SEER) database. All HER2-positive MBC patients were divided randomly into training (n = 144) and validation cohorts (n = 96) according to a ratio of 6:4. Univariate and multivariate Cox regression analyses were used to determine the prognostic factors associated with HER2-positive MBC patients. A clinical prediction model was constructed to predict the overall survival of these patients. The nomogram model was assessed by using receiver operating characteristics (ROC) curves, calibration plots and decision curve analysis (DCA). RESULTS: The Cox regression analysis showed that T-stage, M-stage, surgery and chemotherapy were independent risk factors for the prognosis of HER2-positive MBC patients. The model could also accurately predict the Overall survival (OS) of the patients. In the training and validation cohorts, the C indexes of the OS nomograms were 0.746 (0.677-0.815) and 0.754 (0.679-0.829), respectively. Calibration curves and DCA verified the reliability and accuracy of the clinical prediction model. CONCLUSION: In conclusion, the predictive model constructed had good clinical utility and can help the clinician to select appropriate treatment strategies for HER2-positive MBC patients.


Asunto(s)
Neoplasias de la Mama Masculina , Nomogramas , Receptor ErbB-2 , Humanos , Masculino , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/metabolismo , Neoplasias de la Mama Masculina/mortalidad , Neoplasias de la Mama Masculina/terapia , Receptor ErbB-2/metabolismo , Pronóstico , Persona de Mediana Edad , Tasa de Supervivencia , Programa de VERF , Anciano , Estudios de Seguimiento , Curva ROC , Biomarcadores de Tumor/metabolismo , Adulto
3.
JAMA Oncol ; 10(9): 1272-1281, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-39052257

RESUMEN

Importance: Half of all carriers of inherited cancer-predisposing variants in BRCA1 and BRCA2 are male, but the implications for their health are underrecognized compared to female individuals. Germline variants in BRCA1 and BRCA2 (also known as pathogenic or likely pathogenic variants, referred to here as BRCA1/2 PVs) are well known to significantly increase the risk of breast and ovarian cancers in female carriers, and knowledge of BRCA1/2 PVs informs established cancer screening and options for risk reduction. While risks to male carriers of BRCA1/2 PVs are less characterized, there is convincing evidence of increased risk for prostate cancer, pancreatic cancer, and breast cancer in males. There has also been a rapid expansion of US Food and Drug Administration-approved targeted cancer therapies, including poly ADP ribose polymerase (PARP) inhibitors, for breast, pancreatic, and prostate cancers associated with BRCA1/2 PVs. Observations: This narrative review summarized the data that inform cancer risks, targeted cancer therapy options, and guidelines for early cancer detection. It also highlighted areas of emerging research and clinical trial opportunities for male BRCA1/2 PV carriers. These developments, along with the continued relevance to family cancer risk and reproductive options, have informed changes to guideline recommendations for genetic testing and strengthened the case for increased genetic testing for males. Conclusions and Relevance: Despite increasing clinical actionability for male carriers of BRCA1/2 PVs, far fewer males than female individuals undergo cancer genetic testing. Oncologists, internists, and primary care clinicians should be vigilant about offering appropriate genetic testing to males. Identifying more male carriers of BRCA1/2 PVs will maximize opportunities for cancer early detection, targeted risk management, and cancer treatment for males, along with facilitating opportunities for risk reduction and prevention in their family members, thereby decreasing the burden of hereditary cancer.


Asunto(s)
Proteína BRCA1 , Proteína BRCA2 , Predisposición Genética a la Enfermedad , Humanos , Masculino , Proteína BRCA2/genética , Proteína BRCA1/genética , Factores de Riesgo , Pruebas Genéticas , Neoplasias/genética , Neoplasias/epidemiología , Neoplasias de la Mama Masculina/genética , Neoplasias de la Mama Masculina/terapia , Detección Precoz del Cáncer , Mutación de Línea Germinal , Medición de Riesgo
4.
Technol Cancer Res Treat ; 23: 15330338241261836, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39043043

RESUMEN

Male breast cancer (MBC), one of the rare types of cancer among men where the global incidence rate is 1.8% of all breast cancers cases with a yearly increase in a pace of 1.1%. Since the last 10 years, the incidence has been increased from 7.2% to 10.3% and the mortality rate was decreased from 11% to 3.8%. Nevertheless, the rate of diagnoses has been expected to be around 2.6% in the near future, still there is a great lack in studies to characterize the MBC including the developed countries. Based on our search, it is evidenced from the literature that the number of risk factors for the cause of MBC are significant, which includes the increase in age, family genetic history, mutations in specific genes due to various environmental impacts, hormonal imbalance and unregulated expression receptors for specific hormones of high levels of estrogen or androgen receptors compared to females. MBCs are broadly classified into ductal and lobular carcinomas with further sub-types, with some of the symptoms including a lump or swelling in the breast, redness of flaky skin in the breast, irritation and nipple discharge that is similar to the female breast cancer (FBC). The most common diagnostic tools currently in use are the ultrasound guided sonography, mammography, and biopsies. Treatment modalities for MBC include surgery, radiotherapy, chemotherapy, hormonal therapy, and targeted therapies. However, the guidelines followed for the diagnosis and treatment modalities of MBC are mostly based on FBC that is due to the lack of prospective studies related to MBC. However, there are distinct clinical and molecular features of MBC, it is a need to develop different clinical methods with more multinational approaches to help oncologist to improve care for MBC patients.


Asunto(s)
Neoplasias de la Mama Masculina , Humanos , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama Masculina/genética , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/etiología , Masculino , Factores de Riesgo , Incidencia , Femenino
5.
Breast ; 76: 103762, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38924994

RESUMEN

BACKGROUND: Male breast cancer (MBC) is a rare disease. Although several large-scale studies have investigated MBC patients in other countries, the features of MBC patients in China have not been fully explored. This study aims to explore the features of Chinese MBC patients comprehensively. METHODS: We retrospectively collected data of MBC patients from 36 centers in China. Overall survival (OS) was evaluated by the Kaplan-Meier method, log-rank test, and Cox regression analyses. Multivariate Cox analyses were used to identify independent prognostic factors of the patients. RESULTS: In total, 1119 patients were included. The mean age at diagnosis was 60.9 years, and a significant extension over time was observed (P < 0.001). The majority of the patients (89.1 %) received mastectomy. Sentinel lymph node biopsy was performed in 7.8 % of the patients diagnosed in 2009 or earlier, and this percentage increased significantly to 38.8 % in 2020 or later (P < 0.001). The five-year OS rate for the population was 85.5 % [95 % confidence interval (CI), 82.8 %-88.4 %]. Multivariate Cox analysis identified taxane-based [T-based, hazard ratio (HR) = 0.32, 95 % CI, 0.13 to 0.78, P = 0.012] and anthracycline plus taxane-based (A + T-based, HR = 0.47, 95 % CI, 0.23 to 0.96, P = 0.037) regimens as independent protective factors for OS. However, the anthracycline-based regimen showed no significance in outcome (P = 0.175). CONCLUSION: As the most extensive MBC study in China, we described the characteristics, treatment and prognosis of Chinese MBC population comprehensively. T-based and A + T-based regimens were protective factors for OS in these patients. More research is required for this population.


Asunto(s)
Neoplasias de la Mama Masculina , Mastectomía , Biopsia del Ganglio Linfático Centinela , Humanos , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/mortalidad , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/epidemiología , Masculino , Persona de Mediana Edad , China/epidemiología , Estudios Retrospectivos , Mastectomía/estadística & datos numéricos , Anciano , Biopsia del Ganglio Linfático Centinela/estadística & datos numéricos , Adulto , Pronóstico , Modelos de Riesgos Proporcionales , Estimación de Kaplan-Meier , Taxoides/uso terapéutico , Tasa de Supervivencia , Hidrocarburos Aromáticos con Puentes/uso terapéutico , Antraciclinas/uso terapéutico , Anciano de 80 o más Años
6.
Breast Cancer Res Treat ; 208(1): 29-40, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38896332

RESUMEN

INTRODUCTION: To offer an extensive retrospective experience on the management of male breast cancer. METHODS: A multicenter retrospective observational cohort study was conducted, including male patients diagnosed with breast cancer (invasive or in situ) in 12 Italian breast units from January 1975 to December 2019. Patients aged 18 years or older were assessed for eligibility. Exclusion criteria were metastatic cancer at diagnosis, previous cancer(s), received neoadjuvant treatment, incomplete data on (neo) adjuvant treatment(s), and/or follow-up data. Data on radiological examinations, demographic characteristics, risk factors, histological features, receptor status, treatments, and follow-up were collected. RESULTS: In a series of 671 male patients with breast cancer assessed for eligibility, 403 (28 in situ and 375 invasive neoplasms) were included in the study. All included patients underwent surgery. The median age at surgery was 63.8 years (IQR 56.1-72.1). In 68% of cases, patients underwent echography, and in 55.1%, a mammography. Most patients were ER and PR positive (63.8%), HER2 negative (80.4%), with high (≥ 20%) Ki67 values (61.3%), and luminal B subtype (51.1%). The 10-year overall survival was 73.6% (95% CI 67.0-79.1) for invasive breast cancer and 90% (95% CI 65.6-97.4) for in situ breast cancer. In patients with invasive breast cancer, at univariable analysis, having a G3 tumor (vs. G1), pT2/3/4 (vs. pT1), pN2/3 (vs. pN0), luminal B subtype with Ki67 ≥ 20% (vs. Luminal A), were significantly associated with a higher risk of death. In multivariable analyses, pT2/3/4 (vs. pT1) remained significantly associated with a higher risk of death (HR 3.14, 95% CI 1.83-5.39), and having a HER2 positive or a triple-negative subtype (vs. Luminal A) was also significantly associated with a higher risk of mortality (HR 4.76, 95% CI 1.26-18.1). CONCLUSION: Male breast cancer is a rare disease, the better understanding of which is necessary for a more effective diagnostic and therapeutic approach.


Asunto(s)
Neoplasias de la Mama Masculina , Humanos , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/mortalidad , Masculino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Manejo de la Enfermedad , Receptor ErbB-2/metabolismo , Mastectomía , Biomarcadores de Tumor , Pronóstico
7.
Rev Med Suisse ; 20(874): 968-972, 2024 May 15.
Artículo en Francés | MEDLINE | ID: mdl-38756033

RESUMEN

Breast cancer in men is a rare and understudied disease. Until recently, prospective studies and clinical trials on breast cancer treatments often excluded men. Treatment recommendations were generally extrapolated from the results of clinical trials that included only women. Significant efforts have been made to better understand the biological characteristics, the most effective treatments, and the outcomes of breast cancer in men, as well as to identify clinically relevant differences of this disease. This article reviews the current data on the epidemiology, pathological and clinical characteristics, as well as the treatment of breast cancer in men.


Le cancer du sein chez l'homme est une maladie rare et peu étudiée. Jusqu'à récemment, les études prospectives et les essais cliniques sur les traitements du cancer du sein excluaient souvent les hommes. Les recommandations de traitement étaient généralement extrapolées à partir des résultats d'essais cliniques incluant uniquement des femmes. Des efforts significatifs ont été déployés pour mieux comprendre les caractéristiques biologiques, les traitements les plus efficaces et les résultats du cancer du sein chez les hommes, ainsi que pour identifier les différences cliniquement pertinentes de cette maladie. Cet article passe en revue les données actuelles sur l'épidémiologie, les caractéristiques pathologiques et cliniques, ainsi que le traitement du cancer du sein chez l'homme.


Asunto(s)
Neoplasias de la Mama Masculina , Humanos , Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/patología , Masculino
8.
Oncologist ; 29(6): e750-e762, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38431780

RESUMEN

PURPOSE: Male breast cancer (MBC) is a rare, but increasingly common disease, and lacks prospective studies. Collaborative efforts are needed to understand and address MBC, including its prognosis, in different countries. METHODS: We retrospectively reviewed the clinical, histopathological, and molecular-genetic characteristics, treatments, and survival outcomes of MBC diagnosed between 2007 and 2017 in the Czech Republic. Prognostic factors of overall survival (OS), recurrence-free interval (RFi), and breast cancer-specific mortality (BCSM) were analyzed and indirectly compared to international data. RESULTS: We analyzed 256 patients with MBC (median age 66 years), including 12% with de novo metastatic (M1). Of 201 non-metastatic (M0) patients, 6% were <40 years old, 29% had stage I, 55% were cN0, and 54% underwent genetic testing. Overall, 97% of tumors had estrogen receptor expression ≥10%, 61% had high Ki67 index, 40% were high-grade (G3), and 68% were luminal B-like (HER2-negative). Systemic therapies included endocrine therapy (90%) and chemotherapy (53%). Few (5%) patients discontinued adjuvant endocrine therapy for reasons other than disease relapse or death. Patients treated with aromatase inhibitors alone had significantly shorter RFi (P < .001). OS, RFi, and BCSM were associated with disease stage, T stage, N stage, progesterone receptor expression, grade, and Ki67 index. Median OS reached 122 and 42 months in M0 and de novo M1 patients, respectively. CONCLUSION: Due to the rarity of MBC, this study highlights important findings from real clinical practice. Although the number of patients with MBC with unfavorable features was higher in this Czech dataset than in international studies, the prognosis remains consistent with real-world evidence.


Asunto(s)
Neoplasias de la Mama Masculina , Humanos , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/mortalidad , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/tratamiento farmacológico , Masculino , Estudios Retrospectivos , Anciano , Pronóstico , República Checa/epidemiología , Persona de Mediana Edad , Adulto , Anciano de 80 o más Años
9.
Breast ; 75: 103699, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38460442

RESUMEN

INTRODUCTION: Successful breast cancer outcomes can be jeopardised by adverse events. Understanding and integrating patients' and doctors' perspectives into care trajectories could improve patient safety. This study assessed their views on, and experiences of, medical error and patient safety. METHODS: A cross-sectional, quantitative 20-40 item questionnaire for patients attending Cork University Hospital Cancer Centre and breast cancer doctors in the Republic of Ireland was developed. Domains included demographics, medical error experience, patient safety opinions and concerns. RESULTS: 184 patients and 116 doctors completed the survey. Of the doctors, 41.4% felt patient safety had deteriorated over the previous five years and 54.3% felt patient safety measures were inadequate compared to 13.0% and 27.7% of patients respectively. Of the 30 patients who experienced medical errors/negligence claims, 18 reported permanent or long-term physical and emotional effects. Forty-two of 48 (87.5%) doctors who experienced medical errors/negligence claims reported emotional health impacts. Almost half of doctors involved in negligence claims considered early retirement. Forty-four patients and 154 doctors didn't experience errors but reported their patient safety concerns. Doctors were more concerned about communication and administrative errors, staffing and organisational factors compared to patients. Multiple barriers to error reporting were highlighted. CONCLUSION: This is the first study to assess patients' and doctors' patient safety views and medical error/negligence claims experiences in breast cancer care in Ireland. Experience of medical error/negligence claims had long-lasting implications for both groups. Doctors were concerned about a multitude of errors and causative factors. Failure to embed these findings is a missed opportunity to improve safety.


Asunto(s)
Actitud del Personal de Salud , Neoplasias de la Mama Masculina , Neoplasias de la Mama , Errores Médicos , Seguridad del Paciente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Estudios Transversales , Irlanda , Mala Praxis , Errores Médicos/estadística & datos numéricos , Errores Médicos/psicología , Médicos/psicología , Médicos/estadística & datos numéricos , Encuestas y Cuestionarios , Neoplasias de la Mama Masculina/psicología , Neoplasias de la Mama Masculina/terapia
10.
Breast ; 75: 103713, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38493590

RESUMEN

BACKGROUND: The last years have seen unprecedented improvement in breast cancer (BC) survival rates. However, this entirely apply to female BC patients, since gender minorities (male, transgender/gender-diverse) are neglected in BC phase III registration clinical trials. METHODS: We conducted a scoping review of phase III clinical trials of agents with a current positioning within the therapeutic algorithms of BC. RESULTS: We selected 51 phase III trials. Men enrollment was allowed in 35.3% of trials. In none of the trial inclusion/exclusion criteria referred to transgender/gender-diverse people. A numerical higher rate of enrolled men was observed in the contemporary as compared to historical group. We found a statistically significant association between the drug class and the possibility of including men: 100%, 80%, 50%, 33.3%, 25%, 10% and 9.1% of trials testing ICI/PARP-i, ADCs, PI3K/AKT/mTOR-i, anti-HER2 therapy, CDK4/6-i, ET alone, and CT alone. Overall, 77409 patients were enrolled, including 112 men (0.2%). None of the trial reported transgender/gender-diverse people proportion. Studies investigating PARP-i were significantly associated with the highest rate of enrolled men (1.42%), while the lowest rates were observed for trials of CT (0.13%), ET alone (0.10%), and CDK 4/6-I (0.08%), p < 0.001. CONCLUSIONS: We confirmed that gender minorities are severely underrepresented among BC registration trials. We observed a lower rate of men in trials envisaging endocrine manipulation or in less contemporary trials. This work sought to urge the scientific community to increase the awareness level towards the issue of gender minorities and to endorse more inclusive criteria in clinical trials.


Asunto(s)
Neoplasias de la Mama , Ensayos Clínicos Fase III como Asunto , Selección de Paciente , Minorías Sexuales y de Género , Humanos , Masculino , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/terapia , Minorías Sexuales y de Género/estadística & datos numéricos , Ensayos Clínicos Fase III como Asunto/estadística & datos numéricos , Personas Transgénero/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/tratamiento farmacológico
11.
Breast Cancer ; 31(3): 485-495, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38507145

RESUMEN

PURPOSE: Randomized clinical trials demonstrate that lumpectomy + hormone therapy (HT) without radiation therapy (RT) yields equivalent survival and acceptable local-regional outcomes in elderly women with early-stage, node-negative, hormone-receptor positive (HR +) breast cancer. Whether these data apply to men with the same inclusion criteria remains unknown. METHODS: The National Cancer Database was queried for male patients ≥ 65 years with pathologic T1-2N0 (≤ 3 cm) HR + breast cancer treated with breast-conserving surgery with negative margins from 2004 to 2019. Adjuvant treatment was classified as HT alone, RT alone, or HT + RT. Male patients were matched with female patients for OS comparison. Survival analysis was performed using Cox regression and Kaplan - Meier method. Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding. RESULTS: A total of 523 patients met the inclusion criteria, with 24.4% receiving HT, 16.3% receiving RT, and 59.2% receiving HT + RT. The median follow-up was 6.9 years (IQR: 5.0-9.4 years). IPTW-adjusted 5-yr OS rates in the HT, RT, and HT + RT cohorts were 84.0% (95% CI 77.1-91.5%), 81.1% (95% CI 71.1-92.5%), and 93.0% (95% CI 90.0-96.2%), respectively. On IPTW-adjusted MVA, relative to HT, receipt of HT + RT was associated with improvements in OS (HR: 0.641; p = 0.042). RT alone was not associated with improved OS (HR: 1.264; p = 0.420). CONCLUSION: Among men ≥ 65 years old with T1-2N0 HR + breast cancer, RT alone did not confer an OS benefit over HT alone. Combination of RT + HT demonstrated significant improvements in OS. De-escalation of treatment through omission of either RT or HT at this point should be done with caution.


Asunto(s)
Neoplasias de la Mama Masculina , Mastectomía Segmentaria , Humanos , Neoplasias de la Mama Masculina/radioterapia , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/mortalidad , Neoplasias de la Mama Masculina/terapia , Anciano , Masculino , Radioterapia Adyuvante/métodos , Anciano de 80 o más Años , Femenino , Estudios Retrospectivos , Bases de Datos Factuales , Tasa de Supervivencia , Estimación de Kaplan-Meier , Antineoplásicos Hormonales/uso terapéutico
12.
BMC Cancer ; 24(1): 179, 2024 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-38317128

RESUMEN

BACKGROUND: Men with breast cancer experience unique physical and emotional challenges. However, a thorough understanding of these experiences including the psychosocial effects and supportive care needs have received less attention. In some settings, men with breast cancer experience stigma within the healthcare system and their care needs are not prioritised. This influences the level of professional support offered, consequently worsening their health and well-being outcomes. This review explored the variabilities in the experiences and treatment modalities of male breast cancer (MBC) across different contexts. METHODS: All primary study designs including qualitative, quantitative, and mixed methods studies that reported on the experiences, treatment approaches and outcomes of MBC were included in this systematic review. Six databases (Embase, Medline, PsycINFO, Global Health, CINAHL and Web of Science) were searched for articles from January 2000 to September 2023. A results-based convergence synthesis was used for data analysis and reported using PRISMA guidelines. RESULTS: Of the studies screened (n = 29,687), forty-four fulfilled the predetermined criteria and were included. Our findings relating to the experiences and treatment approaches of MBC are broadly themed into three parts. Theme 1-Navigating through a threat to masculinity: describes how males experienced the illness reflecting on detection, diagnosis, coming to terms with breast cancer, and disclosure. Theme 2- Navigating through treatment: captures the experiences of undergoing breast cancer treatment/ management following their diagnosis. Theme 3-Coping and support systems: describes how MBC patients coped with the disease, treatment process, aftercare/rehabilitative care, and the available support structures. CONCLUSIONS: Men experience a myriad of issues following a breast cancer diagnosis, especially with their masculinity. Awareness creation efforts of MBC among the public and healthcare practitioners are urgently required, which could change the perception of men in promoting early diagnosis, adherence to treatments, post-treatment monitoring, oncological results and a better quality of life. Considerations for training, education and development of specialised guidelines for healthcare practitioners on MBC would provide the necessary knowledge and skills to enhance their practice through the adoption of person-centred and male-specific care strategies. Professional care intervention and support for MBC should not end after the diagnosis phase but should extend to the entire treatment continuum and aftercare including future research focusing on MBC specific clinical trials. TRIAL REGISTRATION: PROSPERO Registration No. CRD42021228778.


Asunto(s)
Neoplasias de la Mama Masculina , Estigma Social , Humanos , Masculino , Neoplasias de la Mama Masculina/psicología , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/diagnóstico , Masculinidad , Calidad de Vida
13.
Mod Pathol ; 37(4): 100452, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38369186

RESUMEN

The molecular characterization of male breast cancer (MaBC) has received limited attention in research, mostly because of its low incidence rate, accounting for only 0.5% to 1% of all reported cases of breast cancer each year. Managing MaBC presents significant challenges, with most treatment protocols being adapted from those developed for female breast cancer. Utilizing whole-genome sequencing (WGS) and state-of-the-art analyses, the genomic features of 10 MaBC cases (n = 10) were delineated and correlated with clinical and histopathologic characteristics. Using fluorescence in situ hybridization, an additional cohort of 18 patients was interrogated to supplement WGS findings. The genomic landscape of MaBC uncovered significant genetic alterations that could influence diagnosis and treatment. We found common somatic mutations in key driver genes, such as FAT1, GATA3, SMARCA4, and ARID2. Our study also mapped out structural variants that impact cancer-associated genes, such as ARID1A, ESR1, GATA3, NTRK1, and NF1. Using a WGS-based classifier, homologous recombination deficiency (HRD) was identified in 2 cases, both presenting with deleterious variants in BRCA2. Noteworthy was the observation of FGFR1 amplification in 21% of cases. Altogether, we identified at least 1 potential therapeutic target in 8 of the 10 cases, including high tumor mutational burden, FGFR1 amplification, and HRD. Our study is the first WGS characterization of MaBC, which uncovered potentially relevant variants, including structural events in cancer genes, HRD signatures, and germline pathogenic mutations. Our results demonstrate unique genetic markers and potential treatment targets in MaBC, thereby underlining the necessity of tailoring treatment strategies for this understudied patient population. These WGS-based findings add to the growing knowledge of MaBC genomics and highlight the need to expand research on this type of cancer.


Asunto(s)
Neoplasias de la Mama Masculina , Neoplasias de la Mama , Humanos , Masculino , Femenino , Neoplasias de la Mama Masculina/genética , Neoplasias de la Mama Masculina/terapia , Hibridación Fluorescente in Situ , Mutación , Neoplasias de la Mama/patología , Oncogenes , Mutación de Línea Germinal , ADN Helicasas/genética , Proteínas Nucleares/genética , Factores de Transcripción/genética
14.
Curr Oncol Rep ; 26(1): 34-45, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-38224426

RESUMEN

PURPOSE OF REVIEW: Male breast cancer is a relatively uncommon and rare disease that is often managed based on evidence adopted from trials pertaining to female breast cancer due to low accrual rates or exclusion of males. This is despite the known differences in the biology and epidemiology of this condition. This review provides an update regarding the management and surveillance of male breast cancer. RECENT FINDINGS: Men with breast cancer tend to undergo more extensive surgery in the breast and axilla. The outcomes of male breast cancer compared to a similar subtype of female breast cancer appear worse when matched for stage. Systemic therapies remain predominantly based on recommendations for female breast cancer, although tamoxifen is the more optimal endocrine therapy for men than women. Surveillance with mammograms is recommended for patients harboring a breast cancer susceptibility gene but is otherwise not advised for men who have undergone a mastectomy. Notably, the role of other imaging modalities, including ultrasound and magnetic resonance imaging, is minimal. Although the focus on survivorship care among men is low, it is abundantly clear that this is a stigmatizing diagnosis for men, and they suffer from long-term physical and psychological sequelae following a diagnosis and treatment of breast cancer. In summary, providing more gender-inclusive care and advocating for increased representation of men in prospective breast cancer studies and clinical trials may help improve outcomes and provide enhanced support for this population.


Asunto(s)
Neoplasias de la Mama Masculina , Neoplasias de la Mama , Femenino , Humanos , Masculino , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama/terapia , Neoplasias de la Mama/tratamiento farmacológico , Mastectomía , Supervivencia , Estudios Prospectivos , Mamografía
15.
J Surg Res ; 293: 685-692, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37839100

RESUMEN

INTRODUCTION: Occult breast cancer (OBC) consists of <0.1% of breast cancer cases in the United States. Male occult breast cancer (mOBC) has not been well-studied outside of case reports, and management is largely based on female OBC (fOBC) studies. We aim to examine the prevalence of mOBC among those in the National Cancer Database with breast cancer and describe treatment modalities received by mOBC compared to fOBC. METHODS: The National Cancer Database was queried for patients with OBC from 2004 to 2018. Chi-Square test and Fisher's exact tests compared patient, clinical, and facility characteristics by sex. Treatment modalities [systemic therapy, radiation therapy, axillary lymph node dissection, modified radical mastectomy (MRM)] were compared. A subgroup analysis examined pathologic upstaging in patients who underwent MRM. RESULTS: Of 23,374 male patients with breast cancer, 0.13% were identified to have mOBC [versus 0.09% in fOBC]. cN2/N3 disease was significantly more prevalent in the mOBC cohort (61.3%) than in the fOBC cohort (30.7%, P < 0.001). Receipt of axillary lymph node dissection or MRM was not significantly different by sex. Male OBC (mOBC) patients were less likely to receive trimodality treatment than fOBC patients. In patients who underwent MRM, more mOBC patients [75%] were pathologically upstaged as T+ after mastectomy than fOBC patients [30%, P < 0.001], questioning the adequacy of diagnostic workup for mOBC compared to fOBC. CONCLUSIONS: This review confirms mOBC as an extremely rare disease. Multimodal treatments have been highly utilized to optimize care in this patient population. Further investigation is warranted to examine the survival benefit of treatment regimens for mOBC.


Asunto(s)
Neoplasias de la Mama Masculina , Neoplasias de la Mama , Humanos , Femenino , Masculino , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/terapia , Neoplasias de la Mama/patología , Mastectomía , Metástasis Linfática/patología , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama Masculina/terapia , Escisión del Ganglio Linfático , Terapia Combinada , Axila/patología
16.
Pol Przegl Chir ; 95(6): 24-30, 2023 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-38058163

RESUMEN

Males account for 1% of all cases of breast cancer. With the aging of the world's population, the disease has exhibited a rise in incidence in recent decades. Male breasts are smaller than female breasts, making the disease easier to spot, but patients often do not report their cases in time due to a lack of awareness. The stage-to-stage prognosis of male breast cancer is comparable to that of their female counterparts. Due to the relative rarity of the disease and poor patient enrollment in large randomized studies, the optimal management of male breast cancer remains uncertain. This article presents a narrative review of male breast cancer in light of recent literature, with an emphasis on epidemiology, clinical features, and current management.


Asunto(s)
Neoplasias de la Mama Masculina , Humanos , Masculino , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama Masculina/terapia , Mutación , Pronóstico
17.
Anticancer Agents Med Chem ; 23(19): 2161-2169, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37605409

RESUMEN

INTRODUCTION: Male breast cancer (MBC) accounts for 0.5%-1% of all breast cancers diagnosed worldwide. However, its biological characteristics can be distinguished from that of female breast cancer (FBC). CASE REPRESENTATION: The diagnostic and treatment approaches for MBC are mainly similar to that of FBC due to the lack of male breast cancer-related studies, clinical trials, and literature. An increasing number of retrospective and prospective studies have been conducted to clarify the individualized care for MBC. Herein, we report three cases of advanced MBC to describe the diagnostic approaches, treatment process, and survival prognosis. CONCLUSION: MBC patients had older age, later stage at first diagnosis, higher expression of hormone receptors, and poor prognosis. A literature review was conducted to determine the incidence, risk factors, disease features, diagnosis, treatment, survival, and management of MBC.


Asunto(s)
Neoplasias de la Mama Masculina , Neoplasias de la Mama , Humanos , Masculino , Femenino , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/epidemiología , Estudios Retrospectivos , Estudios Prospectivos , Neoplasias de la Mama/metabolismo , Pronóstico , Receptores de Estrógenos/metabolismo
18.
Breast Cancer Res Treat ; 201(3): 489-498, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37418032

RESUMEN

PURPOSE: Male breast cancer accounts for approximately 1% of all breast cancer diagnoses. Unfortunately, a lack of information exists regarding late effects of breast cancer treatment in men. METHODS: An online survey directed towards male breast cancer patients was distributed via social medial and emails from June to July 2022. Participants were asked about their disease characteristics, treatments and side effects from the disease or treatment. Patients and treatment variables were reported via descriptive statistics. Univariate logistic regression was performed to evaluate associations between different treatment variables and outcomes expressed by odds ratio. RESULTS: A total of 127 responses were analyzed. Median age of the participants was 64 years (range 56-71 years). A total of 91 participants (71.7%) revealed they experienced late effects secondary to their cancer or cancer treatment. The most concerning physical and psychological symptoms reported were fatigue and fear of recurrence respectively. Axillary lymph node dissection was associated with swollen arm and with difficulty in arm or shoulder movement. Systemic chemotherapy was related to bothersome hair loss and changes on interest in sex; and endocrine therapy was associated with feeling less masculine. CONCLUSION: Our study showed that men suffer several late effects from treatments for breast cancer. Lymphedema, difficulty with arm and shoulder movement, sexual dysfunction and hair loss should be discussed with males as it can be distressing for some patients and decrease their quality of life.


Asunto(s)
Neoplasias de la Mama Masculina , Neoplasias de la Mama , Linfedema , Humanos , Masculino , Persona de Mediana Edad , Anciano , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/terapia , Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama Masculina/terapia , Neoplasias de la Mama Masculina/etiología , Calidad de Vida , Axila/patología , Escisión del Ganglio Linfático/efectos adversos , Linfedema/cirugía
19.
Oncologist ; 28(10): e877-e883, 2023 10 03.
Artículo en Inglés | MEDLINE | ID: mdl-37310797

RESUMEN

INTRODUCTION: Prospective data about quality of life (QoL) in men with breast cancer (BC) are lacking. A prospective registry (EORTC10085) of men with all BC stages, including a QoL correlative study, was performed as part of the International Male Breast Cancer Program. METHODS: Questionnaires at BC diagnosis included the EORTC QLQ-C30 and BR23 (BC specific module), adapted for men. High functioning and global health/QoL scores indicate high functioning levels/high QoL; high symptom-focused measures scores indicate high symptoms/problems levels. EORTC reference data for healthy men and women with BC were used for comparisons. RESULTS: Of 422 men consenting to participate, 363 were evaluable. Median age was 67 years, and median time between diagnosis and survey was 1.1 months. A total of 114 men (45%) had node-positive early disease, and 28 (8%) had advanced disease. Baseline mean global health status score was 73 (SD: 21), better than in female BC reference data (62, SD: 25). Common symptoms in male BC were fatigue (22, SD: 24), insomnia (21, SD: 28), and pain (16, SD: 23), for which women's mean scores indicated more burdensome symptoms at 33 (SD: 26), 30 (SD: 32), and 29 (SD: 29). Men's mean sexual activity score was 31 (SD: 26), with less sexual activity in older patients or advanced disease. CONCLUSIONS: QoL and symptom burden in male BC patients appears no worse (and possibly better) than that in female patients. Future analyses on impact of treatment on symptoms and QoL over time, may support tailoring of male BC management.


Asunto(s)
Neoplasias de la Mama Masculina , Neoplasias de la Mama , Femenino , Humanos , Masculino , Anciano , Preescolar , Calidad de Vida , Neoplasias de la Mama Masculina/terapia , Estudios Prospectivos , Estado de Salud , Neoplasias de la Mama/terapia , Encuestas y Cuestionarios
20.
Dtsch Med Wochenschr ; 148(6): 301-306, 2023 03.
Artículo en Alemán | MEDLINE | ID: mdl-36878228

RESUMEN

Male breast cancer is an unknown field for many practitioners. Patients often see different doctors before the correct diagnosis is made - often too late. This article is intended to point out risk factors, initiation of diagnostics and therapy. In the dawning age of molecular medicine, we will also take a look at genetics.


Asunto(s)
Neoplasias de la Mama Masculina , Médicos , Humanos , Masculino , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/genética , Neoplasias de la Mama Masculina/terapia , Cognición , Factores de Riesgo
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