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1.
PLoS One ; 15(6): e0232800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497148

RESUMO

Second primary breast cancer (SPBC) is becoming one of the major obstacles to breast cancer (BC) control. This study was aimed to determine the trend of SPBC incidence over time and the risk of developing SPBC in site-specific primary cancer survivors in the United States. The Surveillance, Epidemiology, and End Results (SEER) 13 registry (1992-2015) was used to identify SPBC patients with previous malignancies. Standardized incidence ratio (SIR) was computed to compare the incidence rates of the observed cases of SPBC in cancer survivors over the expected cases in the general population. Elevated risk of SPBC was observed in women with previous BC (SIR = 1.74) or thyroid cancer (SIR = 1.17). Women with initial skin melanoma in older age (≥50 years) (SIR = 1.11), or White race (SIR = 1.11) presented an elevated incidence of SPBC than the general female population. Besides, Asian/Pacific Islander (API) women with cancer of corpus uteri, ovary, bladder, or kidney were prone to developing SPBC when compared with the general population, with SIRs of 1.61, 1.35, 1.48, and 1.70, respectively. Male BC patients showed profound risk of developing SPBC (SIR = 34.86). Male leukemia patients also presented elevated risk of developing SPBC (SIR = 2.06). Our study suggests significant increase of SPBC in both sexes in the United States. Elevated risk of SPBC exists in survivors with primary BC, female thyroid cancer, male leukemia, and API female cancer patients with primary genitourinary cancer. Our study is helpful in developing strategies for BC control and prevention on specific first primary cancer survivors with an elevated risk of SPBC.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer , Segunda Neoplasia Primária/epidemiologia , Adulto , Fatores Etários , Idoso , Grupos de Populações Continentais/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Leucemia/epidemiologia , Masculino , Melanoma/epidemiologia , Pessoa de Meia-Idade , Neoplasias Hormônio-Dependentes/epidemiologia , Especificidade de Órgãos , Programa de SEER , Neoplasias Cutâneas/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Estados Unidos/epidemiologia , Neoplasias Urogenitais/epidemiologia
2.
Isr Med Assoc J ; 22(3): 160-163, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32147980

RESUMO

BACKGROUND: Male breast cancer (MBC) is a rare disease that is poorly understood. Treatment protocols are widely extrapolated from breast cancer in women. OBJECTIVES: To review the experience with MBC of a single center in Israel over a period of 22 years. METHODS: This single center retrospective study evaluated all patients diagnosed with MBC over a period of 22 years (1993-2015). Data were extracted from patient medical charts and included demographics, clinical, surgical, and oncological outcomes. RESULTS: The study comprised 49 patients. Mean age at diagnosis was 64.1 ± 13.5 years. The majority were diagnosed at early stages (1A-2A) (54.4%), 30.6% were stage 3B mostly due to direct skin and nipple involvement, and 59.2% of the patients had node negative disease. All of the patients were diagnosed with invasive ductal carcinoma and 30.6% had concomitant ductal carcinoma in situ. Estrogen receptor (ER) status was predominantly positive and luminal B (HER2-) was the most common subtype. Of the patients, 18.4% were BRCA carriers. The majority of patients underwent mastectomy. Radiotherapy was delivered to 46.9% and hormonal therapy to 89.8%. Chemotherapy was administered to 42.9%. Overall survival was 79.6% with a median survival of 60.1 (2-178) months; 5- and 10-year survival was 93.9% and 79.6%, respectively. Progesterone receptor (PR)-negative patients had a significantly improved overall survival. CONCLUSIONS: MBC has increasing incidence. PR-negative status was associated with better overall survival and disease-free interval. Indications to radiotherapy and hormonal therapy need standardization and will benefit from prospective randomized control trials.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/terapia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/terapia , Intervalo Livre de Doença , Humanos , Israel/epidemiologia , Masculino , Mastectomia/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
3.
Clin Imaging ; 60(1): 84-89, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31864206

RESUMO

Male breast cancer is a rare malignancy. Due to low prevalence and limited data to support male breast cancer screening, there are currently no recommendations for image-based screening in asymptomatic men and few recommendations for men at high risk for breast cancer. However, symptomatically diagnosed cancers in men are typically advanced, suggesting that earlier detection may improve outcomes. In this article we briefly review the risk factors for male breast cancer, and discuss the potential benefits and possible drawbacks of routine image-based screening for men at high risk for breast cancer.


Assuntos
Neoplasias da Mama Masculina/diagnóstico por imagem , Adulto , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama Masculina/epidemiologia , Detecção Precoce de Câncer , Feminino , Humanos , Masculino , Mamografia , Programas de Rastreamento , Pessoa de Meia-Idade , Fatores de Risco
4.
Cancer ; 126(1): 26-36, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31588557

RESUMO

BACKGROUND: Male breast cancer (MBC) is a rare disease for which there is limited understanding of treatment patterns and prognostic factors. METHODS: Men with TNM stage I to stage III breast cancer diagnosed between 2004 and 2014 in the National Cancer Data Base were included. Trends in treatment modalities were described using the average annual percentage change (AAPC) and estimated using Joinpoint software for the analysis of trends. Kaplan-Meier curves and the multivariate Cox proportional hazards regression model were used to compare survival between subgroups and to identify prognostic factors. RESULTS: A total of 10,873 MBC cases were included, with a median age at diagnosis of 64 years. Breast-conserving surgery was performed in 24% of patients, and 70% of patients undergoing breast conservation received radiotherapy. Approximately 44% of patients received chemotherapy, and 62% of patients with estrogen receptor-positive disease received endocrine therapy. Oncotype DX was ordered in 35% of patients with lymph node-negative, estrogen receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative tumors. During the study period, there was a significant increase in the rates of total mastectomy, contralateral prophylactic mastectomy, radiotherapy after breast conservation, ordering of Oncotype DX, and the use of endocrine therapy (P < .05). On multivariate analysis, factors found to be associated with worse overall survival were older age, black race, higher Charlson Comorbidity Index, high tumor grade and stage of disease, and undergoing total mastectomy. Residing in a higher income area; having progesterone receptor-positive tumors; and receipt of chemotherapy, radiotherapy, and endocrine therapy were associated with better overall survival. CONCLUSIONS: Despite the lack of prospective randomized trials in patients with MBC, the results of the current study demonstrated that the treatment of this disease has evolved over the years. These findings further the understanding of the modern treatment and prognosis of MBC, and identify several areas for further research.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Mama/cirurgia , Prognóstico , Neoplasias de Mama Triplo Negativas/epidemiologia , Idoso , Mama/patologia , Neoplasias da Mama Masculina/genética , Neoplasias da Mama Masculina/cirurgia , Neoplasias da Mama Masculina/terapia , Receptor alfa de Estrogênio/genética , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Estimativa de Kaplan-Meier , Masculino , Mastectomia , Mastectomia Segmentar , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Receptor ErbB-2/genética , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/cirurgia , Neoplasias de Mama Triplo Negativas/terapia , Estados Unidos/epidemiologia
5.
Br J Cancer ; 121(12): 991-1000, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31719684

RESUMO

BACKGROUND: Metastatic breast cancer (MBC) behaviour differs depending on hormone receptors (HR) and human epidermal growth factor receptor (HER2) statuses. METHODS: The kinetics of central nervous system (CNS) metastases (CNS metastasis-free survival, CNSM-FS) and subsequent patient's prognosis (overall survival, OS) according to the molecular subtype were retrospectively assessed in 16703 MBC patients of the ESME nationwide multicentre MBC database (Kaplan-Meier method). RESULTS: CNS metastases occurred in 4118 patients (24.6%) (7.2% at MBC diagnosis and 17.5% later during follow-up). Tumours were HER2-/HR+ (45.3%), HER2+/HR+ (14.5%), HER2+/HR- (14.9%) and triple negative (25.4%). Median age at CNS metastasis diagnosis was 58.1 years (range: 22.8-92.0). The median CNSM-FS was 10.8 months (95% CI: 16.5-17.9) among patients who developed CNS metastases. Molecular subtype was independently associated with CNSM-FS (HR = 3.45, 95% CI: 3.18-3.75, triple-negative and HER2-/HR+ tumours). After a 30-month follow-up, median OS after CNS metastasis diagnosis was 7.9 months (95% CI: 7.2-8.4). OS was independently associated with subtypes: median OS was 18.9 months (HR = 0.57, 95% CI: 0.50-0.64) for HER2+/HR+ , 13.1 months (HR = 0.72, 95% CI: 0.65-0.81) for HER2+/HR-, 4.4 months (HR = 1.55, 95% CI: 1.42-1.69) for triple-negative and 7.1 months for HER2-/HR+ patients (p <0.0001). CONCLUSIONS: Tumour molecular subtypes strongly impact incidence, kinetics and prognosis of CNS metastases in MBC patients. CLINICAL TRIAL REGISTRATION: NCT03275311.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Neoplasias do Sistema Nervoso/epidemiologia , Neoplasias de Mama Triplo Negativas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama Masculina/classificação , Neoplasias da Mama Masculina/genética , Neoplasias da Mama Masculina/patologia , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Cinética , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias do Sistema Nervoso/genética , Neoplasias do Sistema Nervoso/patologia , Neoplasias do Sistema Nervoso/secundário , Prognóstico , Receptor ErbB-2/genética , Neoplasias de Mama Triplo Negativas/classificação , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/patologia , Adulto Jovem
6.
Breast ; 48: 65-72, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31539869

RESUMO

BACKGROUND: Male breast cancer (MBC) is a rare and understudied disease. There is limited evidence on association between environmental and occupational agents and MBC. Some similarities in risk factors may be shared with female breast cancer. We evaluated solvents, metals, exhaust gases and other agents in relation to MBC within the large Nordic Occupational Cancer Study (NOCCA). METHODS: The study included 1469 MBC cases and 7345 controls from Finland, Iceland and Sweden, matched for the date of birth, sex and country. Cases were identified through national cancer registries. Data on occupation and other demographic indicators were collected from census records and population registries. Overall, 24 occupational exposures were assessed. Exposure estimates were assigned by linking job titles to job-exposure matrices (NOCCA-JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. RESULTS: Significantly decreased overall OR was observed for physical workload (OR = 0.78, 95% CI 0.67-0.91). Protective effect of physical workload was stronger by increasing exposure level with significant dose-response relationship (p-trend<0.01). Non-significantly increased ORs were observed for trichloroethylene, iron, lead, chromium, welding fumes and wood dust, and decreased ORs for asbestos, silica dust and perchloroethylene. However, these results were not consistent across all analyses. CONCLUSIONS: The current study showed 20-25% protective effect for physical workload at work, while no strong evidence for other agents was observed.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Países Escandinavos e Nórdicos , Carga de Trabalho
7.
S Afr J Surg ; 57(3): 56, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31392868

RESUMO

BACKGROUND: The purpose of this descriptive study was to determine and compare the incidence of left-sided and rightsided breast cancer at Dr George Mukhari Academic Hospital from January 2000 to June 2016. It aimed to determine if there was a significant variation in laterality of breast cancer at our institution. METHOD: A retrospective study. Medical records of breast cancer (BC) patients who were newly diagnosed from January 2000 to June 2016 were reviewed. Emphasis was on biopsy results (histology and/or cytology) and/or history of chemotherapy, and breast cancer laterality. RESULTS: Out of 1482 patients, 1427 had unilateral BC and 55 (3.7%) bilateral cancer. A total of 789 (55.3%) patients had left-sided breast cancer (LSBC) and 638 (44.7%) had right BC. Left BC was 10.6% more common than right BC with a left to right laterality ratio (LRR) of 1.24. There was a statistically significant relationship between laterality and stage (p = 0.050), with the right breast having more advanced stage cancers (88.7%) compared to the left breast (85%). There was no statistically significant difference between age, site and histological type of BC and laterality (p = 0.740, p = 0.052, p = 0.394 respectively). CONCLUSION: Left to right BC excess does exist in patients that were newly diagnosed at Dr George Mukhari Academic Hospital, South Africa, from January 2000 to June 2016.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/patologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/patologia , Neoplasias Unilaterais da Mama/epidemiologia , Neoplasias Unilaterais da Mama/patologia , Centros Médicos Acadêmicos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama Masculina/metabolismo , Carcinoma Ductal de Mama/metabolismo , Feminino , Humanos , Incidência , Antígeno Ki-67/metabolismo , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Receptor ErbB-2/metabolismo , Receptores Estrogênicos/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , África do Sul/epidemiologia , Neoplasias Unilaterais da Mama/metabolismo , Adulto Jovem
8.
Pan Afr Med J ; 33: 22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312338

RESUMO

Breast cancer is a complex disease characterized by the accumulation of multiple molecular alterations giving each tumor phenotype and an own evolutionary potential. This study aimed to describe the distribution of the profile and molecular subtypes of breast cancers followed at Surgical Oncology Unit of Donka National Hospital. This was retrospective and descriptive study on cases of breast cancer in which the hormone receptor status and expression of the Her2 oncogene have been performed from 2007 to 2016. We recorded 58 cases including 56 (96.6%) women and 2 (3.4%) men. The average age was 48.2 ± 10.9. Invasive ductal carcinoma accounted for 50 (86.2%) cases. The SBR grade was II in 31(53.4%) cases, III in 21 (36.2%) cases and I in 6 (10.3%) cases. The tumor was classified as T4 in 36 (62.1%) cases; it was metastatic in 11(19.0%) cases. Estrogen receptors were positive in 29 (50.0%) cases, progesterone receptors positive in 25 (43.1%) cases, the Her2 oncogene was positive in 22 (39.3%) cases. The distribution of molecular sub-types was: 20 (34.5%) luminal A, 15 (25.9%) triple negative, 13 (22.4%) Her2 overexpressed, 8 (13.8%) luminal B and 2 (3.2%) undetermined. This preliminary study showed the poor accessibility of immunohistochemistry for the molecular diagnosis of breast cancer in our country. Luminal A subtypes and triple negatives were more common. The determination of molecular subtypes is a rational basis for hormone therapy and targeted therapy, thus personalizing the treatment of breast cancer.


Assuntos
Neoplasias da Mama Masculina/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Neoplasias de Mama Triplo Negativas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/genética , Carcinoma Ductal de Mama/epidemiologia , Feminino , Guiné/epidemiologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Receptor ErbB-2/genética , Receptores Estrogênicos/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Neoplasias de Mama Triplo Negativas/epidemiologia
9.
Breast Cancer Res Treat ; 177(3): 705-711, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31280425

RESUMO

PURPOSE: To investigate the utility of mammography for breast cancer screening in a population of males at increased risk for breast cancer. METHODS: In this HIPAA-compliant institutional review board-approved single-institution study, mammography records and clinical data of 827 male patients who underwent digital mammography from September 2011-July 2018 were analyzed via the electronic medical record. 664 of these men presented with masses, pain, or nipple discharge and were excluded from this study. The remaining 163 asymptomatic men with familial and/or personal history of breast cancer, or with a known germline mutation in BRCA, underwent screening mammography and were included in this analysis. RESULTS: 163 asymptomatic men (age: mean 63 years, range 24-87 years) underwent 806 screening mammograms. 125/163 (77%) had a personal history of breast cancer and 72/163 (44%) had a family history of breast cancer. 24/163 (15%) were known mutation carriers: 4/24 (17%) BRCA1 and 20/24 (83%) BRCA2. 792/806 (98%) of the screening mammograms were negative (BI-RADS 1 or 2); 10/806 (1.2%) were classified as BI-RADS 3, all of which were eventually downgraded to BI-RADS 2 on follow-up. 4/806 (0.4%) mammograms were abnormal (BI-RADS 4/5): all were malignant. The cancer detection rate in this cohort was 4.9 cancers/1000 examinations. CONCLUSIONS: In our cohort, screening mammography yielded a cancer detection rate of 4.9 cancers/1000 examinations which is like the detection rate of screening mammography in a population of women at average risk, indicating that screening mammography is of value in male patients at high risk for breast cancer.


Assuntos
Neoplasias da Mama Masculina/diagnóstico por imagem , Neoplasias da Mama Masculina/epidemiologia , Detecção Precoce de Câncer , Mamografia , Adulto , Idoso , Idoso de 80 Anos ou mais , Detecção Precoce de Câncer/métodos , Grupos Étnicos , Humanos , Masculino , Mamografia/métodos , Programas de Rastreamento , Pessoa de Meia-Idade , Vigilância da População , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Adulto Jovem
10.
Eur J Cancer Care (Engl) ; 28(5): e13117, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31231921

RESUMO

BACKGROUND: Breast cancer (BC) in men is a rare and neglected disease representing <1% of all cancers in men and only 1% of all incident BC in western countries. OBJECTIVE: This study aimed to describe trends in the prevalence of patients hospitalised for male BC in France from 2009 to 2013, using the national administrative database (PMSI). METHODS: We included all men aged ≥18 admitted to hospital for BC during this period and estimated the prevalence of male breast cancer hospitalised in France over 5 years. We also describe clinical characteristics and treatments in men with surgery for BC over the 5-year period of the study. RESULTS: The prevalence of patients hospitalised for BC significantly decreased from 7.5 per 100,000 adult male inhabitants in 2009 to 6.3 per 100,000 in 2013. Considering the entire period, 2009-2013, we found a prevalence of 25.5 per 100,000 adult male inhabitants over 5 years. At 1 year of follow-up, we found a significant trend for at least one comorbidity (from 44.6% in 2009 to 51.2% in 2013, p = 0.04) but not for malignant nodes and metastasis. CONCLUSIONS: Ours is the first study to analyse the prevalence of patients hospitalised for male breast cancer and its changes over time in the whole population of a country. Our study also provides data on the clinical characteristics and treatments of male BC in France.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Hospitalização , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias da Mama Masculina/patologia , Neoplasias da Mama Masculina/terapia , Comorbidade , Bases de Dados Factuais , Diabetes Mellitus/epidemiologia , França/epidemiologia , Humanos , Hipertensão/epidemiologia , Linfonodos/patologia , Masculino , Mastectomia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Estudos Retrospectivos
11.
Med Oncol ; 36(8): 70, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31203460

RESUMO

Alterations in BRCA2, PALB2, CHEK2, and p53 genes have been identified for their association with male breast cancer in various studies. The incidence of male breast cancer in India is consistent with its global rate. The present study was carried out with an aim to evaluate the genetic alterations in male breast cancer patients from Malwa region of Punjab, India. Four male breast cancer patients belonging to different families were recruited from Guru Gobind Singh Medical College and Hospital, Faridkot, India. A total of 51 genes reported with implications in the pathogenesis of breast cancer were screened using next generation sequencing. Germline variations were found in BRCA1, BRCA2, PMS2, p53, and PALB2 genes, previously reported to be associated with MBC as well as FBC. In addition to these, 13 novel missense alterations were detected in eight genes including STK11, FZR1, PALB2, BRCA2, NF2, BAP1, BARD1, and CHEK2. Impact of these missense alterations on structure and function of protein was also analyzed through molecular dynamics simulation. Structural analysis of these single nucleotide polymorphisms (SNPs) revealed significant impact on the encoded protein functioning.


Assuntos
Neoplasias da Mama Masculina/genética , Idoso , Proteína BRCA2/genética , Neoplasias da Mama Masculina/epidemiologia , Quinase do Ponto de Checagem 2/genética , Proteína do Grupo de Complementação N da Anemia de Fanconi/genética , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Simulação de Dinâmica Molecular , Mutação , Linhagem , Polimorfismo de Nucleotídeo Único , Proteínas Serina-Treonina Quinases/genética , Proteína Supressora de Tumor p53/genética , Ubiquitina-Proteína Ligases/genética
12.
BMJ ; 365: l1652, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088823

RESUMO

OBJECTIVE: To investigate the incidence and characteristics of breast cancer in transgender people in the Netherlands compared with the general Dutch population. DESIGN: Retrospective, nationwide cohort study. SETTING: Specialised tertiary gender clinic in Amsterdam, the Netherlands. PARTICIPANTS: 2260 adult trans women (male sex assigned at birth, female gender identity) and 1229 adult trans men (female sex assigned at birth, male gender identity) who received gender affirming hormone treatment. MAIN OUTCOME MEASURES: Incidence and characteristics (eg, histology, hormone receptor status) of breast cancer in transgender people. RESULTS: The total person time in this cohort was 33 991 years for trans women and 14 883 years for trans men. In the 2260 trans women in the cohort, 15 cases of invasive breast cancer were identified (median duration of hormone treatment 18 years, range 7-37 years). This was 46-fold higher than in cisgender men (standardised incidence ratio 46.7, 95% confidence interval 27.2 to 75.4) but lower than in cisgender women (0.3, 0.2 to 0.4). Most tumours were of ductal origin and oestrogen and progesterone receptor positive, and 8.3% were human epidermal growth factor 2 (HER2) positive. In 1229 trans men, four cases of invasive breast cancer were identified (median duration of hormone treatment 15 years, range 2-17 years). This was lower than expected compared with cisgender women (standardised incidence ratio 0.2, 95% confidence interval 0.1 to 0.5). CONCLUSIONS: This study showed an increased risk of breast cancer in trans women compared with cisgender men, and a lower risk in trans men compared with cisgender women. In trans women, the risk of breast cancer increased during a relatively short duration of hormone treatment and the characteristics of the breast cancer resembled a more female pattern. These results suggest that breast cancer screening guidelines for cisgender people are sufficient for transgender people using hormone treatment.


Assuntos
Neoplasias da Mama/epidemiologia , Estrogênios/efeitos adversos , Transexualidade/tratamento farmacológico , Adulto , Antagonistas de Androgênios/uso terapêutico , Neoplasias da Mama Masculina/epidemiologia , Estrogênios/uso terapêutico , Feminino , Humanos , Incidência , Masculino , Países Baixos/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Testosterona/uso terapêutico , Adulto Jovem
13.
Cancer Epidemiol Biomarkers Prev ; 28(5): 980-986, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30842126

RESUMO

BACKGROUND: In case reports, concerns have been raised as to whether finasteride use increases the risk of male breast cancer. Previous epidemiologic evidence on the potential link is conflicting. This study aimed to assess whether an association between finasteride use and male breast cancer exists after accounting for potential confounders. METHODS: The source population consisted of all men (≥35 years) from Denmark (1995-2014), Finland (1997-2013), and Sweden (2005-2014). Cases with incident male breast cancer were identified in the cancer registries and matched with 50 density-sampled, age, and country-matched male population controls per case. Exposure information on finasteride use was derived from the prescription registries. Potential confounders were identified using the directed acyclic graph methodology and measured by use of information from nation-wide registries. RESULTS: The study population comprised 1,005 male breast cancer cases and 43,058 controls. Confounder-adjusted odds of finasteride exposure were not statistically significantly increased [OR, 1.09; 95% confidence interval (CI), 0.77-1.54] in breast cancer cases relative to controls. There was no evidence of a dose-response relationship, as the group with greatest exposure to finasteride was associated with lowest OR of male breast cancer [OR, 0.72 (95% CI, 0.40-1.30)]. Sensitivity analyses did not reveal marked changes in results with different exposure definitions or for specific subgroups. CONCLUSIONS: Results from this study provided no evidence that finasteride use was associated with male breast cancer. IMPACT: This large confounder-adjusted study supports the view that exposure to finasteride is not associated materially with male breast cancer risk.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Finasterida/administração & dosagem , Inibidores de 5-alfa Redutase/administração & dosagem , Inibidores de 5-alfa Redutase/efeitos adversos , Adulto , Idoso , Neoplasias da Mama Masculina/induzido quimicamente , Estudos de Casos e Controles , Dinamarca/epidemiologia , Finasterida/efeitos adversos , Finlândia/epidemiologia , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Fatores de Risco , Suécia/epidemiologia
14.
Am J Ind Med ; 62(3): 205-211, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30648268

RESUMO

BACKGROUND: The recently established Occupational Disease Surveillance System (ODSS) was used to examine breast cancer risk in women and men by occupation and industry. METHODS: Ontario workers in the ODSS cohort (1983-2016) were followed up for breast cancer diagnosis through the Ontario Cancer Registry. Cox-proportional hazard models were used to calculate age-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: A total of 17 865 and 492 cases were identified in working women (W) and men (M), respectively. Elevated risks were observed in management (W: HR = 1.54, 95% CI = 1.40-1.70; M: HR = 2.79, 95% CI = 1.44-5.39), administrative/clerical (W: HR = 1.16, 95% CI = 1.11-1.21; M: HR = 1.45, 95% CI = 1.06-1.99), and teaching (W: HR = 1.54, 95% CI = 1.44-1.63; M: HR = 3.00, 95% CI = 1.49-6.03). Other elevated risks were observed in nursing/health, social sciences, and janitor/cleaning services for both genders. CONCLUSIONS: Common occupational associations in both genders warrant investigation into job-related risk factors, such as sedentary behavior, shift work, ionizing radiation, and chemical exposures.


Assuntos
Neoplasias da Mama/epidemiologia , Indústrias/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Ocupações/estatística & dados numéricos , Vigilância da População , Pessoal Administrativo/estatística & dados numéricos , Neoplasias da Mama Masculina/epidemiologia , Educação/estatística & dados numéricos , Feminino , Serviço de Limpeza/estatística & dados numéricos , Humanos , Masculino , Enfermagem/estatística & dados numéricos , Ontário/epidemiologia , Sistema de Registros , Medição de Risco , Ciências Sociais/estatística & dados numéricos
15.
Breast Cancer Res Treat ; 175(1): 1-4, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30666539

RESUMO

PURPOSE: Atypical ductal hyperplasia (ADH) significantly increases the risk of breast cancer in women. However, little is known about the implications of ADH in men. METHODS: Review of 932 males with breast pathology was performed to identify cases of ADH. Patients were excluded if ADH was upgraded to cancer on excision, or if they had contralateral breast cancer. Cases were reviewed to determine whether any male with ADH developed breast cancer. RESULTS: Nineteen males were diagnosed with ADH from June 2003 to September 2018. All had gynecomastia. Surgical procedure was mastectomy in 8 patients and excision/reduction in 11. One patient had their nipple areola complex removed, and 1 required a free nipple graft. Median patient age at ADH diagnosis was 25 years (range 18-72 years). Of the 14 patients with bilateral gynecomastia, 10 had bilateral ADH and 4 had unilateral. Five cases of ADH were described as severe, bordering on ductal carcinoma in situ. No patient reported a family history of breast cancer. No patient took tamoxifen. At a mean follow-up of 75 months (range 4-185 months), no patient developed breast cancer. CONCLUSION: Our study is the first to provide follow-up information for males with ADH. With 6 years of mean follow-up, no male in our series has developed breast cancer. This suggests that either ADH in men does not pose the same risk as ADH in women or that surgical excision of symptomatic gynecomastia in men effectively reduces the risk of breast cancer.


Assuntos
Ginecomastia/epidemiologia , Ginecomastia/patologia , Glândulas Mamárias Humanas/patologia , Adolescente , Adulto , Idoso , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/etiologia , Neoplasias da Mama Masculina/patologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/etiologia , Seguimentos , Ginecomastia/cirurgia , Humanos , Hiperplasia , Masculino , Mastectomia , Pessoa de Meia-Idade , Vigilância em Saúde Pública , Risco , Adulto Jovem
17.
Breast Cancer Res Treat ; 173(1): 37-48, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30267249

RESUMO

PURPOSE: Male breast cancer (BC) is rare, representing approximately 1% of cancers that occur in men and approximately 1% of all BCs worldwide. Because male BC is rare, not much is known about the disease, and treatment recommendations are typically extrapolated from data available from clinical trials enrolling female BC patients. METHODS: We review the epidemiology, risk factors, prognosis, and the varied molecular and clinicopathologic features that characterize male BC. In addition, we summarize the available data for the use of systemic therapy in the treatment of male BC and explore the ongoing development of targeted therapeutic agents for the treatment of this subgroup of BCs. RESULTS: There are important biological differences between male and female BC. Male BC is almost exclusively hormone receptor positive (+), including the androgen receptor (AR), and is associated with an increased prevalence of BRCA2 germline mutations, especially in men with increased risk for developing high-risk BC. Additional research is warranted to better characterize male BC. To accomplish this, a multi-national consortium approach, such as the International Male Breast Cancer Program, is needed in response to the scarcity of patients. This approach allows the pooling of information from a large number of men with BC and the creation of registries for future therapeutic-focused clinical trials. CONCLUSIONS: Given the unique biology of BC in men, promising new therapeutic targets are currently under investigation, including the use of poly-ADP-ribose polymerase inhibitors or AR-targeted agents either as monotherapy or in combination with other agents.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/terapia , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Neoplasias da Mama Masculina/etiologia , Ensaios Clínicos como Assunto , Epigênese Genética , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Programa de SEER
18.
J Investig Med ; 67(3): 699-705, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30368484

RESUMO

This study aims to understand the clinical features, treatment, and prognosis of patients with male breast cancer (MBC) in Shanxi province of China from 2007 to 2016. Data for 77 patients with MBC were collected for analysis. Immunohistochemistry, pathological results, and other data such as demographic characteristics (age, marital status, smoking history, drinking history, and family history of cancer) as well as clinical data were investigated by retrieving information from the patients' medical records. A total of 12,404 patients were diagnosed with breast cancer between 2007 and 2016, and 77 were patients with MBC among them. The median diagnosis age of patients with MBC was 62 years (range, 24-84 years). The most common complaint was a painless lump in the breast, accounting for 68.8% of the patients, and the main pathological type in MBC was infiltrating ductal carcinoma (66.2%). In terms of hormone receptors, 80.5% (62/77) of patients with MBC were estrogen receptor positive, 75.3% (58/77) of patients were progesterone receptor positive, and only 6.5% (5/77) of patients were HER2 overexpressing. The multivariant Cox proportional hazards regression analysis showed that M stage is an independent prognostic factor (p=0.018, HR=18.791, 95% CI 1.663 to 212.6). The epidemiological and clinical features of Chinese MBC are similar to that of other countries. As the Chinese public have limited knowledge of MBC, it is necessary to increase awareness among them about it. Further research with a large sample size is required for better understanding of the risks associated with MBC.


Assuntos
Neoplasias da Mama Masculina/diagnóstico , Neoplasias da Mama Masculina/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama Masculina/terapia , China/epidemiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida/tendências
19.
BMC Cancer ; 18(1): 1285, 2018 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-30577784

RESUMO

BACKGROUND: The prevalence and distribution of histologically diagnosed breast disease are not well documented in low income countries, Uganda inclusive. Although the greater majority of breast lesions globally are benign, breast cancer is the most frequently diagnosed cancer all over the world. We aimed at documenting the prevalence of different breast diseases histologically diagnosed at the histopathology laboratory of the Department of Pathology of the Makerere University College of Health Sciences (MakCHS Lab) over a decade (2005-2014). We also describe the demographic characteristics of the patients in Uganda diagnosed with breast disease at the MakCHS Lab during the same period. METHODS: This was a 10 year retrospective study of histologically diagnosed breast disease between 2005 and 2014 inclusive at the MakCHS Lab. We extracted information from hard copies of all 2510 histopathology reports retrieved from archives of the Department of Pathology at the MakCHS Lab. 640 records that were either damaged beyond recognition of key details, were duplicated, were implausible or had no conclusive diagnosis made were excluded. Information to be analyzed was then entered into Epidata (version 3.1) on a password protected laptop. Data analysis was done using SPSS software (v16 for Windows × 64). RESULTS: From the 1870 patients' records eventually analyzed, breast disease was most diagnosed in female patients (97.1%). The overall mean age for breast disease diagnosis was 33 years (S.D ± 16.46) and median age 26 years (IQR: 20-43). Fibroadenoma (40.1%) was the most diagnosed breast disease overall. We noticed steadily increasing frequency of diagnosis of cancerous breast diseases over the last half of the study period. Invasive ductal carcinoma was the most diagnosed breast cancer (326 cases, 55.6%). A high female to male breast cancer ratio of 48:1 was observed. The highest regional breast cancer proportion was from the Western region of the Country. CONCLUSIONS: There is need for more research into the picture of breast disease in the country, covering various demographic characteristics of the country's population for all regions and informing about its incidence rates and prevalence and also the breast cancer risk estimate for benign breast disease.


Assuntos
Doenças Mamárias/epidemiologia , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama/epidemiologia , Fibroadenoma/epidemiologia , Adulto , Doenças Mamárias/diagnóstico , Doenças Mamárias/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Neoplasias da Mama Masculina/diagnóstico , Neoplasias da Mama Masculina/patologia , Feminino , Fibroadenoma/diagnóstico , Fibroadenoma/patologia , Humanos , Masculino , Fatores de Risco , Uganda/epidemiologia
20.
Clin J Oncol Nurs ; 22(6): 610, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30452015

RESUMO

Male breast cancer is associated with hereditary risk for developing breast and other cancers. An estimated 4% of men with breast cancer have BRCA1 mutations, and 4%-16% have BRCA2 mutations. Men with a diagnosis of breast cancer have unique needs that need to be addressed in a caring and comprehensive manner.


Assuntos
Proteína BRCA2/genética , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/genética , Predisposição Genética para Doença/epidemiologia , Educação de Pacientes como Assunto/métodos , Comitês Consultivos , Idoso , Neoplasias da Mama Masculina/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Prevalência , Prognóstico
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