ABSTRACT
RESUMEN El cáncer de mama en el sexo masculino es una entidad clínica poco frecuente, tiene una presentación unimodal a los 71 años de edad, generalmente se presenta de manera similar a la forma en que se presenta en el sexo femenino. Su causa es poco conocida. Los sarcomas son tumores de componentes mesenquimatoso que constituyen del 0,2-1 % de todos los tumores de mama, y menos del 5 % del total. El sarcoma neurogénico, a su vez, es un tumor extremadamente raro. Representa del 1-2 % aproximadamente, de los tumores de los nervios periféricos con transformación maligna. Debido a la rareza geográfica e histopatológica de este tipo y mucho más en pacientes masculinos se presentó este caso. Paciente masculino de 57 años de edad, con el diagnóstico de un sarcoma de la mama derecha. Se le realizó una mastectomía radical más quimioterapia y radioterapia adyuvante. Los estudios de inmunohistoquímicos permitieron llegar al diagnóstico de sarcoma neurogénico.
ABSTRACT Breast cancer in men (BCM) is a rare clinical entity that has a unimodal presentation at the age of 71 years, and generally presents in a similar way it presents in the female sex. Its etiology remains almost unknown. Sarcomas are tumors of mesenchymal components representing from 0.2 to 1 % of all the breast tumors and less than 5 % of the total. The neurogenic sarcoma is also an extremely rare tumor. It represents around 1-2 % of the peripheral nerves tumors with malignant transformations. Due to location and histopathological rarity of this kind of tumors, much more in male patients, the authors presented the case of a male patient, aged 57 years, with the diagnosis of a left breast sarcoma. He undergone a radical mastectomy plus adjuvant chemotherapy and radiotherapy. The immunohystochemical studies allowed arriving to the diagnosis of neurogenic sarcoma.
Subject(s)
Humans , Male , Middle Aged , Breast/pathology , Immunohistochemistry/methods , Breast Neoplasms, Male/surgery , Breast Neoplasms, Male/diagnosis , Breast Neoplasms, Male/etiology , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/drug therapy , Breast Neoplasms, Male/radiotherapy , Mastectomy , Sarcoma, Clear Cell , Neurofibrosarcoma/surgery , Neurofibrosarcoma/diagnosis , Neurofibrosarcoma/etiology , Neurofibrosarcoma/pathologyABSTRACT
El cáncer de mama (CM) en el hombre (CMM) es una entidad poco frecuente. Si bien tiene algunas semejanzas con el CM femenino, es una patología con un perfil propio. El objetivo del estudio consiste en conocer las características del CMM y su manejo en nuestro medio. Materiales y métodos: estudio retrospectivo que incluyó pacientes diagnosticados de CMM en tres centros del Uruguay en un período de 15 años. Resultados: se incluyeron 12 pacientes; la mediana de edad fue 68 años; un tercio de ellos tenían antecedentes familiares (AF). Características clínico patológicas: todos los tumores fueron carcinomas ductales con grado histológico (GH) 2-3, » se hallaban en estadio (E) I, la mitad (6) en EII, 6 tuvieron metástasis axilares, 2/3 fueron receptores de estrógeno (RE) / receptores de progesterona (RP) +. Se definieron 3 subtipos biológicos: I) HER2- RE/RP+: 2/3 de los pacientes; II) HER2+: 1/6; y III) triple negativo: 1/6. Todos los pacientes con enfermedad localizada fueron sometidos a mastectomía y la mayoría recibió tratamiento con quimioterapia (QT). La totalidad de quienes presentaron enfermedad localizada RE/RP+ recibieron hormonoterapia adyuvante con buena adherencia y tolerancia. Dos de los once pacientes tratados con criterio radical recayeron en la evolución; el resto permanece en controles o tratamiento sin evidencia de recaída. Conclusión: presentamos una serie de pacientes con CMM, con un perfil similar al reportado en la literatura. La edad de presentación fue superior a la del CM femenino, y la mayoría fueron RE/RP +, HER 2-; sin embargo, en esta serie los pacientes se presentaron en estadio localizado y con tumores de alto grado en una proporción mayor a lo descrito en la literatura.
Breast cancer (BC) in men (MBC) is an uncommon clinical entity. Even though it shares some similarities with female BC, it has a distinctive profile. The objective of this study was to identify the characteristics of MBC and learn how it is managed in our setting. Materials and methods: retrospective study including patients diagnosed with MBC in three centers in Uruguay for a period of 15 years. Results: 12 patients were enrolled; the median age was 68 years; a third of whom had a family history (FH). Clinical and pathological characteristics: all of the tumors were ductal carcinomas of histological grade (HG) 2-3, 1/4 were stage (S) I, half (6) were SII, 6 had axillary metastases, 2/3 were estrogen receptor (ER) / progesterone receptor (PR) +. Three biological subtypes were defined: I) HER2- ER/PR+: 2/3 of patients; II) HER2+: 1/6; and III) triple-negative: 1/6. All patients with localized cancer underwent a mastectomy and most were treated with chemotherapy (CHT). All of those who presented with localized, ER/PR+ cancer received adjuvant hormone therapy, with good adherence and tolerance. Two of the eleven patients treated with radical surgery recurred during evolution; the rest remain in follow-up or treatment without evidence of recurrence. Conclusion: we presented a series of patients with MBC, with a profile similar to the one reported in the literature. Age at presentation was higher than that of female BC, and most were ER/PR +, HER 2-. However, patients in this series presented with breast cancer in the localized stage and high-grade tumors in a higher proportion than is described in the literature.
O câncer de mama (CM) em homens (CMM) é uma entidade clínica incomum. Embora tenha algumas semelhanças com o CM feminino, é uma patologia com o seu próprio perfil. O objetivo deste estudo foi conhecer as características do CMM e seu manejo no nosso meio. Materiais e métodos: estudo retrospectivo com pacientes com diagnóstico de CMM em três centros do Uruguai em um período de 15 anos. Resultados: foram incluídos 12 pacientes; a mediana da idade foi 68 anos; um terço deles tinha antecedentes familiares (AF). Características clínico-patológicas: todos os tumores foram carcinomas ductais de grau histológico (GH) 2-3, 1/4 estavam no estágio (E) I, a metade (6) no EII, 6 apresentaram metástases axilares, 2/3 foram receptores de estrogênio (RE) / receptores de progesterona (RP) +. Foram definidos 3 subtipos biológicos: I) HER2- RE/RP+: 2/3 dos pacientes; II) HER2+: 1/6; e III) triplo-negativo: 1/6. Todos os pacientes com doença localizada foram submetidos a mastectomia e a maioria receberam tratamento com quimioterapia (QT). A totalidade dos que apresentaram doença localizada RE/RP+ recebeu hormonioterapia adjuvante com boa adesão e tolerância. Dois dos onze pacientes tratados com critério radical recaíram na evolução; o resto permanece sob monitoramento ou tratamento sem evidência de recaída. Conclusão: apresentamos uma série de pacientes com CMM, com um perfil semelhante ao descrito na literatura. A idade de apresentação foi maior do que para o CM feminino, e a maioria foram RE/RP +, HER 2-; entretanto, os pacientes desta série apresentaram-se com estágio localizado e tumores de alto grau em uma proporção maior do que a descrita na literatura.
Subject(s)
Humans , Male , Middle Aged , Aged , Carcinoma, Ductal, Breast , Breast Neoplasms, Male/surgery , Breast Neoplasms, Male/diagnosis , Breast Neoplasms, Male/drug therapy , Antineoplastic Agents/therapeutic use , Recurrence , Clinical Evolution , Retrospective Studies , Chemotherapy, Adjuvant , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/radiotherapy , Neoadjuvant TherapyABSTRACT
We previously demonstrated that alkyl gallates coupled to triphenylphosphine have a selective and efficient antiproliferative effect by inducing mitochondrial uncoupling in vitro due to the increased mitochondrial transmembrane potential of tumor cells. Therefore, in this work, the in vivo antitumor activities of alkyl gallate triphenylphosphonium derivatives (TPP+C8, TPP+C10 and TPP+C12) were evaluated in a syngeneic murine model of breast cancer. We found that TPP+C10 increased the cytosolic ADP/ATP ratio and significantly increased the AMP levels in a concentration-dependent manner in TA3/Ha murine mammary adenocarcinoma cells. Interestingly, TPP+C10 induced a decrease in the levels of cellular proliferation markers and promoted caspase-3 activation in tumor-bearing mice. Additionally, TPP+C10 inhibited tumor growth in the syngeneic mouse model. Importantly, 30days of intraperitoneal (i.p.) administration of the combination of TPP+C10 (10mg/kg/48h) and the antibiotic doxycycline (10mg/kg/24h) completely eliminated the subcutaneous tumor burden in mice (n=6), without any relapses at 60days post-treatment. This enhancement of the individual activities of TPP+C10 and doxycycline is due to the uncoupling of oxidative phosphorylation by TPP+C10 and the inhibition of mitochondrial biogenesis by doxycycline, as demonstrated by loss of mitochondrial mass and overexpression of PGC1-α as an adaptive response. Moreover, i.p. administration of TPP+C10 (10mg/kg/24h) to healthy mice did not produce toxicity or damage in organs important for drug metabolism and excretion, as indicated by hematological, biochemical and histological assessments. These findings suggest that the combination of TPP+C10 with doxycycline is a valuable candidate therapy for breast cancer management.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/pharmacology , Breast Neoplasms, Male/drug therapy , Gallic Acid/pharmacology , Mammary Neoplasms, Experimental/drug therapy , Organophosphorus Compounds/pharmacology , Adenocarcinoma/genetics , Adenocarcinoma/metabolism , Adenocarcinoma/pathology , Adenosine Triphosphate/metabolism , Animals , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Apoptosis/drug effects , Breast Neoplasms, Male/genetics , Breast Neoplasms, Male/metabolism , Breast Neoplasms, Male/pathology , Caspase 3/metabolism , Cell Line, Tumor , Cell Proliferation/drug effects , Dose-Response Relationship, Drug , Doxycycline/pharmacology , Gallic Acid/analogs & derivatives , Male , Mammary Neoplasms, Experimental/genetics , Mammary Neoplasms, Experimental/metabolism , Mammary Neoplasms, Experimental/pathology , Mice , Mitochondria/drug effects , Mitochondria/metabolism , Mitochondria/pathology , Organelle Biogenesis , Oxidative Phosphorylation/drug effects , Oxygen Consumption/drug effects , Signal Transduction/drug effects , Time Factors , Tumor Burden/drug effectsABSTRACT
BACKGROUND: male breast cancer is a disease with low incidence, which is further reduced when it comes to bilateral synchronous presentation. There are few published cases in recent years. The aim is to establish guidelines for the management of this disorder that is so rare. CLINICAL CASE: a 75-year-old with tumors in both breasts, which were completely resected with removal of palpable nodes. The histopathological study reported ductal carcinoma. The indicated treatment was adjuvant tamoxifen and radiotherapy. The patient is currently in a disease-free period. CONCLUSIONS: this is a rare disease, whose main treatment is surgery, hence the importance of early diagnosis. Most cases require adjuvant chemotherapy and radiotherapy because they are usually diagnosed at an advanced stage.
antecedentes: el cáncer de mama en el hombre es una enfermedad con baja incidencia, que se reduce aún más cuando es bilateral sincrónica. Existen pocas publicaciones en los últimos años. Objetivo: establecer pautas para el tratamiento de este cáncer, aunque sea infrecuente. Caso clínico: paciente masculino de 75 años de edad, con tumores en ambas mamas, que se le resecaron completamente con exéresis de ganglios palpables. El estudio histopatológico informó que se trataba de un carcinoma ductal infiltrante no especificado. Se indicó tratamiento adyuvante con tamoxifeno y radioterapia; en la actualidad está libre de enfermedad. Conclusiones: el carcinoma mamario bilateral sincrónico en el varón es una enfermedad poco frecuente. Su tratamiento principal es la cirugía, de ahí la importancia del diagnóstico temprano. En la mayoría de los casos se requiere quimioterapia y radioterapia adyuvante porque suelen diagnosticarse en un estadio avanzado.
Subject(s)
Breast Neoplasms, Male , Carcinoma, Ductal, Breast , Neoplasms, Multiple Primary , Aged , Antineoplastic Agents, Hormonal/therapeutic use , Breast Neoplasms, Male/drug therapy , Breast Neoplasms, Male/epidemiology , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/radiotherapy , Breast Neoplasms, Male/surgery , Carcinoma, Ductal, Breast/drug therapy , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/radiotherapy , Carcinoma, Ductal, Breast/surgery , Chemotherapy, Adjuvant , Combined Modality Therapy , Estrogen Receptor Modulators/therapeutic use , Estrogens , Humans , Lymph Node Excision , Male , Mastectomy , Neoplasms, Hormone-Dependent/drug therapy , Neoplasms, Hormone-Dependent/pathology , Neoplasms, Hormone-Dependent/radiotherapy , Neoplasms, Hormone-Dependent/surgery , Neoplasms, Multiple Primary/drug therapy , Neoplasms, Multiple Primary/epidemiology , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/radiotherapy , Neoplasms, Multiple Primary/surgery , Radiotherapy, Adjuvant , Tamoxifen/therapeutic useABSTRACT
El objetivo del presente trabajo es presentar el comportamiento clínico patológico de 8 pacientes del sexo masculino con carcinoma de la mama, atendidos en el Instituto Oncológico "Dr. Luis Razetti" durante los años 2004-2005. El cáncer de mama en hombres representó el 2,33 por ciento, 37,5 por ciento fueron adenocarcinoma ductal infiltrante, 37,5 por ciento estadio IIIA, 87,5 por ciento se trató con mastectomías radicales modificadas, 57,25 por ciento expresan receptores de estrógenos, 28,57 por ciento sobre expresan Her2neu, 37,5 por ciento recibió adyuvancia, 62,5 por ciento con tamoxifeno, el seguimiento promedio fue de 44 meses, 37,5 por ciento de recaídas local y 62,5 por ciento están libres de enfermedad a los 5 años. El cáncer de mama en hombres es muy poco frecuente. El tratamiento primario es la cirugía, siguiendo los mismos lineamientos para la adyuvancia que en las mujeres.
The objective of the present work is analyzing the clinic pathologic status of 8 patients of sex male, attending in the Oncological Institute "Dr. Luis Razetti" during the 2004-2005 years. The breast cancer in male represented the 2.33 percent, in 37.5 percent of them were ductal infiltrante adenocarcinoma, 37.5 percent were state IIIA,87.5 percent were treated with surgery: Modified radical mastectomy, 57.25 percent express estrogen receptors, 28,57 percent over express Her2neu. 37.5 percent received adjuvant, 62.5 percent with tamoxifen, the average of periodic control was 44 month, and 37.5 percent of local recurrence and 62.5 percent of the patients are free of disease to 5 years. The breast cancer in male is less frequent. The primary treatment is surgery, with the same form to the adjuvant as in women.
Subject(s)
Humans , Male , Mastectomy, Radical , Breast Neoplasms, Male/surgery , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/drug therapy , Breast Neoplasms, Male/therapy , Adenocarcinoma/pathology , Antibodies, Monoclonal/immunology , Biopsy/methods , Carcinoma, Intraductal, Noninfiltrating/pathologyABSTRACT
AIM: In several commonly used regimens, chemotherapy doses are split across different days of the cycle. We aimed to determine the feasibility of growth factor support with once-per-cycle pegfilgrastim in this setting. METHODS: This phase II study in breast cancer patients assessed the utility of a single 6 mg subcutaneous dose of pegfilgrastim administered on day 9 of an intravenous (IV) "split" CMF (cyclophosphamide 600 mg/m(2), methotrexate 40 mg/m(2) and 5-fluorouracil 600 mg/m(2)) chemotherapy regimen administered on days 1 and 8 and repeated every 28 days for 6 cycles. RESULTS: Fifty-eight patients were enrolled, with 49 completing the study. For the primary endpoint, 48 patients (83%) received >or=85% of the relative dose intensity (RDI) of chemotherapy over all 6 cycles (95% confidence interval [CI], 71-91%). Across all chemotherapy cycles, 41 patients (71%) received all scheduled cycles on time and most patients (n=49, 84%) received >or=85% of the planned dose of all chemotherapy agents in all cycles. In total, 295/319 cycles (92%) were delivered on schedule and >or=85% of the planned dose of all chemotherapy agents were administered in 309/319 cycles (97%). Febrile neutropenia was reported in only 2 patients (3%). There were no grade 4 adverse events related to pegfilgrastim. DISCUSSION: Day 9 pegfilgrastim administration was well tolerated and provided effective protection against neutropenia in patients receiving IV CMF on days 1 and 8, allowing chemotherapy to be delivered on time and at the scheduled dose in most patients.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Breast Neoplasms, Male/drug therapy , Breast Neoplasms/drug therapy , Carcinoma/drug therapy , Granulocyte Colony-Stimulating Factor/administration & dosage , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemotherapy, Adjuvant , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Filgrastim , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Granulocyte Colony-Stimulating Factor/adverse effects , Humans , Injections, Intravenous , Male , Methotrexate/administration & dosage , Methotrexate/adverse effects , Middle Aged , Neutropenia/prevention & control , Polyethylene Glycols , Recombinant Proteins , Treatment OutcomeABSTRACT
BACKGROUND: Recombinant granulocyte colony-stimulating factors (G-CSFs) such as Filgrastim are used to treat chemotherapy-induced neutropenia. We investigated a new G-CSF, XM02, and compared it to Neupogen after myelotoxic chemotherapy in breast cancer (BC) patients. METHODS: A total of 348 patients with BC receiving docetaxel/doxorubicin chemotherapy were randomised to treatment with daily injections (subcutaneous 5 microg/kg/day) for at least 5 days and a maximum of 14 days in each cycle of XM02 (n = 140), Neupogen (n = 136) or placebo (n = 72). The primary endpoint was the duration of severe neutropenia (DSN) in cycle 1. RESULTS: The mean DSN in cycle 1 was 1.1, 1.1, and 3.9 days in the XM02, Neupogen, and placebo group, respectively. Superiority of XM02 over placebo and equivalence of XM02 with Neupogen could be demonstrated. Toxicities were similar between XM02 and Neupogen. CONCLUSION: XM02 was superior to placebo and equivalent to Neupogen in reducing DSN after myelotoxic chemotherapy.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms, Male/drug therapy , Breast Neoplasms/drug therapy , Granulocyte Colony-Stimulating Factor/therapeutic use , Neutropenia/drug therapy , Adult , Aged , Analysis of Variance , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/pathology , Breast Neoplasms, Male/pathology , Docetaxel , Double-Blind Method , Doxorubicin/adverse effects , Doxorubicin/therapeutic use , Female , Filgrastim , Granulocyte Colony-Stimulating Factor/adverse effects , Granulocyte Colony-Stimulating Factor/pharmacokinetics , Humans , Male , Middle Aged , Neoplasm Staging , Neutropenia/chemically induced , Neutrophils/drug effects , Recombinant Proteins , Taxoids/adverse effects , Taxoids/therapeutic use , Treatment OutcomeABSTRACT
The majority of breast cancers in male patients are hormone receptor positive. Tamoxifen has proven to be successful in both adjuvant and metastatic settings and remains the standard of care. Given the improved outcomes in female patients with aromatase inhibitors (AI), these drugs have become a potential therapeutic tool for male patients. Preliminary data show effective suppression of oestradiol levels in males treated with AI and some reports have demonstrated objective responses. Here we report a case of a male patient with metastatic breast cancer treated with letrozole who achieved clinical response associated with a decrease in blood oestradiol levels.
Subject(s)
Antineoplastic Agents, Hormonal/therapeutic use , Aromatase Inhibitors/therapeutic use , Breast Neoplasms, Male/drug therapy , Carcinoma, Ductal, Breast/drug therapy , Estrogens , Neoplasms, Hormone-Dependent/drug therapy , Nitriles/therapeutic use , Progesterone , Triazoles/therapeutic use , Breast Neoplasms, Male/blood , Breast Neoplasms, Male/chemically induced , Breast Neoplasms, Male/enzymology , Carcinoma, Ductal, Breast/blood , Carcinoma, Ductal, Breast/chemically induced , Carcinoma, Ductal, Breast/enzymology , Carcinoma, Ductal, Breast/radiotherapy , Carcinoma, Ductal, Breast/secondary , Combined Modality Therapy , Cyproterone Acetate/adverse effects , Cyproterone Acetate/therapeutic use , Estradiol/blood , Estrogens, Conjugated (USP)/adverse effects , Estrogens, Conjugated (USP)/therapeutic use , Humans , Letrozole , Lymphatic Metastasis , Male , Middle Aged , Neoplasms, Hormone-Dependent/blood , Neoplasms, Hormone-Dependent/chemically induced , Neoplasms, Hormone-Dependent/enzymology , Phobic Disorders/drug therapy , Receptors, Estrogen/analysis , Receptors, Progesterone/analysis , Spinal Neoplasms/radiotherapy , Spinal Neoplasms/secondary , Testosterone/blood , Treatment OutcomeABSTRACT
INTRODUCTION: To investigate the value of baseline serum levels of VEGF, bFGF, endostatin and their ratio as predictive factors of response to endocrine therapy in patients with metastatic breast cancer (MBC) and positive ER treated with letrozole after tamoxifen failure. MATERIALS AND METHOD: The serum levels of endostatin, VEGF and bFGF were determined in postmenopausal patients with progressing MBC from serum samples obtained before initiation of letrozole. The relation between serum angiogenic factor levels and TTP was investigated. RESULTS: Seventy-six patients (45.2%) presented a high endostatin level (> 24.6 ng/ml), 40% low bFGF levels (0 pg/ml) and 50.4% low VEGF (=/< 187 ng/ml). With a median follow-up of 22 months, the median TTP was 12.3 months. Median TTP was worse in patients with high endostatin concentration as well as in the low bFGF group, but was not affected when VEGF was considered. When the two factors were combined, the median TTP of patients with endostatin > 24.6 ng/ml and bFGF equal 0 pg/ml was 9.5 months versus 19.5 months in patients with endostatin =/< 24.6 ng/ml and bFGF > 0 pg/ml. CONCLUSIONS: The baseline levels of bFGF and endostatin are predictive factors of efficacy in patients with MBC treated with letrozole and can select groups with different TTP.