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1.
J Pak Med Assoc ; 74(4): 672-676, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38751260

ABSTRACT

OBJECTIVE: To determine the characteristics and risk factors of breast cancer patients in a tertiary care setting. METHODS: The retrospective, cross-sectional study was conducted at the Sindh Institute of Urology and Transplantation, Karachi, and comprised data of all patients diagnosed with breast cancer from March 2017 to December 2021. Demographic characteristics, clinical presentation, stage of the disease and histopathological characteristics were noted. Data related to all the variables was not available in all cases. Data was analysed using SPSS 23. RESULTS: Of the 690 patients, 683(99%) were females and 7(1%) were males. The mean age at presentation was 49.3±13.5 years, while the mean duration of symptoms was 10.24±17.64) months. Most of the females were married 642(93%) and multiparous 484(70.9%), while 293(42.5%) had breastfed their children for >1 year, and 412(59.7%) had no history of contraception use. The most common stage at presentation was stage II (48.6%), and most patients had grade II 395(57.2%) invasive ductal carcinoma, with Luminal A molecular subtype noted in 287(41.6%) cases. CONCLUSIONS: The characteristics of breast cancer in the sample had certain distinctions compared to other populations. It is important to integrate all datasets and develop guidelines appropriate to Pakistani population.


Subject(s)
Breast Neoplasms , Humans , Female , Breast Neoplasms/epidemiology , Breast Neoplasms/pathology , Cross-Sectional Studies , Pakistan/epidemiology , Middle Aged , Risk Factors , Adult , Retrospective Studies , Male , Neoplasm Staging , Breast Neoplasms, Male/epidemiology , Breast Neoplasms, Male/pathology , Breast Feeding/statistics & numerical data , Carcinoma, Ductal, Breast/epidemiology , Carcinoma, Ductal, Breast/pathology , Parity , Aged , Neoplasm Grading , Marital Status
2.
Radiographics ; 44(6): e230181, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38752766

ABSTRACT

The number of men undergoing breast imaging has increased in recent years, according to some reports. Most male breast concerns are related to benign causes, most commonly gynecomastia. The range of abnormalities typically encountered in the male breast is less broad than that encountered in women, given that lobule formation rarely occurs in men. Other benign causes of male breast palpable abnormalities with characteristic imaging findings include lipomas, sebaceous or epidermal inclusion cysts, and intramammary lymph nodes. Male breast cancer (MBC) is rare, representing up to 1% of breast cancer cases, but some data indicate that its incidence is increasing. MBC demonstrates some clinical features that overlap with those of gynecomastia, including a propensity for the subareolar breast. Men with breast cancer tend to present at a later stage than do women. MBC typically has similar imaging features to those of female breast cancer, often characterized by an irregular mass that may have associated calcifications. Occasionally, however, MBC has a benign-appearing imaging phenotype, with an oval shape and circumscribed margins, and therefore most solid breast masses in men require tissue diagnosis. Histopathologic evaluation may alternatively reveal other benign breast masses found in men, including papillomas, myofibroblastomas, and hemangiomas. Radiologists must be familiar with the breadth of male breast abnormalities to meet the rising challenge of caring for these patients. ©RSNA, 2024 Supplemental material is available for this article.


Subject(s)
Breast Neoplasms, Male , Gynecomastia , Humans , Male , Gynecomastia/diagnostic imaging , Breast Neoplasms, Male/diagnostic imaging , Diagnosis, Differential
3.
Rev Med Suisse ; 20(874): 968-972, 2024 May 15.
Article in French | MEDLINE | ID: mdl-38756033

ABSTRACT

Breast cancer in men is a rare and understudied disease. Until recently, prospective studies and clinical trials on breast cancer treatments often excluded men. Treatment recommendations were generally extrapolated from the results of clinical trials that included only women. Significant efforts have been made to better understand the biological characteristics, the most effective treatments, and the outcomes of breast cancer in men, as well as to identify clinically relevant differences of this disease. This article reviews the current data on the epidemiology, pathological and clinical characteristics, as well as the treatment of breast cancer in men.


Le cancer du sein chez l'homme est une maladie rare et peu étudiée. Jusqu'à récemment, les études prospectives et les essais cliniques sur les traitements du cancer du sein excluaient souvent les hommes. Les recommandations de traitement étaient généralement extrapolées à partir des résultats d'essais cliniques incluant uniquement des femmes. Des efforts significatifs ont été déployés pour mieux comprendre les caractéristiques biologiques, les traitements les plus efficaces et les résultats du cancer du sein chez les hommes, ainsi que pour identifier les différences cliniquement pertinentes de cette maladie. Cet article passe en revue les données actuelles sur l'épidémiologie, les caractéristiques pathologiques et cliniques, ainsi que le traitement du cancer du sein chez l'homme.


Subject(s)
Breast Neoplasms, Male , Humans , Breast Neoplasms, Male/epidemiology , Breast Neoplasms, Male/diagnosis , Breast Neoplasms, Male/therapy , Breast Neoplasms, Male/pathology , Male
4.
J Mammary Gland Biol Neoplasia ; 29(1): 8, 2024 Apr 04.
Article in English | MEDLINE | ID: mdl-38573417

ABSTRACT

How cancer patterns in humans compare to those of other species remains largely unknown and there is an even bigger knowledge gap for rare cancers like male breast cancer. One Health is a convergence of human and animal healthcare that encourages cross-pollination of medical research uniting human and veterinary medicine. Recognising that breast cancer occurs spontaneously in other male species (e.g. primates, canines, felines), and knowing that no laboratory models exist for male breast cancer, which limits our ability to perform functional studies, we explored the feasibility of applying One Health to breast cancer in men by conducting a narrative review of the topic. Spontaneous development of breast cancer was reported in captive male primates and in companion canines and felines. Some parallels in tumour biology of human male breast cancer with canines and primates were found. The age distribution, pattern of biomarker expression and metastasis were similar, with mammary tumours typically detected after two-thirds of average lifespan. However, instances of triple negative and inflammatory breast cancer, which are rarely observed in human male breast cancer, were found in canines and histological classification was inconsistent between species. These disparities need redressing to enable full exploration of the One Health paradigm in rare cancers.


Subject(s)
Breast Neoplasms, Male , Cat Diseases , Dog Diseases , One Health , Humans , Male , Animals , Cats , Dogs , Primates
5.
Tidsskr Nor Laegeforen ; 144(5)2024 Apr 23.
Article in Norwegian | MEDLINE | ID: mdl-38651722

ABSTRACT

Background: Breast cancer in men accounts for around 1 % of all cases of the disease. The study aimed to identify histopathological parameters and selected biomarkers in men with breast cancer. Material and method: Retrospective study of archival material from 53 men diagnosed with breast cancer at the department of pathology, Haukeland University Hospital, in the period 1996-2020. The prevalence of the oestrogen receptor (ER), progesterone receptor (PGR) and Human Epidermal Growth Factor (HER2) biomarkers was examined. Results: Median age at time of diagnosis was 72 years. Median tumour diameter was 24 mm. Forty-nine tumours were classified histologically as invasive carcinoma of no special type (NST), 29 tumours were histologic grade 2 and 18 were grade 3. Fifty-two tumours were ER positive, 39 were PGR positive and four were HER2 positive. Twenty-five patients had lymph node metastases. Interpretation: Our findings indicate that men with breast cancer are diagnosed at an older age than women, and that men have a more advanced stage than women at the time of diagnosis. The histopathology and expression of biomarkers of breast cancer differ between men and women.


Subject(s)
Biomarkers, Tumor , Breast Neoplasms, Male , Receptor, ErbB-2 , Receptors, Estrogen , Receptors, Progesterone , Humans , Male , Aged , Middle Aged , Retrospective Studies , Receptor, ErbB-2/metabolism , Receptors, Progesterone/metabolism , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/diagnosis , Receptors, Estrogen/metabolism , Aged, 80 and over , Adult , Female , Lymphatic Metastasis , Neoplasm Staging , Neoplasm Grading , Age Factors
6.
J Natl Compr Canc Netw ; 22(4): 237-243, 2024 04 17.
Article in English | MEDLINE | ID: mdl-38631387

ABSTRACT

BACKGROUND: Germline genetic testing is a vital component of guideline-recommended cancer care for males with pancreatic, breast, or metastatic prostate cancers. We sought to determine whether there were racial disparities in germline genetic testing completion in this population. PATIENTS AND METHODS: This retrospective cohort study included non-Hispanic White and Black males with incident pancreatic, breast, or metastatic prostate cancers between January 1, 2019, and September 30, 2021. Two nationwide cohorts were examined: (1) commercially insured individuals in an administrative claims database, and (2) Veterans receiving care in the Veterans Health Administration. One-year germline genetic testing rates were estimated by using Kaplan-Meier methods. Cox proportional hazards regression was used to test the association between race and genetic testing completion. Causal mediation analyses were performed to investigate whether socioeconomic variables contributed to associations between race and germline testing. RESULTS: Our cohort consisted of 7,894 males (5,142 commercially insured; 2,752 Veterans). One-year testing rates were 18.0% (95% CI, 16.8%-19.2%) in commercially insured individuals and 14.2% (95% CI, 11.5%-15.0%) in Veterans. Black race was associated with a lower hazard of testing among commercially insured individuals (adjusted hazard ratio [aHR], 0.73; 95% CI, 0.58-0.91; P=.005) but not among Veterans (aHR, 0.99; 95% CI, 0.75-1.32; P=.960). In commercially insured individuals, income (aHR, 0.90; 95% CI, 0.86-0.96) and net worth (aHR, 0.92; 95% CI, 0.86-0.98) mediated racial disparities, whereas education (aHR, 0.98; 95% CI, 0.94-1.01) did not. CONCLUSIONS: Overall rates of guideline-recommended genetic testing are low in males with pancreatic, breast, or metastatic prostate cancers. Racial disparities in genetic testing among males exist in a commercially insured population, mediated by net worth and household income; these disparities are not seen in the equal-access Veterans Health Administration. Alleviating financial and access barriers may mitigate racial disparities in genetic testing.


Subject(s)
Genetic Testing , Pancreatic Neoplasms , Prostatic Neoplasms , Humans , Male , Prostatic Neoplasms/genetics , Prostatic Neoplasms/pathology , Prostatic Neoplasms/diagnosis , Genetic Testing/statistics & numerical data , Genetic Testing/methods , Middle Aged , Pancreatic Neoplasms/genetics , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/diagnosis , Retrospective Studies , Aged , Breast Neoplasms/genetics , Breast Neoplasms/pathology , Breast Neoplasms/diagnosis , Healthcare Disparities/statistics & numerical data , Germ-Line Mutation , Breast Neoplasms, Male/genetics , Breast Neoplasms, Male/diagnosis , Breast Neoplasms, Male/pathology , United States , Adult , Genetic Predisposition to Disease , Black or African American/statistics & numerical data , Black or African American/genetics
7.
J Obstet Gynaecol Res ; 50(6): 970-981, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38561241

ABSTRACT

OBJECTIVE: This study aimed to examine the relative risk of risk factor in male and female breast cancer (BC) deaths in China and analyzed the changing trends in BC mortality rates from 1990 to 2019. METHODS: Open data from the Global Burden of Disease database from 1990 to 2019 were analyzed to assess the number of BC deaths and age-standardized mortality rates (ASMR) in China. The age-period-cohort model was employed to study age effects, period effects, cohort effects, as well as local drift and net drift of the data, determining the impact of changing risk factors on crude mortality rates and ASMR of BC. RESULTS: In 2019, the number of BC deaths across all age groups in China increased by 130.38% compared to 1990, with an increase of 125.68% in females and 648.80% in males. The ASMR for BC and male BC increased in 2019, while female BC ASMR declined. Overall, alcohol consumption and smoking as risk factors contributed to increased mortality rates of BC with advancing age. Over the entire study period, the net drift of alcohol consumption in females for BC was 0.06% (95% confidence interval [CI]: -0.24% to 0.36%), while for smoking it was -0.64% (95% CI: -0.83% to -0.45%). For males, the net drift of alcohol consumption for BC was 6.75% (95% CI: 5.55% to 7.96%), and for smoking, it was 6.09% (95% CI: 2.66% to 9.64%). CONCLUSION: Hence, improving awareness of BC-related risk factors and implementing prevention strategies are necessary to alleviate future BC burdens.


Subject(s)
Breast Neoplasms, Male , Breast Neoplasms , Humans , Female , Male , China/epidemiology , Middle Aged , Risk Factors , Breast Neoplasms/mortality , Aged , Adult , Breast Neoplasms, Male/mortality , Breast Neoplasms, Male/epidemiology , Aged, 80 and over , Mortality/trends , Alcohol Drinking/epidemiology , Young Adult , Smoking/epidemiology , East Asian People
8.
BMC Geriatr ; 24(1): 282, 2024 Mar 25.
Article in English | MEDLINE | ID: mdl-38528444

ABSTRACT

BACKGROUND: Male breast cancer constitutes a minority of breast cancer diagnoses, yet its incidence has been on the rise in recent decades. However, elderly male breast cancer patients have been inadequately represented in clinical trials, posing challenges in treatment decisions. This study seeks to clarify the efficacy of chemotherapy in this demographic and identify the population most likely to benefit from such intervention. METHODS: We conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database, encompassing a total of 1900 male breast cancer patients aged 70 years or older. Among them, 1652 were categorized in the no-chemotherapy group, while 248 were in the chemotherapy group. A multifactorial logistic regression model was employed to investigate the determinants influencing the administration of chemotherapy in elderly male breast cancer patients. Additionally, the multivariate Cox proportional hazards regression model was applied to identify factors associated with outcomes, with overall survival (OS) as the primary endpoint. RESULTS: Multivariate logistic regression analysis revealed that grade, tumor size, and nodal status were robust predictors for elderly male breast cancer patients receiving chemotherapy. Furthermore, the multivariate analysis demonstrated that chemotherapy conferred benefits compared to the no-chemotherapy group (HR = 0.822, 95% CI: 0.682-0.991, p = 0.040). Stratified analyses indicated that individuals with N+, poorly/undifferentiated grade, and stage II/III disease could derive benefits from chemotherapy. Upon further investigation of progesterone receptor (PR) positive patients, it was found that only stage III patients experienced significant benefits from chemotherapy (HR = 0.571, 95% CI: 0.372-0.875, p = 0.010). Conversely, in PR negative patients, both stage II (HR = 0.201, 95% CI: 0.051-0.792, p = 0.022) and stage III patients (HR = 0.242, 95% CI: 0.060-0.972, p = 0.046) derived benefits from chemotherapy. CONCLUSION: Adjuvant chemotherapy may benefit certain elderly male breast cancer patients, specifically those with positive lymph node status, poorly/undifferentiated grade, and PR-positive in stage III, as well as PR-negative expression in stage II/III. Given favorable physical tolerance, it is advisable not to hastily dismiss chemotherapy for these elderly male breast cancer patients.


Subject(s)
Breast Neoplasms, Male , Breast Neoplasms , Aged , Humans , Male , Retrospective Studies , Breast Neoplasms, Male/drug therapy , Breast Neoplasms, Male/pathology , SEER Program , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Chemotherapy, Adjuvant , Proportional Hazards Models
9.
J Cancer Res Ther ; 20(1): 98-102, 2024 Jan 01.
Article in English | MEDLINE | ID: mdl-38554305

ABSTRACT

BACKGROUND: The goal of this research is to investigate the clinical characteristics and prognosis of men with metastatic breast cancer (mMBC). METHODS: A retrospective analysis of the data of 28 patients was conducted. Kaplan-Meier and Cox regression analyses were used to assess overall survival (OS) and prognostic variables. RESULTS: At the time of diagnosis, the median age was 57 years (range 26-86). The most prevalent pathological subtype was invasive ductal carcinoma (92.6%). HER2 positivity was 21.6% in patients, with estrogen and progesterone receptor positivity at 96.4% and 71.4%, respectively. Bone-75%, lung-39.3%, brain-21.4%, and adrenal gland-10.7% were the most prevalent metastatic sites. Trastuzumab-based chemotherapy was given to six patients. During the study period, 14 patients (or half) died. All patients had a median OS of 42.6 months (range: 21.6-63.7). The OS rates after 1, 3, and 5 years were 95.7%, 54.2%, and 36.6%, respectively. The number of metastatic locations (P = 0.045), brain metastasis (P = 0.033), and a history of regular alcohol intake (P = 0.008) were all shown to be statistically significant factors affecting OS in univariate analysis. However, multivariate analysis did not support the findings. In addition, we discovered that trastuzumab-based therapy and de-novo metastatic disease had no effect on OS for mMBC. CONCLUSIONS: The data on mMBC is restricted because of its rarity. The prognosis of mMBC was shown to be poor in this investigation. Despite the small number of patients, we discovered that in univariate analysis, having brain metastases, the number of metastatic locations, and a history of alcohol intake may be prognostic factors.


Subject(s)
Brain Neoplasms , Breast Neoplasms, Male , Breast Neoplasms , Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Breast Neoplasms, Male/drug therapy , Retrospective Studies , Receptor, ErbB-2 , Disease-Free Survival , Breast Neoplasms/pathology , Trastuzumab/therapeutic use , Prognosis , Brain Neoplasms/drug therapy , Brain Neoplasms/secondary , Kaplan-Meier Estimate
10.
Breast Cancer ; 31(3): 485-495, 2024 May.
Article in English | MEDLINE | ID: mdl-38507145

ABSTRACT

PURPOSE: Randomized clinical trials demonstrate that lumpectomy + hormone therapy (HT) without radiation therapy (RT) yields equivalent survival and acceptable local-regional outcomes in elderly women with early-stage, node-negative, hormone-receptor positive (HR +) breast cancer. Whether these data apply to men with the same inclusion criteria remains unknown. METHODS: The National Cancer Database was queried for male patients ≥ 65 years with pathologic T1-2N0 (≤ 3 cm) HR + breast cancer treated with breast-conserving surgery with negative margins from 2004 to 2019. Adjuvant treatment was classified as HT alone, RT alone, or HT + RT. Male patients were matched with female patients for OS comparison. Survival analysis was performed using Cox regression and Kaplan - Meier method. Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding. RESULTS: A total of 523 patients met the inclusion criteria, with 24.4% receiving HT, 16.3% receiving RT, and 59.2% receiving HT + RT. The median follow-up was 6.9 years (IQR: 5.0-9.4 years). IPTW-adjusted 5-yr OS rates in the HT, RT, and HT + RT cohorts were 84.0% (95% CI 77.1-91.5%), 81.1% (95% CI 71.1-92.5%), and 93.0% (95% CI 90.0-96.2%), respectively. On IPTW-adjusted MVA, relative to HT, receipt of HT + RT was associated with improvements in OS (HR: 0.641; p = 0.042). RT alone was not associated with improved OS (HR: 1.264; p = 0.420). CONCLUSION: Among men ≥ 65 years old with T1-2N0 HR + breast cancer, RT alone did not confer an OS benefit over HT alone. Combination of RT + HT demonstrated significant improvements in OS. De-escalation of treatment through omission of either RT or HT at this point should be done with caution.


Subject(s)
Breast Neoplasms, Male , Mastectomy, Segmental , Humans , Breast Neoplasms, Male/radiotherapy , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/mortality , Breast Neoplasms, Male/therapy , Aged , Male , Radiotherapy, Adjuvant/methods , Aged, 80 and over , Female , Retrospective Studies , Databases, Factual , Survival Rate , Kaplan-Meier Estimate , Antineoplastic Agents, Hormonal/therapeutic use
11.
Breast ; 75: 103703, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38461570

ABSTRACT

BACKGROUND: Sentinel lymph node biopsy (SLNB) is commonly used in the surgical management of male breast cancer. Contrary to female breast cancer, limited data exist about its performance in male breast cancer. The objective of this systematic review and meta-analysis was to evaluate the SLNB accuracy in male breast cancer. METHODS: MEDLINE, EMBASE, Web of Science and The Cochrane Library were searched from January 1995 to April 2023 for studies evaluating the SLNB identification rate and false-negative rate in male breast cancer with negative preoperative axillary evaluation and primary surgery. For SLNB false-negative rate, the gold standard was the histology of axillary lymph node dissection (ALDN). Methodological quality was assessed by using the QUADAS-2 tool. Pooled estimates of the SLNB identification rate and false-negative rate were calculated. Heterogeneity of the pooled studies was evaluated using I2 index. RESULTS: A total of 12 retrospective studies were included. The 12 studies that reported the SLNB identification rate gathered a total of 164 patients; the 5 studies that reported the SLNB false-negative rate gathered a total of 50 patients with a systematic ALND. The pooled estimate of the SLNB identification rate was 99.0%. The SLNB false-negative rates were 0% in the 5 included studies and consequently so as the pooled estimate of the false-negative rate with no heterogeneity. CONCLUSION: SLNB for male breast cancer, following negative preoperative axillary assessment and primary surgery, appears feasible, consistent, and effective. Our research supports conducting immediate SLNB histological evaluation to facilitate prompt ALND in case of positive results.


Subject(s)
Axilla , Breast Neoplasms, Male , Sentinel Lymph Node Biopsy , Humans , Sentinel Lymph Node Biopsy/statistics & numerical data , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/surgery , Male , False Negative Reactions , Lymph Node Excision/statistics & numerical data , Lymphatic Metastasis , Retrospective Studies , Middle Aged
12.
Breast ; 75: 103713, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38493590

ABSTRACT

BACKGROUND: The last years have seen unprecedented improvement in breast cancer (BC) survival rates. However, this entirely apply to female BC patients, since gender minorities (male, transgender/gender-diverse) are neglected in BC phase III registration clinical trials. METHODS: We conducted a scoping review of phase III clinical trials of agents with a current positioning within the therapeutic algorithms of BC. RESULTS: We selected 51 phase III trials. Men enrollment was allowed in 35.3% of trials. In none of the trial inclusion/exclusion criteria referred to transgender/gender-diverse people. A numerical higher rate of enrolled men was observed in the contemporary as compared to historical group. We found a statistically significant association between the drug class and the possibility of including men: 100%, 80%, 50%, 33.3%, 25%, 10% and 9.1% of trials testing ICI/PARP-i, ADCs, PI3K/AKT/mTOR-i, anti-HER2 therapy, CDK4/6-i, ET alone, and CT alone. Overall, 77409 patients were enrolled, including 112 men (0.2%). None of the trial reported transgender/gender-diverse people proportion. Studies investigating PARP-i were significantly associated with the highest rate of enrolled men (1.42%), while the lowest rates were observed for trials of CT (0.13%), ET alone (0.10%), and CDK 4/6-I (0.08%), p < 0.001. CONCLUSIONS: We confirmed that gender minorities are severely underrepresented among BC registration trials. We observed a lower rate of men in trials envisaging endocrine manipulation or in less contemporary trials. This work sought to urge the scientific community to increase the awareness level towards the issue of gender minorities and to endorse more inclusive criteria in clinical trials.


Subject(s)
Breast Neoplasms , Clinical Trials, Phase III as Topic , Patient Selection , Sexual and Gender Minorities , Humans , Male , Female , Breast Neoplasms/drug therapy , Breast Neoplasms/therapy , Sexual and Gender Minorities/statistics & numerical data , Clinical Trials, Phase III as Topic/statistics & numerical data , Transgender Persons/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Breast Neoplasms, Male/therapy , Breast Neoplasms, Male/drug therapy
13.
Indian J Pathol Microbiol ; 67(2): 401-404, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38427763

ABSTRACT

ABSTRACT: Syringoid eccrine carcinoma of nipple is an extremely rare neoplasm of adnexal origin with variable clinical appearance and diverse histologic findings. Syringoid eccrine carcinoma (SEC) is often a diagnostic dilemma due to its morphology and presentation. Usually, these malignancies arise as non-ulcerated nodules or plaques in the head & neck region including the trunk. They are locally aggressive and have an infiltrative growth pattern with a propensity for metastasis. SEC is characterized by syringoma-like tadpole morphology with ductular differentiation and predominant desmoplasia. Immunostaining in SEC is variable and this variability is believed to arise from the tumor's ability to differentiate along multiple routes including sweat secretory and or ductal differentiation. Here we present a rare case of SEC/ syringomatous carcinoma of nipple in a 51-year-old male breast with associated axillary lymph node metastasis. As per English literature, this is the second case of SEC in nipple of male patient.


Subject(s)
Breast Neoplasms, Male , Lymphatic Metastasis , Nipples , Sweat Gland Neoplasms , Humans , Male , Middle Aged , Nipples/pathology , Sweat Gland Neoplasms/pathology , Sweat Gland Neoplasms/diagnosis , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/diagnosis , Lymph Nodes/pathology , Immunohistochemistry , Eccrine Glands/pathology , Biomarkers, Tumor/analysis , Axilla , Carcinoma/pathology , Carcinoma/diagnosis , Carcinoma/secondary
14.
Oncologist ; 29(6): e750-e762, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38431780

ABSTRACT

PURPOSE: Male breast cancer (MBC) is a rare, but increasingly common disease, and lacks prospective studies. Collaborative efforts are needed to understand and address MBC, including its prognosis, in different countries. METHODS: We retrospectively reviewed the clinical, histopathological, and molecular-genetic characteristics, treatments, and survival outcomes of MBC diagnosed between 2007 and 2017 in the Czech Republic. Prognostic factors of overall survival (OS), recurrence-free interval (RFi), and breast cancer-specific mortality (BCSM) were analyzed and indirectly compared to international data. RESULTS: We analyzed 256 patients with MBC (median age 66 years), including 12% with de novo metastatic (M1). Of 201 non-metastatic (M0) patients, 6% were <40 years old, 29% had stage I, 55% were cN0, and 54% underwent genetic testing. Overall, 97% of tumors had estrogen receptor expression ≥10%, 61% had high Ki67 index, 40% were high-grade (G3), and 68% were luminal B-like (HER2-negative). Systemic therapies included endocrine therapy (90%) and chemotherapy (53%). Few (5%) patients discontinued adjuvant endocrine therapy for reasons other than disease relapse or death. Patients treated with aromatase inhibitors alone had significantly shorter RFi (P < .001). OS, RFi, and BCSM were associated with disease stage, T stage, N stage, progesterone receptor expression, grade, and Ki67 index. Median OS reached 122 and 42 months in M0 and de novo M1 patients, respectively. CONCLUSION: Due to the rarity of MBC, this study highlights important findings from real clinical practice. Although the number of patients with MBC with unfavorable features was higher in this Czech dataset than in international studies, the prognosis remains consistent with real-world evidence.


Subject(s)
Breast Neoplasms, Male , Humans , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/mortality , Breast Neoplasms, Male/therapy , Breast Neoplasms, Male/drug therapy , Male , Retrospective Studies , Aged , Prognosis , Czech Republic/epidemiology , Middle Aged , Adult , Aged, 80 and over
15.
Arch Gynecol Obstet ; 309(6): 2811-2819, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38472501

ABSTRACT

BACKGROUND: Following the positive iDFS and OS results of the phase III clinical trials monarchE, NATALEE and OlympiA, new oral anticancer agents (the CDK4/6 inhibitors abemaciclib, ribociclib as well as the PARP inhibitor olaparib) have recently been introduced into the treatment of high-risk early breast cancer (eBC). However, only few male patients were included in these trials (0.4%, 0.6% and 0.3%, respectively). The objective of this real-world analysis was to determine the proportion of male patients with eBC fulfilling the clinical high-risk criteria of above-mentioned trials. PATIENTS AND METHODS: We conducted a data inquiry and analysis with the Cancer Registry of Baden-Württemberg of men with breast cancer diagnosed between January 1, 2015 and December 31, 2021. Men with eBC were identified and the number of patients at clinical high-risk according to the inclusion criteria of monarchE, NATALEE and OlympiA was assessed. RESULTS: Of 397 men with eBC, 354 (89.1%) had a HR + /Her2- and 4 (1.0%) a triple-negative subtype. 84 patients (21.2%) met the clinical high-risk criteria according to the monarchE, 189 (47.6%) those according to the NATALEE and 50 (12.6%) those according to the OlympiA trial. CONCLUSION: In a large real-world sample, more men with eBC are at clinical high risk according to the inclusion criteria of monarchE, NATALEE and OlympiA than would be expected in women. This is most likely due to more advanced stages at initial diagnosis in men. To evaluate whether CDK4/6 and PARP inhibitors improve prognosis also in men should be the topic of future real- world analyses.


Subject(s)
Breast Neoplasms, Male , Feasibility Studies , Registries , Humans , Male , Breast Neoplasms, Male/drug therapy , Middle Aged , Aged , Chemotherapy, Adjuvant , Adult , Molecular Targeted Therapy/methods , Aminopyridines/therapeutic use , Poly(ADP-ribose) Polymerase Inhibitors/therapeutic use , Benzimidazoles/therapeutic use , Benzimidazoles/administration & dosage , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Purines
16.
Pathologica ; 116(1): 62-68, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38482676

ABSTRACT

Male breast cancer (MBC) accounts for approximately 1% of all breast cancers and among these infiltrating lobular carcinomas (ILC) represents only 1-2% of all MBC cases. Pleomorphic invasive lobular carcinoma (PILC) is an aggressive variant of ILC with only eight cases reported until now in males. Up to 10% of MBC cases have a germline pathogenic variant in a predisposing gene such as BRCA1 and BRCA2 genes. Mutations in PALB2 (partner and localizer of BRCA2) have been reported in men with breast cancer, with a frequency that ranges from 0.8 to 6.4%, but it has never been reported in male ILC. Here, we report a rare and interesting case of an invasive pleomorphic/solid lobular carcinoma, which carries a pathogenic variant in PALB2 gene, and a family history of breast cancer without other well defined risk factors for developing this type of neoplasia. In addition, we review the current literature.


Subject(s)
Breast Neoplasms, Male , Breast Neoplasms , Carcinoma, Lobular , Male , Humans , Carcinoma, Lobular/genetics , Carcinoma, Lobular/pathology , Germ-Line Mutation , Breast Neoplasms/genetics , Breast Neoplasms, Male/genetics , Breast Neoplasms, Male/pathology , Mutation , Genetic Predisposition to Disease , Fanconi Anemia Complementation Group N Protein/genetics
17.
Mod Pathol ; 37(4): 100452, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38369186

ABSTRACT

The molecular characterization of male breast cancer (MaBC) has received limited attention in research, mostly because of its low incidence rate, accounting for only 0.5% to 1% of all reported cases of breast cancer each year. Managing MaBC presents significant challenges, with most treatment protocols being adapted from those developed for female breast cancer. Utilizing whole-genome sequencing (WGS) and state-of-the-art analyses, the genomic features of 10 MaBC cases (n = 10) were delineated and correlated with clinical and histopathologic characteristics. Using fluorescence in situ hybridization, an additional cohort of 18 patients was interrogated to supplement WGS findings. The genomic landscape of MaBC uncovered significant genetic alterations that could influence diagnosis and treatment. We found common somatic mutations in key driver genes, such as FAT1, GATA3, SMARCA4, and ARID2. Our study also mapped out structural variants that impact cancer-associated genes, such as ARID1A, ESR1, GATA3, NTRK1, and NF1. Using a WGS-based classifier, homologous recombination deficiency (HRD) was identified in 2 cases, both presenting with deleterious variants in BRCA2. Noteworthy was the observation of FGFR1 amplification in 21% of cases. Altogether, we identified at least 1 potential therapeutic target in 8 of the 10 cases, including high tumor mutational burden, FGFR1 amplification, and HRD. Our study is the first WGS characterization of MaBC, which uncovered potentially relevant variants, including structural events in cancer genes, HRD signatures, and germline pathogenic mutations. Our results demonstrate unique genetic markers and potential treatment targets in MaBC, thereby underlining the necessity of tailoring treatment strategies for this understudied patient population. These WGS-based findings add to the growing knowledge of MaBC genomics and highlight the need to expand research on this type of cancer.


Subject(s)
Breast Neoplasms, Male , Breast Neoplasms , Humans , Male , Female , Breast Neoplasms, Male/genetics , Breast Neoplasms, Male/therapy , In Situ Hybridization, Fluorescence , Mutation , Breast Neoplasms/pathology , Oncogenes , Germ-Line Mutation , DNA Helicases/genetics , Nuclear Proteins/genetics , Transcription Factors/genetics
18.
Breast ; 74: 103694, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38417232

ABSTRACT

BACKGROUND: The experiences, physical and mental health and needs of women with breast cancer have been studied in some detail, but there is a lack of discussion of the experiences of stakeholder groups such as men with breast cancer, partners and carers and healthcare professionals. The aim of this study was to explore and understand the experiences and perceptions of male breast cancer stakeholders from diagnosis through to survivorship. METHODS: We conducted a thematic review of qualitative studies included in a large published scoping review on male breast cancer (reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews extension). To be included in a qualitative evidence review, studies had to use qualitative methods for data collection and analysis to capture the perspectives of men with breast cancer, partners or caregivers, and healthcare workers. Key characteristics and findings were extracted and a conceptual coding framework was summarized using thematic analysis. RESULTS: Out of a total of 310 studies in the research literature (published research articles and gray literature), 15 studies met the inclusion criteria. These studies reported on the experiences of men with breast cancer, partners or caregivers, and healthcare workers, with participant numbers ranging from 2 to 31. A total of 17 descriptive themes (study outcomes) were identified. From these, four high-level analytic themes emerged: (1) Predicament; (2) Emotion; (3) Support; (4) Coping. CONCLUSIONS: The gender stigma that exists at the patient, healthcare system, and family-society levels largely influences the experiences of the male breast cancer stakeholder population. To address gender inequalities in breast cancer care, healthcare organizations and society at large should remain equally attentive to the needs of male and female breast cancer patients. These needs include reducing healthcare and social stigma, providing gender-specific information and emotional support, and access to support groups.


Subject(s)
Breast Neoplasms, Male , Humans , Male , Female , Health Personnel/psychology , Qualitative Research , Mental Health
19.
JAMA Oncol ; 10(4): 508-515, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38421673

ABSTRACT

Importance: In women with hormone receptor-positive (HR+) breast cancer, the risk of distant recurrence and death persists for at least 20 years from diagnosis. The risk of late mortality in men with HR+ breast cancer has not been reported. Objective: To report 20-year risks of breast cancer-specific mortality (BCSM) and non-BCSM in men with stage I to III HR+ breast cancer and identify factors associated with late BCSM. Design, Setting, and Participants: An observational cohort study was conducted of men diagnosed with HR+ breast cancer from 1990 to 2008, using population-based data from the Surveillance, Epidemiology, and End Results program. Men diagnosed with stage I to III HR+ breast cancer were included in the analysis. Cumulative incidence function was used to estimate the outcomes of baseline clinicopathologic variables regarding cumulative risk of BCSM and non-BCSM since diagnosis. Smoothed hazard estimates over time were plotted for BCSM. Fine and Gray multivariable regression evaluated the association of preselected variables with BCSM, conditional on having survived 5 years. Main Outcome Measure: BCSM. Results: A total of 2836 men with stage I to III HR+ breast cancer were included, with a median follow-up of 15.41 (IQR, 12.08-18.67) years. Median age at diagnosis was 67 (IQR, 57-76) years. The cumulative 20-year risk of BCSM was 12.4% for stage I, 26.2% for stage II, and 46.0% for stage III. Smoothed annual hazard estimates for BCSM revealed an increase in late hazard rates with each incremental node category, reaching a bimodal distribution in N3 and stage III, with each having peaks in hazard rates at 4 and 11 years. Among patients who survived 5 years from diagnosis, the adjusted BCSM risk was higher for those younger than 50 years vs older than 64 years, those with grade II or III/IV vs grade I tumors, and stage II or III vs stage I disease. Conclusions and Relevance: The findings of this study suggest that, in men with stage I to III HR+ breast cancer, the risk of BCSM persists for at least 20 years and depends on traditional clinicopathologic factors, such as age, tumor stage, and tumor grade. Among men with higher stages of disease, the kinetics of the BCSM risk appear different from the risk that has been reported in women.


Subject(s)
Breast Neoplasms, Male , Aged , Humans , Male , Middle Aged , Cohort Studies , Neoplasm Staging , Breast Neoplasms, Male/epidemiology , Breast Neoplasms, Male/genetics , Breast Neoplasms, Male/mortality , Breast Neoplasms, Male/pathology , Receptors, Estrogen/genetics , Receptors, Estrogen/metabolism , Risk Assessment , Time Factors , SEER Program
20.
Breast Dis ; 43(1): 1-8, 2024.
Article in English | MEDLINE | ID: mdl-38363600

ABSTRACT

BACKGROUND: Male breast cancer (MBC) accounts for one percent of all breast cancers. Due to the lack of awareness and routine screening programs, most patients present with systemic disease at the time of diagnosis with low overall survival. OBJECTIVES: This study aims to investigate the prognostic factors of male breast cancer and its correlation with established prognostic parameters and patient outcomes. METHODS: Thirty-eight male breast cancer patients are identified from the MKA Breast Cancer Clinic database, and their corresponding clinical and pathological characteristics are obtained. Cut-off values of 1% and 10% are applied to further classify ER and PR results. RESULTS: Older men are more likely to develop MBC than younger men and are more likely to have spread to axillary lymph nodes. Invasive ductal carcinoma is a more common histologic type in MBC. All the tested patients have ER and PR positivity. Distant metastasis developed in 17/38 (44.7%) patients. Bone metastasis is seen commonly in metastatic MBC. CONCLUSIONS: According to our cohort, MBC is seen in older males, presents in later stages, and shows hormone receptor positivity and a tendency to bone involvement. MBC is a heterogenous but distinct biological entity requiring a specific clinical and pathological approach.


Subject(s)
Bone Neoplasms , Breast Neoplasms, Male , Breast Neoplasms , Carcinoma, Ductal, Breast , Humans , Male , Aged , Breast Neoplasms/pathology , Breast Neoplasms, Male/pathology , Prognosis , Lymph Nodes/pathology , Carcinoma, Ductal, Breast/pathology , Receptors, Progesterone
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