ABSTRACT
ABSTRACT Breast cancer (BC) is mainly considered a disease in women, but male BC (MaBC) accounts for approximately 1.0% of BC diagnoses and 0.5% of malignant neoplasms in the western population. The stigmatization of MaBC, the fact that men are less likely to undergo regular health screenings, and the limited knowledge of health professionals about MaBC contribute to men being diagnosed at more advanced stages. The aim of this article is to increase the visibility of MaBC among urologists, who have more contact with male patients. This review highlights key points about the disease, the risk factors associated with MaBC, and the options for treatment. Obesity and increased population longevity are among the important risk factors for MaBC, but published studies have identified family history as extremely relevant in these patients and associated with a high penetrance at any age. There is currently no screening for MaBC in the general population, but the possibility of screening in men at high risk for developing BC can be considered. The treatment of MaBC is multidisciplinary, and, because of its rarity, there are no robust clinical studies evaluating the role of systemic therapies in the management of both localized and metastatic disease. Therefore, in current clinical practice, treatment strategies for men with breast cancer are extrapolated from information arising from studies in female patients.
ABSTRACT
Introdução: A enterocolite neutropênica (EN) consiste em ulceração ou necrose da mucosa do ceco, íleo terminal e cólon ascendente, sendo uma condição clínica ocasionada como evento adverso de medicamentos, principalmente em esquemas quimioterápicos. Por ser uma condição com alto índice de mortalidade, o presente relato tem como objetivo contribuir significativamente para discussões que envolvem a EN e a participação da equipe multiprofissional no desfecho clínico. Relato do caso: Paciente do sexo masculino, 75 anos, com diagnóstico de câncer de mama, evoluindo com EN após tratamento com quimioterapia adjuvante. A presença de comorbidades e a idade foram os principais fatores complicadores do quadro de tiflite. Por ser uma toxicidade importante e que pode levar à piora do quadro clínico do paciente com câncer, abordar esse tema é fundamental para um diagnóstico mais rápido, com possibilidade de medidas preventivas. Conclusão: Sendo assim, em virtude do notório aumento dos casos de EN, aponta-se como perspectiva a qualificação da equipe de saúde para a inserção de profissionais ainda mais especializados, capazes de contribuir e identificar os sinais e sintomas relacionados com toxicidades hematológicas, resultado de tratamentos quimioterápicos.
Introduction: Neutropenic enterocolitis (NE) consists of ulceration or necrosis of the mucosa of the cecum, terminal ileum, and ascending colon, being a clinical condition caused by an adverse drug event, mainly in chemotherapy regimens. As it is a high mortality rate condition, this report aims to contribute significantly to discussions involving NE and the participation of the multidisciplinary team in the clinical outcome. Case report: This is a 75-year-old male patient diagnosed with Breast Cancer, who developed EN after treatment with adjuvant chemotherapy. The presence of comorbidities and age were the main complicating factors in typhlitis. As it is an important toxicity and can lead to a worsening of the clinical condition of cancer patients, addressing this issue is essential for a faster diagnosis with the possibility of preventive measures. Conclusion: Therefore, in view of the notorious increase of cases of NE, the perspective of the qualification of the health team is pointed out, for the inclusion of even more specialized professionals capable of contributing and identifying the signs and symptoms related to hematological toxicities, result of chemotherapy treatments.
Introducción: La enterocolitis neutropénica (EN) consiste en la ulceración o necrosis de la mucosa del ciego, íleon terminal y colon ascendente, siendo una condición clínica causada por un evento adverso farmacológico, principalmente en regímenes de quimioterapia. Al tratarse de una afección con una alta tasa de mortalidad, este informe tiene como objetivo contribuir de manera significativa a las discusiones que involucran al EN y la participación del equipo multidisciplinario en el resultado clínico. Relato del caso: Paciente masculino, 75 años, diagnosticado de cáncer de mama, que desarrolló EN después del tratamiento con quimioterapia adyuvante. La presencia de comorbilidades y la edad fueron los principales factores de complicación en Tiflite. Como se trata de una toxicidad importante y puede conducir a un empeoramiento de la condición clínica de los pacientes con cáncer, abordar esta cuestión es fundamental para un diagnóstico más rápido con la posibilidad de medidas preventivas. Conclusión: Por tanto, ante el notable incremento de casos de EN, se apunta la perspectiva de la calificación del equipo de salud, para la inclusión de profesionales aún más especializados capaces de aportar e identificar los signos y síntomas relacionados con las toxicidades hematológicas, un resultado de los tratamientos de quimioterapia.
Subject(s)
Humans , Male , Aged , Breast Neoplasms, Male , Enterocolitis, Neutropenic/drug therapy , Patient Care Team , Chemotherapy, Adjuvant , Drug-Related Side Effects and Adverse ReactionsABSTRACT
Abstract Objective: To assess the relationship between 5α-reductase inhibitors (5ARIs) and the risk of male breast cancer (MBC). Material and Methods: We systematically searched Medline via PubMed, Embase and the Cochrane Library Central Register up to May 2017 to identify published articles related to 5ARIs and the risk of MBC. Results: Summary effect estimates were calculated by a random-effect model, and tests for multivariable-unadjusted pooled risk ratios (RR) and heterogeneity, as well as the sensitivity analyses were conducted to assess publication bias. All four studies were conducted in a quality assessment according to the Newcastle Ottawa Scale system. The strength of association between 5ARIs and the prevalence of MBC was evaluated by using summarized unadjusted pooled RR with a 95% confidence interval [CI]. Four studies involving 595.776 participants, mean age range from 60 to 73.2 years old, were included in a meta-analysis, which produced a summary unadjusted RR of the risk of MBC for the treatment of 5ARIs of 1.16 (95% CI 0.85-1.58, P=0.36) and the multivariable-adjusted RR is 1.03, (95% CI 0.75-1.41, p=0.86). There was no heterogeneity among included studies (I2=0%, P=0.49). Estimates of total effects were generally consistent with the sensitivity. Conclusion: We did not observe a positive association between the use of 5ARIs and MBC. The small number of breast cancer cases exposed to 5ARIs and the lack of an association in our study suggest that the development of breast cancer should not influence the prescribing of 5ARIs therapy.
Subject(s)
Humans , Male , Aged , Breast Neoplasms, Male/chemically induced , 5-alpha Reductase Inhibitors/adverse effects , Odds Ratio , 5-alpha Reductase Inhibitors/administration & dosage , Middle AgedABSTRACT
El cáncer de mama en hombres es poco frecuente, representa menos del 1 % de todos los cánceres masculinos, se presenta entre los 60-70 años con un pico de edad de 67 años; el carcinoma ductal invasivo es el que prevalece en varones, clínicamente se detecta como un nódulo unilateral indoloro retroareolar, o paraareolar. A diferencia de la mujer donde se realizan estudios de tamizaje, en los hombres suele diagnosticarse más tarde, porque buscan atención médica tardíamente por la poca incidencia de cáncer en pacientes masculinos, por la ausencia de signos y síntomas tempranos. Actualmente se puede utilizar para el diagnóstico la mamografía que ayuda a diferenciar entre enfermedades mamarias benignas y malignas. En este artículo se presenta el caso clínico de un paciente que acude al Instituto Hondureño de Seguridad Social, a quien se le diagnosticó carcinoma ductal.
Breast cancer in men is rare, it represents less then 1% of all male cancers, it's present between the ages of 60 through 70 years with an age peak at 67 years; the invasive ductal carcinoma is the most prevalent in men. Clinically, it is detected as an odorless, unilateral retro- or paraareolar nodule. Unlike with women, where screening studies are performed, in men it's usually diagnosed later on, because the low incidence of this cancer in male patients and the absence of early signs and symptoms leads to a delayed search for medical attention delayed. For diagnosis, a mammography can be used that helps differentiate between benign and malign mammary diseases. In this article we presented the clinical case of a patient that visits the Honduran Social Security Institute, diagnosed with ductal carcinoma.
Subject(s)
Humans , Mammary Glands, Human , Breast NeoplasmsABSTRACT
Objective To evaluate the performance and feasibility of sentinel node biopsy(SNB) in male breast cancer patients using Methylthioninium Chloride Injection.Methods At the First Affiliated Hospital of Zhengzhou University,there are 11 patients in group from March 2010 to December 2014.The clinical stage was cT1-T2N0M0.All patients using Methylthioninium Chloride Injection as the tracer.11 patients are given with sentinel lymph node biopsy,while given the axillary lymph node dissection.Results In 11 cases of male breast cancer patients,10 cases obtained the sentinel lymph nodes,the detection rate was 90.9％ (10/11).The sentinel lymph node is in 1-3,the average is 1.7 gold.Non sentinel lymph nodes are in 8-14,the average is 10.5 gold.The coincidence rate is 90.0％ The sensitivity is 100％ and The precision is 60％.Conclusions Sentinel lymph node biopsy can accurately predict the metastasis of axillary lymph node of breast cancer in male patients.
ABSTRACT
Objective To evaluate the clinicopathological features,treatments and prognostic factors of male breast cancer (MBC) patients.Methods Clinical data of 102 MBC patients with histopathology confirmation at Tianjin Medical University Cancer Hospital were retrospectively analyzed.Results All 102 cases got follow-up.The follow-up rate was 100％.The follow-up period was 3-279 months.The mean follow-up period was 65 months.During the follow-up period,recurrence was found in 21 cases,metastasis occurred in 28 cases (including pulmonary metastasis in 8,osseous metastasis in 7,hepatic metastasis in 9,brain metastasis in 3,and soft tissues and adrenal gland metastasis in 1).The 5-year disease free survival rate was 54.3％ and the 5-year overall survival rate was 72.8％.Univariate analysis showed that tumor size,axillary lymph node status,TNM stage,chemotherapy influenced the disease free and overall survival.Multivariate Cox regression shows that axillary lymph node status (P =0.085)was the independent prognostic factor of disease free survival for MBC.Tumor size(P =0.041)and axillary lymph node (P =0.024) status were independent prognostic factors of overall survival for MBC.Conclusions Early diagnosis and comprehensive treatment strategy consisting of radical mastectomy is essential to improve the survival of patients with MBC.
ABSTRACT
Objective To investigate the clinicopathological features,diagnosis and treatment experience,in order to improve the recognition of male breast cancer and prepare for the study of standardized treatment of breast cancer.Methods Data of epidemiological characteristics,clinical and pathological parameters,treatment and outcome from 43 male breast cancer patients were collected and analyzed in Peking University Cancer Hospital and Beijing Hospital from January 2009 to December 2014.Results Of these patients,42 (97.6％) cases presented with located tumors,11 (25.5％) cases were on pathological stage Ⅲ or stage Ⅳ,and 40 (93.0％) cases were with hormone receptor positive breast cancer and 3 (6.9％) cases were with human epidermal growth factor receptors (HER)-2 positive breast cancer.Patients were stratified according to more or less than 70 years of age,and there were no significant differences in clinicopathological features between the two year groups.But 3 cases with HER-2 over-expressed were all less than 70 years old.38 (88.4％) patients underwent surgical treatment,among which 32 HR-positive patients (74.4％) received tamoxifen as adjuvant endocrine therapy.The median follow-up periods was 31 months (6.1-55.4 months),7 (16.3％) patients developed local recurrence or distant metastasis.Conclusions Male breast cancer is often diagnosed at a later stage and has inferior outcome.Majority of male breast cancer are found to be HR positive,hence hormonal therapy should be strongly considered.
ABSTRACT
Male breast cancer (MBC)is one of rare malignant carcinomas,of which the pathogenesis and biological characteristics remain elusive.Recently,it has been reported that breast cancer susceptibility gene (BRCA)1 ,BRCA2,checkpoint kinase 2 (CHEK2)and partner and localizer of BRCA2 (PALB2)play important roles in the pathogenesis of MBC.Whereas the relationship between BRCA1 -interacting protein 1 (BRIP1 )and MBC is still controversial.
ABSTRACT
Granular cell tumor of the breast is a rare tumor arising from Schwann cells. Although it is usually a benign tumor, its characteristics can mimic those of breast carcinoma clinically, radiologically, and macroscopically. The tongue is the single most common anatomic site involved; however, a granular cell tumor may arise in virtually any site of the body. We report on a 67-year-old male patient with a palpable breast mass presenting as an irregular mass on mammography and ultrasound.
Subject(s)
Aged , Humans , Male , Breast Neoplasms , Breast Neoplasms, Male , Breast , Granular Cell Tumor , Mammography , Schwann Cells , Tongue , UltrasonographyABSTRACT
Objective To investigate general and clinicopathological characteristics of male breast cancer and analyze the factors affecting the outcomes of the patients.Methods Fifty-nine male breast cancer patients treated at Cancer Hospital of Zhengzhou University from January 2002 to December 2011 were included into the study.The clinicopathologic features and 5-year survival rate were retrospectively analyzed.The clinicopathologieal characteristics were investigated by univariate analysis to evaluate the impact of these factors on patient survival.Results The median age at diagnosis was 64 years old in these patients.The positive rate of ER/PR was 74.6 ％ (44/59).The patients were followed up for 9-123 months.The 5-year survival rate was 61％.Patients in stages Ⅰ and Ⅱ had better overall survival than those in stages Ⅲ and Ⅳ.Conclusion The male breast cancer patient has special clinical characteristics.TNM stage is a significant predictor of the overall survival.
ABSTRACT
Male breast cancer is rare,it mainly caused by the interaction of the genetic factors,hormone levels,way of life,and the environment.Its clinical manifestations are indolent tumors.The diagnosis method includes clinical medical examination and imaging examination,and pathology examination.The treatment is in reference to the female breast cancer treatment model,including surgery,chemoradiotherapy and endocrine therapy.Tumor size and axillary lymph nodes involvement are independent predictors of overall survival.
ABSTRACT
A neoplasia mamária no homem é um evento pouco freqüente, quanto mais em paciente jovem.Quando essa neoplasia é do tipo leucemia linfóide aguda torna-se uma situação rara. Dessa forma, odiagnóstico apropriado com métodos de imagem, como mamografia e ultra-sonografia, além da biópsiacom agulha e do estudo imunoistoquímico, auxiliam na indicação da terapêutica sistêmica.
The male breast localization of an acute lymphoblastic leukemia is a rare event. The use of mammography,ultrasound and fine needle or core biopsy could help in this diagnosis. The imunohistochemistrycomplete an orientation for the systemic treatment.
Subject(s)
Humans , Male , Adult , Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Breast Neoplasms, Male/diagnosis , Immunohistochemistry , Mammography , Neoplasm Recurrence, Local , Ultrasonography, MammaryABSTRACT
Objective To analyze the clinical data of male breast cancer (MBC),and investigate the clinical characteristics and factors potentialy affecting prognosis of male breast cancer. Methods A retrospective case-control study was performed on 17 MBC and 102 female breast cancer cases from January 1996 to 2008, treated in the hospital with pathologic proofs. Results MBC accounted for 1.15% (17/1473) of all cases. The initial visiting age was older, the time from the appearance of lump to the first doctor contact was longer, the positive rate of axiUary lymph node metastasis and local skin change incidence ratio was higher in the male group (P <0.05); there was no significant difference about overall 5-year disease-specific survival between the two groups (P >0.05), when tumor stages and nodal involvement were checked, Conclusion This study suggests that the two groups' prognosis is similar, the gender is uncertain prognostic factor.
ABSTRACT
Objective To explore the diagnosis,treatment and prognosis of male breast cancer.Methods The clinical data of 17 male patients with breast cancer were analyzed retrospectively.Results The average age of these 17 patients was 59.6 years.In these 17 male cases,the breast cancer in 3 cases was stageⅠ,in 5 cases stageⅡ,in 7 cases stage Ⅲ,and in 2 cases stage Ⅳ.The major pathological type was typical invasive ductal carcinoma.The breast cancer positive rates of estrogen receptor was 82.4 % and progestogen receptor(PR) was 72.5 %.All of these cases were treated by radical operation and postoperative adjuvant radiotherapy,endocrine therapy and(or) chemotherapy.One patient was lost to follow-up,2 died of non-tumor disease 8 months and 3 years after operation,respectively,and the other 14 have survived for 1-12 years after operation.Conclusions Male breast cancer is an uncommon disease,age of onset is more advanced,and the misdiagnostic rate is high.Tamoxifen is the first choice of hormone therapy.Many factors influence the prognosis of male breast cancer,the most important of which are the TNM stage of tumor,and condition of lymph node involvement.
ABSTRACT
Objective To explore the clinical characteristics,diagnosis,treatment,and prognosis of male breast cancer.Methods The clinical data of 38 cases of male breast cancer,who were treated in the two hospital during the past 10 years,were analyzed retrospectively.The diagnosis was mainly based on preoperative B-ultrasound,radiography with molybdenum target tube and fine needle aspiration.Among the 38 cases,radical mastectomy was conducted in 3 cases,modified radical mastectomy in 27 cases,simple mastectomy in 5 cases,and operation was refused in 3 cases.Postoperatively,radiotherapy was adopted in 4 cases,simple endocrinotherapy in 7 cases,radiotherapy plus chemotherapy in 9 cases,and chemotherapy plus endocrinotherapy in 8 cases.Results Median age at treatment was 58.5(53-82)years.TNM staging included stageⅠin 13 cases,stageⅡ in 19 cases,stageⅢ in 4 cases,and stageⅣ in 2 cases.Median follow-up was 73.8 months(2 months-10 years),and follow-up rate was 73.6%(28/38).During the follow-up,13 cases died including 8 cases died of local recurrence and metastasis,and 5 cases died of heart and brain disease.The 5-and 10-year overall survival rate was 71.6% and 55.3% respectively;5-and 10-year disease-specific survival of stageⅠ,Ⅱ was 92.6% and 78.9% respeoively;among 6 cases of stageⅢ,Ⅳ 4 were followed,and all 4 cases died with in 3 years.Conclusions Male breast cancer has a long course,poor prognosis and low survival rate.Combined therapy with modified radical mastectomy,as its basis,is the treatment of choice for male breast cancer.There is a certain correlation between the prognosis of male breast cancer and clinical stage of the disease.