Rare case of multiple primary malignant neoplasms

Multiple Primary Malignant Neoplasms (MPMNs) are rarely reported and are defined as the diagnosis of ?2 independent, primary malignancies of different histologies/ origins in a single individual. In this study, we report a patient with Male Breast Cancer (MBC) and coexisting Small Lymphocytic Lymphoma (SLL) and Chronic Lymphocytic Leukemia (CLL). A 65-year-old male with complaints of a lump in his left breast since 2 years. CT scan findings were a non-homogeneous mass in the left breast along with bilateral axillary lymphadenopathy. Modified radical mastectomy was done. Microscopic examination showed the features of infiltrating duct carcinoma NOS: Modified Nottingham Bloom Richardson抯 Grade II in breast specimen. A peripheral smear of the patient showed features of chronic lymphocytic leukemia (absolute lymphocyte count was 16400 cells/mm3). IHC of breast tumor showed ER/PR positivity with H scores of 350 and 240 respectively and HER- 2/Neu protein expression was negative with a score of (1+). Lymph nodes were immunoreactive for CD 19, CD 23 and CD 5. Cells were non-reactive for Cyclin D1a and CD3. This is probably the first case of MBC with SLL and CLL. The diagnosis is consistent with synchronous MPMNs, which are increasingly reported nowadays.

Hemogram index parameters in the evaluation of male breast cancer and inflammatory response: a case-control study

SUMMARY OBJECTIVE: Our aim was to investigate the hemogram index parameters and their clinical significance in the evaluation of the inflammatory response of patients with male breast cancer, who are rarely observed in the literature. METHODS: In total, 22 (n=22) healthy male and 28 (n=28) male breast cancer patients without synchronous/metachronous tumors were included in this study. They were grouped as the healthy male control group (Group 1) and the male breast cancer patient group (Group 2). The male breast cancer was divided into two subgroups, namely, early stage [(stage: 0/I/II) (Group 2A)] and late stage [(stage: III/IV) (Group 2B)], and their hemogram index parameters were compared. RESULTS: A significant (p>0.05) increase was observed in neutrophil/lymphocyte ratio (NLR) and·platelet/lymphocyte ratio (PLR) values in the late stage (Group 2B: stage III/IV) compared to the early stage (Group 2A: stage 0/I/II) and healthy control (Group 1) groups. CONCLUSIONS: In male breast cancer patients, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were significantly higher as the stage of cancer increased. These readily available simple tests can be used to evaluate the host's inflammatory response in male breast cancer.

A preliminary study on the probability of causation of male breast cancer for occupational radiation workers / 中华放射医学与防护杂志

Objective:To explore the probability of causation method ology of male breast cancer and to provide theoretical basis for the diagnosis of occupational radiogenic male breast cancer in China.Methods:Using the male excess relative risk model (EAR) fitted from the Japanese atomic bomb survivors and the female excess absolute risk model (ERR) provided by the Biological Effect of Ionizing Radiation Committee VII (BEIRVII), the breast dose and the probability of causation of the previous case of male breast cancer were calculated.Results:The average probability of causation ( PC) calculated by male ERR model was 94.6%, and the upper limit of 95% PC was 98.3%. Using female EAR model and female breast cancer incidence, the average PC was 70.3%, and the upper limit of 95% PC was 153.3%. when male breast cancer incidence was used, the average PC was 99.2%.By both methods, the male breast cancer patient could be determined to be caused by occupational radiation exposure. Conclusions:The upper limit of 95% PC calculated by female EAR model and female breast cancer incidence was higher than that by male ERR model.The uncertainty of probability of causation for female EAR model still need further research. Occupational radiogenic male breast was proposed to listed in occupational radiogenic neoplasms, which will make the list more perfect and scientific and reasonable to meet potential claims.

Male breast cancer: The Philippine General Hospital experience

RATIONALE/OBJECTIVE@#Breast cancer among males is often diagnosed at a later age and at an advanced stage. The study aimed to present the epidemiology, associated risk factors, clinical and pathological characteristics, treatment patterns and outcomes of male breast cancer patients treated at the Philippine General Hospital from January 2008- December 2017. Information from this study can provide for better understanding of the disease and basis for creating guidelines toward better outcomes. @*METHODS@#Retrospective study of medical records involving male breast cancer patients who underwent surgery and treatment at the Philippine General Hospital from January 2008- December 2017.@*RESULTS@#Male breast cancer accounted for 15 (0.26%) of 5,777 resected breast specimens for breast cancer patients with a 1:384 male to female ratio. The mean age of presentation was 60 years. The most common presentation was a retro-areolar mass, with 33% of patients presenting post-excision. Sixty-seven percent were at Stage II and 20% at Stage III. About 94% of patients have invasive ductal carcinoma, while the only other histology is papillary carcinoma at 13%. Majority of those tested were both estrogen receptor and progesterone receptor (ER/PR) positive (33% versus 1 %), and Her2neu negative. All patients underwent modified radical mastectomy. Only two patients were documented to have received adjuvant chemotherapy while one patient received neoadjuvant chemotherapy.@*CONCLUSION@#Breast cancer remains to be a rare disease among males, is often diagnosed at a later age and at an advanced stage. Because of its rarity, awareness is necessary not only in the community but also among healthcare providers to identify and treat the problem earlier. Further investigation and prospective studies are recommended.

Incidence and Mortality of Male Breast Cancer in Hubei Province from 2012 to 2015 / 肿瘤防治研究

Objective To analyze the incidence and mortality of male breast cancer in Hubei Province from 2012 to 2015. Methods The data reported by the Hubei Provincial Cancer Registry from 2012 to 2015 were collected for analyzing the incidence and mortality trends of male breast cancer according to year, urban and rural areas and age. We also compared the difference of incidence and mortality between male and female breast cancer. Results A total of 106 new cases of male breast cancer were reported in Hubei Cancer Registry from 2012 to 2015 with an incidence rate of 0.43/105, and 10052 new cases of female breast cancer with an incidence rate of 42.76/105; the male-to-female incidence ratio was 1:99. Male breast cancer death cases was 37 with the death rate of 0.15/105, and female breast cancer death cases was 2201 with the death rate of 9.36/105; the male-to-female mortality ratio was 1:62. The incidence and mortality of breast cancer between male and female varied by year, urban and rural areas. Male breast cancer was less common in young men (< 35 years old), and the incidence increased with age after 35 years old; male breast cancer deaths were rare in men under 45 years old, and the mortality rate increased with age. The incidence and mortality of male breast cancer patients over 85 years old reached the peak. Conclusion Male breast cancer is rare in clinical practice, and the incidence rate is much lower than that of female breast cancer. Even so, it is necessary to study the epidemiological law of male breast cancers' incidence and mortality, which can be used for prevention and treatment of male breast cancer.

Male breast cancer a rare entity: the experience from North-East India

Background: Breast cancer is one of the most common malignancy among women but it is not common in men. Male breast cancer (MBC) is a rare disease and accounts for ∼1% of all cancers in men. There is lack of data related to MBC. The objective was to study the clinic-pathological characteristics and outcome of MBC patients at this institute.Methods: It is a retrospective study. Author analyzed clinico-pathological factors, management and follow up details of all patients with MBC from 2012 to 2018 at the cancer centre.Results: Total 20 patients were included in the study. No risk factor identified in any patient. The median age at diagnosis was 57.5 years. Most common location was central quadrant. Most common stage at presentation was stage 3. Fifteen patients underwent upfront surgery while neoadjuvant chemotherapy was given to two patients. One patient had complete pathological response (cPR). The median follow up was 24 months (4-60 months). Three patients developed local recurrence (3 chest wall and 1 axilla). Two patients developed distant metastasis (lung, liver and bone). Actual overall survival rate at 5 years was 67.5% with median disease-free survival was 55%.Conclusions: Multicentric trials are necessary to understand the predictive and prognostic markers and to improve the outcome in male breast cancer.

Immunophenotyping of male breast cancer - Experience at a tertiary care centre

Background: Male breast cancers (MBCs) are uncommon and account for 1% of all breast cancers. Medical conditions that increase the estrogen to testosterone ratio are implicated as the risk factors. Morphologically similar, but MBCs have biological differences compared with female breast cancer (FBC). Purpose: The present study was aimed to examine the immunophenotype of MBC, subsequent molecular subtypes, their association with clinicopathological features, and prognosis. Materials and Methods: We analyzed clinicopathological features of 42 cases of MBC, and classified them according to molecular classification using immunohistochemistry (IHC). This is the second largest study from India. Results and Conclusion: Median age of patients was 61 years (age range: 41-87 years). Invasive duct carcinoma comprised 95.2% of cases. Tumor grade II and III was seen in 50% and 47.6% of cases, respectively, and advanced stage disease (III/IV) was seen in 45.2% cases (n = 39). Estrogen receptor (ER) was positive in 97.6% cases, progesterone receptor (PR) in 83.3%, androgen receptor (AR) in 76.2%, HER2 in 4.8%, Cyclin-D1 in 92.9%, Bcl2 in 66.7%, GCDFP-15 in 23.8%, p53 in 16.7%, and Ki67 index was low (<14%) in 66.7% cases. Molecular subtyping of these cases revealed 64.3% of luminal A, 35.7% of luminal B, and no HER2 rich/driven category or triple negative case. There was no statistical significance between luminal A and B category pertaining to overall stage of tumor (P = 0.905). Lymph node metastasis was more commonly associated with luminal B category (P = 0.089). p53 positivity showed significant association with luminal A cases (P = 0.002) and nodal metastasis (P = 0.042). GCDFP-15 positivity showed significant association with higher tumor grade (P = 0.042) and stage (P = 0.047). Stage was the most significant prognostic marker (P < 0.0001). On follow-up (n = 27), all the six cases that showed recurrence/persistent disease were high stage (III/IV) on presentation.

Clinicopathologic analysis of 38 male breast cancers / 中国实用外科杂志

OBJECTIVE: To analyze the clinicopathologic characteristics and molecular subtype in male breast cancer(MBC). METHODS: The clinical features, histological features and molecular subtype of 38 cases of male breast cancers admitted from January 2013 to March 2019 in Clinical Pathology Diagnostic Center of Ningbo were analyzed retrospectively. RESULTS: Thirty-eight patients were diagnosed with MBC, accounting for 0.83% of all the breast cancer in the same term. The median age was 68.5(range from 24 to 88). Tumor were located in left side in 20 cases, right side in 18 cases. Twenty-nine cases were diagnosed as invasive ductal carcinoma, two cases of secretory breast cancer, one case of invasive solid papillary carcinoma, two cases of intraductal papillary carcinoma with microinvasive, and four cases of encapsulated papillary carcinoma(two of them with microinvasive). Sixteen patients had lymphatic metastasis when the tumor was diagnosed. Imunohistochemically, ER was positive in 36 cases, while PR was positive in 35 cases.Eighteen cases were Luminal A type, while sixteen were Luminal B type and two cases were basal-like subtype.CONCLUSION: MBC is a rare malignant neoplasm, and most patients are diagnosed older and at advanced clinical stage,what is more, there is more possibility of second non-breast primary cancer. All suggesting that early diagnosis,treatment and more intensive surveillance are important. MBC needs further study.

Expression and clinical significance of p57KIP2,cyclin D1,and cyclin E in male breast can-cer / 中国肿瘤临床

Objective:To explore the relationship between the expression of p57KIP2,cyclin D1,and cyclin E receptors in male breast can-cer(MBC)and its clinical significance.Methods:Data of MBC cases diagnosed in The First Affiliated Hospital of Wenzhou Medical Uni-versity between January 2000 and December 2016 were reviewed.Forty cases of infiltrating ductal carcinoma(IDC)and 20 cases of male ductal carcinoma in situ(DCIS)were selected,and 20 cases of gynecomastia(GYM)were selected as controls.The expression of p57KIP2,cyclin D1,and cyclin E mRNA and protein in the tissue samples obtained from IDC,DCIS,and GYM cases were measured by re-verse transcription polymerase chain reaction and immunohistochemistry,respectively.Results:The expression of p57KIP2mRNA in IDC was 0.18±0.07,which was lower than that in DCIS(0.42±0.05)and GYM(0.75±0.04).The rate of p57KIP2positivity in IDC was 25%(10/40),which was lower than that in DCIS 60%(12/20)and GYM 90%(18/20).There were significant differences in the expression of p57KIP2mRNA and protein among the three groups(P<0.05).The expression of cyclin D1 and cyclin E mRNA in IDC was 0.92±0.12 and 0.96±0.08,which was higher than that in DCIS(0.72±0.06,0.64±0.01)and GYM(0.38±0.03,0.21±0.02),respectively.Cyclin D1 and cy-clin E protein positive rates in IDC were 90%(36/40)and 88%(35/40),which were higher than those in DCIS[80%(16/20),85%(17/20)],and GYM[25%(5/20),20%(4/20)].In IDC tissues,the expression of p57KIP2,cyclin D1,and cyclin E proteins was associated with the clinical stage and histological grade(P<0.05),and the expression of p57KIP2protein was correlated with axillary node metastasis(P<0.05).There was a negative correlation between the expression of p57KIP2and cyclin D1 and between p57KIP2and cyclin E.However,the correlation between cyclin D1 and cyclin E expression was positive(P<0.05).Conclusions:p57KIP2,cyclin D1,and cyclin E may play an im-portant role in the development and progression of MBC.Combined clinicopathological detection of p57KIP2,cyclin D1,and cyclin E can aid future research on MBC.

To strengthen the diagnosis and treatment of male breast cancer in China / 中华内分泌外科杂志

Male breast cancer is a rare disease with an incidence of about 1％ of breast cancers in USA,and about 1.4％ in China.Male breast cancer accounts for 1.9％ to 6.5％(with the mean value of 2.9％) of breast cancers in southwest of China.In China,male breast cancer is usually with poor prognosis caused by delayed diagnosis and treatment,because of being ignored by the community.It is important to strengthen the popular science propaganda,diagnosis and treatment of male breast cancer in China.

Analysis of clinical features and prognostic factors on 30 cases of male breast cancer / 临床外科杂志

Objective To explore the clinicopathlogical characteristics and prognostic factors of male breast cancer.Methods Clinical data from 30 cases of male breast cancer patients were collected, the survival curve of PFS was drawn and the survival rate and survival prognosis were estimated.Results There were 29 cases(97%)of estrogen receptor positive patients in total. The tumor pathology grades (χ2=6.141,P=0.013)and the status of hormone receptor(χ2=10.465,P=0.005)affected the prog-nosis of male patients with breast cancer in univariate analysis. And the tumor pathology grades(χ2=5.271,P=0.022,HR =5.762)affected the prognosis in multivariate analysis. Conclusion In male breast cancer patients,the positive rate of estrogen receptor is relatively high,and the tumor pathology grades is one of the most important factors affecting prognosis.

Tumor neuroendocrino primario de mama en un hombre / Primary neuroendocrine breast tumor found in a man

El cáncer de mama en hombres es una entidad poco frecuente y muy poco estudiada. Su pronóstico y manejo aun distan de lo ideal y de lo que se ha logrado en cáncer mamario en mujeres. Los tumores neuroendocrinos de la mama son aún más raros. Su comportamiento tiende en la mayoría de los casos a ser incierto y su manejo controversial. El reporte de caso se trata de un paciente masculino de 67 años, con historia de aparición de masa en mama derecha, con diagnóstico inicial de tumor mal diferenciado, con posterior inmunohistoquimica que informa tumor neuroendocrino primario de la mama. El diagnóstico temprano de cáncer de mama en hombres implica un verdadero reto para los sistemas de salud. Debemos conocer más sobre su fisiopatología y factores de riesgo(AU)

The early diagnosis of breast cancer in men represents a real challenge for the health systems. Therefore, our knowledge about its physiopathology and risk factors must be expandedBreast cancer in men is a rare and poorly studied malady. The prognosis and management is far from being ideal and from the achievements of the female breast cancer treatment. Even rare are neuroendocine breast tumors. In most of cases, its behavior is uncertain and its management is controversial. This was the report of a male patient aged 67 years, with history of right breast mass, initially diagnosed as a poorly differentiated tumor with later immunohistochemical test that reported the existence of a primary neuroendocrine breast tumor(AU)

Cutaneous Metastasis from Male Breast Cancer 10 Years after Treatment: A Case Report and Review of the Korean Literature / 대한피부과학회지

No abstract available.

Male breast cancer: A single institute experience.

BACKGROUND: Male breast cancer (MBC) is a rare disease and accounts for 1% of all breast cancers. There is limited data on MBC from India. The aim of our study was to assess clinico‑pathological parameters and outcome in MBC patients. MATERIALS AND METHODS: This analysis was carried out in 76 patients of MBC who were registered at Institute Rotary Cancer Hospital of All India Institute Of Medical Sciences between 1996 and 2012. Patients’ records were retrospective reviewed and data obtained from the computer database using International Classification of Diseases code (C‑50). RESULTS: The median age was 59 years (range: 28‑80). The median duration of symptoms was 11 months (range: 0.5‑40). Breast lump was the most common presenting symptom (left > right side). American Joint Committee on Cancer (7th edition) stage distribution was Stage I‑2.6%, Stage II‑13.1%, Stage III‑59.3% and Stage IV‑25%. Modified radical mastectomy was the commonest surgical procedure. Moreover, 30% of tumors were high‑grade and 70% had pathological node positive disease. Estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2)/neu positivity was 80% and 28%, respectively. Triple negative breast cancer constituted 19% of cases. With a median follow‑up of 36 months, 3 years relapse free survival and overall survival was 60% and 80%. Advanced stage and visceral metastasis at baseline predicted poor outcome. CONCLUSION: MBC constituted 0.8% at our institute. Our study population had a longer time to presentation, advanced disease at presentation, more HER2/neu positivity and triple negativity higher than the available literature.

Related research of male breast cancer and CAG repeat polymorphism of AR gene / 实用肿瘤学杂志

Objectiv e To investigate the correlation between ( CAG) n repeat polymorphism of androgen receptor(AR)geneandmalebreastcancer.Methods 40casesofmalebreastcancerand40controlswerecol-lected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplifica -tion,sequencing and calculated the number of CAG repeats frquency .χ2 test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk .Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared (CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk .Longer CAG repeats can increase the risk of male breast cancer .

Cutaneous Lesions As A Presenting Sign Of Metastases In Male Breast Cancer: A Rare Clinical Entity

Male breast cancer accounts for only 1% of cancers in men and 1% of breast cancers. Cutaneous metastases occur less than 10% of all patients with visceral malignancies and are considered a rare and late event in progression of metastatic disease. A 45-year-old man presented with a lump in the left breast which was confirmed to be infiltrating ductal carcinoma. He underwent a left mastectomy and axillary clearance followed by chemotherapy and radiotherapy to the left chest wall. However, he was non-compliant to adjuvant tamoxifen due to hot flushes. One year later, he presented with biopsy proven cutaneous metastases. Initially he had complete excision of the lesions, however, two months later more skin lesions appeared predominantly over the chest wall and back. Hormonal therapy failed to control the metastases as such he was treated with systemic chemotherapy. He is currently on third line chemotherapy.

Male breast cancer in Indian patients: Is it the same.

Background: Cancer of the male breast accounts for about 1% of all malignancies in men and 1% of all breast cancers. Poor level of awareness often results in late presentation and delayed diagnosis in our environment. This study was done to analyse the demographic data, management and survival of male breast cancers in Indian subset of patients and compare it with that of western literature. Materials and Methods: A 10 year (2001-2010) retrospective study of all male breast cancers was done. Data regarding the incidence, presentation, histopathology, stage and grade of tumor, management and outcome of patients were analysed. Results: 26 cases of male breast cancer were encountered. This comprised 0.4% of all breast cancers seen in our department during the 10 year period. The ages of patients ranged from 45-75 years with a mean age of 57 years. Family history was present in 4 patients. Clinically, symptoms included self-detected lump in 23 (88.5%) patients, nipple retraction in 12 (46.1%) and pain in 12 (46.1%). All cases were unilateral (16 on right, 10 on left). Disease most commonly involved central quadrant (9 patients). Grade 3 disease was found in 13 patients and Stage 3 disease was most commonly encountered (13 patients). None of our patients received neo adjuvant chemotherapy. 20 (76.9%) patients had modified radical mastectomy and 6 (23.1%) had radical mastectomy. Most of our patients were hormone receptor positive (21 patients). Bilateral orchidectomy, Adjuvant chemotherapy, Adjuvant radiotherapy and Tamoxifen were offered in 3 (11.5%), 16 (61.5%), 17 (65.4%) and 15 (57.7%) patients respectively. Follow up ranged from 1-59 months. Conclusion: Male breast cancer is rare in our centre. Late presentation with advanced disease is a common feature in our environment. Further multiinstitutional, prospective studies are needed for better understanding of management of male breast cancers in Indian subset of patients.

Comparison of male and female resectable breast cancer and their clinicopathological characteristics / 中华内分泌外科杂志

ObjectiveTo analyze clinicopathological characteristics and treatment of male breast cancer (MBC) and the matched female breast cancer (FBC). To compare the survival difference between the 2 groups.To study the factors influencing the prognosis of MBC.Methods63 MBC patients treated in Tianjin Medical University Cancer Institute and Hospital from Jan.1995 to Dec.2008 were enrolled in this study.Each MBC patient in the database was matched with 2 FBC patients.The matching criteria were with similar age, diagnosis time, and TNM stage.Chi-square test and Fisher exact test were employed to compare the clinicopathologic characteristics of MBC and FBC.Kaplan-Meier method, Log-rank test, and Cox hazard regression model were employed respectively to make survival analysis, surival rate comparison and multivariate analysis.ResultsThe 10-year disease-free survival (DFS) rate was 53.9％ for men and 65.1％ for women (P =0.047).The 10-year overall survival (OS) rate was 61.9％ for men and 77％ for women (P =0.032).Univariate analysis showed TNM stage, surgical method and recurrence were factors influencing the prognosis of MBC patients. Multivariate analysis showed TNM stage was an independent factor influencing the prognosis of MBC patients.ConclusionsFBC patients had a better 10-year OS rate and DFS rate than MBC patients.TNM stage is an independent factor influencing the prognosis of MBC patients.

Diagnosis and treatment of 17 cases male breast cancer / 中华内分泌外科杂志

Objective To investigate the clinical features and treatment of male breast cancer. Methods Retrospective analysis was made on 17 cases of male breast cancer treated in our hospital and the City Peoples Hospital from 1995 to 2009. Results The number of male breast cancer accounted for 0.7% of the total breast cancer admitted in the same period. All the 17 cases were diagnosed by pathology, including 10 cases infiltrating ductal carcinoma, 3 cases Paget disease, 2 cases adenocarcinoma, 1 case medullary carcinoma and 1 case mucinous adenocarcinoma. Conclusions The common symptom of male breast cancer is a painless lump under the areola, sometimes with nipple retraction, nipple discharge, and pain. Prognosis of male breast cancer is related to treatment timing and whether the treatment is standard or not. Surgical approaches are mainly based on modified radical mastectomy and radical mastectomy. Autologus skin graft is often needed. Postoperative chemotherapy, radiotherapy, endocrine therapy and traditional Chinese medicine therapy depend on clinical and pathological features.

Intracystic Papillary Carcinoma in the Male Breast

Intracystic papillary carcinoma (IPC) is an extremely rare disease in the male breast with a few case reports. We present a case of a 61-year-old male who had IPC and review regarding diagnosis, characteristics and treatment. He had a chief complaint of a subareolar mass. It was diagnosed as a benign cystic intraductal papilloma by fine needle aspiration outside hospital. His radiologic studies including mammography and ultrasonography showed a suspicious malignant mass categorized as a BIRADS 4A in the right subareolar area. Therefore, the patient underwent wide excision without sentinel lymph node biopsy. The final pathologic results revealed a 1.6 cm sized intraductal papillary carcinoma of low nuclear grade with clear resection margin. He has taken tamoxifen and received adjuvant radiation therapy.