Cáncer de mama en coraza en hombre: un caso poco frecuente

El cáncer de mama en coraza constituye una de las formas clínicas de presentación de las metástasis cutáneas del cáncer mamario. Es de aparición poco frecuente, sobre todo, en el sexo masculino. Se presenta el caso de un paciente de sexo masculino, de 74 años de edad, de color de piel negra, con antecedente de diabetes e hipertensión arterial que acudió a consulta de mastología provincial por presentar desde hacía algunos meses dolor discreto y unas lesiones pruriginosas en la mama derecha. Además de otros exámenes se le realizó biopsia escisional de pequeño fragmento de la lesión con estudio por parafina que informó metástasis cutánea de un carcinoma mamario en coraza según su forma de presentación clínica. Se muestra el caso porque no se localizó ninguna publicación en la provincia Cienfuegos ni en el país de un caso en el sexo masculino, por lo cual se considera de interés para el personal médico la publicación de este reporte.

Shell breast cancer is one of the clinical forms of presentation of cutaneous metastases of breast cancer. It is rare, especially in males. The case of a 74-year-old male patient with black skin color, with a history of diabetes and high blood pressure, who attended a provincial mastology consultation for a few months of mild pain and pruritic lesions on his neck, is presented the right breast. In addition to other examinations, an excisional biopsy of a small fragment of the lesion was performed with a paraffin study, which reported cutaneous metastasis of a shell breast carcinoma according to its clinical presentation. The case is shown because no publication was found in the province of Cienfuegos or in the country of a male case, which is why the publication of this report is considered of interest to medical personnel.

An introduction to male breast cancer for urologists: epidemiology, diagnosis, principles of treatment, and special situations

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.

An introduction to male breast cancer for urologists: epidemiology, diagnosis, principles of treatment, and special situations.

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.

Enterocolite Neutropênica em Paciente com Câncer de Mama em Uso de Quimioterapia Adjuvante: Relato de Caso / Neutropenic Enterocolitis in a Breast Cancer Patient using Adjuvant Chemotherapy: Case Report / Enterocolitis Neutropénica en Paciente con Cáncer de Mama que Usa Quimioterapia Adyuvante: Reporte de Caso

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.

Breast Cancer in Men: Clinical and Pathological Analysis of 817 Cases.

The objective of the current study was to describe breast cancer cases in men according to age, stage, and histology, calculating risks compared to women. It is a retrospective cross-sectional study of all breast cancer cases of the Hospital Cancer Registry of São Paulo state, Brazil, 2000-2015. Variables were age, sex, stage, and histology. Absolute numbers and proportions, Mann-Whitney test and prevalence ratio with 95% confidence interval were used. The study included 93,737 cases, of which 817 were males. The mean age at diagnosis was 60.3 years in men and 56.2 years in women (p < .001). Stage II was the most common in both sexes (33.9% in men and 36.5% in women). Men had a higher frequency of stage III than women (PR 1.18, 95% CI 1.01-1.37). Stage 0 was significantly more common in women (PR 0.69, 95% CI 0.51-0.94). Ductal carcinoma and its variants were the most common histological types in both sexes (88.7% in men and 89.0% in women). Men had a higher frequency of rarer histological types such as papillary (PR 2.17, 95% CI 1.36-3.44) and sarcomas (PR 4.10, 95% CI 1.86-9.01). In conclusion, in men, breast cancer diagnosis occurred in more advanced ages and stages. Invasive ductal carcinoma was the primary histological type observed, although rarer types were more frequent.

5-alpha Reductase inhibitors and risk of male breast cancer: a systematic review and meta-analysis

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.

5-alpha Reductase Inhibitors and risk of male breast cancer: a systematic review and meta-analysis.

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 na association in our study suggest that the development of breast cancer should not influence the prescribing of 5ARIs therapy.

Cáncer de mama en hombre: Presentación de caso / Male Breast Cancer: Case Report

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.

Aspectos mamográficos e ultra-sonográficos de leucemia linfóide aguda na mama masculina / Mammography and ultrasound in a case of acute lymphoblastic leukemia in the male breast

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.