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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.
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Humanos , Masculino , Neoplasias da Mama Masculina/patologia , Neoplasias da Mama Masculina/diagnóstico por imagem , Contagem de Células Sanguíneas , Linfócitos/patologia , Estudos de Casos e Controles , Estudos Retrospectivos , NeutrófilosRESUMO
To our knowledge, this is the first case reported in the English literature of simultaneous occult male metastatic breast cancer presenting as pulmonary nodules and right axillary lymph node metastasis in a chronic lymphocytic leukemia (CLL) patient and is the second case of simultaneous male breast cancer and CLL reported. The first case was reported by Dubashi et al. [Curr Oncol. 2011;18(2):e101-2] in 2011. This unique clinical and pathological entity presents various challenges in its management, including early detection, screening, and treatment.
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Male breast cancer (MBC) is now considered molecularly different from female breast cancer (FBC). Evidence from studies indicates that common genetic and epigenetic features of FBC are not shared with those diagnosed in men. Genetic predisposition is likely to play a significant role in the tumorigenesis of this rare disease. Inherited germline variants in BRCA1 and BRCA2 account for around 2% and 10% of MBC cases, respectively, and the lifetime risk of breast cancer for men harboring BRCA1 and BRCA2 mutations is 1.2% and 6.8%. As for FBC, pathogenic mutations in other breast cancer genes have also been recently associated with an increased risk of MBC, such as PALB2 and CHEK2 mutations. However, while multigene germline panels have been extensively performed for BC female patients, the rarity of MBC has resulted in limited data to allow the understanding of the magnitude of risk and the contribution of recently identified moderate penetrance genes of FBC for MBC predisposition. This review gathers available data about the germline genetic landscape of men affected by breast cancer, estimated risk associated with these genetic variants, and current guidelines for clinical management.
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PURPOSE: Male breast cancer is an uncommon disease, and population-based information regarding prognostic factors is limited. Most cases are hormone receptor (HR) positive; however, the association of tumor subtype with overall survival (OS) and breast cancer-specific survival (BCSS) is unclear. METHODS: Using SEER data, we identified men with invasive breast cancer between 2010 and 2017 with known HR and HER2 status. We examined tumor subtypes by patient characteristics and performed multivariate Cox proportional hazards analyses to determine the associations of each variable with OS and BCSS. RESULTS: We included 2389 men with a median follow-up of 43 months (IQR 19-68). Median age was 66 years. Tumor subtype distribution was 84.1% HR+/HER2-, 12.7% HR+/HER2+ , 0.8% HR-/HER2+, and 2.3% triple-negative (TN). In univariate analysis, OS at 5 years was 76.5% for HR+/HER2-, 65.1% for HR+/HER2+ , 84.2% for HR-/HER2+, and 48.1% for TN (p < 0.0001). Of all subtypes, TN had the worst BCSS (p < 0.0001). Stage, tumor subtype and race were significantly associated with OS and BCSS in multivariate analysis. Adjusted Cox hazard ratios for OS by tumor subtype with HR+/HER2- as reference were 1.55 for HR+/HER2+ (p = 0.001), 1.1 for HR-/HER2+ (p = 0.888), and 3.59 for TN (p < 0.001). CONCLUSION: We observed significant differences in survival outcomes by tumor subtype. Poor outcomes among men with HER2+ and TN disease suggest possible under-treatment, aggressive tumor biology, and/or more advanced disease at presentation. Studies to better understand the inferior survival for men with these subtypes are warranted and will likely require international collaboration.
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Neoplasias da Mama Masculina , Neoplasias da Mama , Idoso , Biomarcadores Tumorais , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/genética , Humanos , Estimativa de Kaplan-Meier , Masculino , Prognóstico , Receptor ErbB-2/genética , Receptores de Estrogênio/genética , Receptores de Progesterona/genéticaRESUMO
BACKGROUND: Male Breast Cancer (MBC) is rare, which makes its understanding and treatment be extrapolated from what is known about the occurrence in women, with few epidemiological studies, with few epidemiological studies. Therefore, the aim of the present paper was to study breast cancer mortality in adult males in Brazil and its administrative regions between 2005 and 2015. METHODS: Ecological study with data on MBC mortality in adults between 2005 and 2015. Data were obtained from the Mortality Information System of the Department of Informatics of SUS (the Unified Health System of the country). Descriptive statistics were used for MBC mortality and linear regression to analyze the relationship between mortality and the country's administrative regions. Percentage Change (PC) and Annual Percentage Change (APC) were the trend measures used for MBC mortality for the period. RESULTS: Between 2005 and 2015, there were 1521 deaths due to MBC in adults in Brazil. Regarding mortality by region, there was great oscillation in the rates of the country as a whole (PC = 113,87; ß = 0,009 (IC95% 0,000 - 0,018); r2 = 0,381; P = 0,043). The highest increase in MBC mortality occurred in patients aged 80 years or older (PC = 161,04; ß = 0,201 (IC95% 0,640 - 0,339); r2 = 0,550; P = 0,009) and there was significant increase in deaths for the 50-54-year age group (PC = 224,01; ß = 0,135 (CI95% 0,052; 0,218); r2 = 0,601; P = 0,005). CONCLUSION: Mortality in adults due to MBC increased in Brazil during the study period with the highest percentage increase occurring for individuals aged 80 years or older.
Assuntos
Neoplasias da Mama Masculina/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil , Análise de Dados , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Adulto JovemRESUMO
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)
Assuntos
Humanos , Masculino , Idoso , Neoplasias da Mama Masculina/diagnóstico por imagem , Mastectomia Radical Modificada/efeitos adversos , Tumores Neuroendócrinos/cirurgia , Neoplasias Unilaterais da Mama/radioterapiaRESUMO
PURPOSE: To compare the disease-free survival (DFS) and overall survival (OS) rates of men and women undergoing treatment for breast cancer. METHODS: A retrospective cohort study of patients with breast cancer diagnosed and treated at the Cancer Hospital III of the National Cancer Institute of Brazil, Rio de Janeiro, Brazil, between 1999 and 2013. Male breast cancer cases were matched for age, year of diagnosis, and clinical staging to three female cases (1:3). Patient characteristics were abstracted from hospital records and medical charts. Cases were analyzed using descriptive statistics, and comparisons between the genders were performed using Kaplan-Meier curves and Cox regression analysis with 95% confidence intervals. RESULTS: The study population comprised 98 men and 294 women. There were significant differences (p < 0.05) between the genders for marital status, alcohol consumption, smoking, presence of hypertension and other comorbidities, histological type of tumor, expression of estrogen receptors, progesterone receptors, human epidermal growth factor receptor-type 2, type of breast surgery, neoadjuvant chemotherapy, adjuvant radiotherapy, and use of palliative bisphosphonate therapy. Five- and 10-year DFS rates were, respectively, 80.0 and 51.4% for men and 71.4 and 63.5% for women (p = 0.245), and 5- and 10-year OS rates were, respectively, 65.0 and 47.5% for men and 56.5 and 41.4% for women (p = 0.221). CONCLUSION: There was no significant difference in prognosis (DFS and OS rates) between the genders, but significant differences in sociodemographic and clinical characteristics were detected between male and female breast cancer cases.
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Neoplasias da Mama Masculina/patologia , Neoplasias da Mama/patologia , Taxa de Sobrevida , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
PURPOSE: To describe the clinical-epidemiological features of male patients with breast cancer in Brazil. METHODS: Data from male patients with breast cancer treated from 2000 through 2009 were obtained from the Brazilian Hospital Cancer Register databases. Descriptive statistics were performed. RESULTS: A total of 1189 male patients were included. The mean age at diagnosis was 59.6 years (± 13.6). Tumours were categorised as clinical stage I (14.3%), stage II (38.3%), stage III (34.1%) and stage IV (13.3%). The most frequent histological type was invasive ductal carcinoma (83.7%). The first course treatment (alone or combined) consisted of chemotherapy in 53.2%, surgery in 49.2, radiation therapy in 36.8 and hormonal therapy in 21.0%; 3.4% of cases did not receive treatment. Treatment modality varies according to the tumor-node-metastasis (TNM) stage. The inadequate response rate was 15.9%, and 7.4% of patients died after the first course of treatment. Adequate response according to the first-course cancer treatment, after adjusted for clinical stage, was associated with being Caucasian (odds ratio (OR) = 2.50; 95% confidence interval (95% CI): 1.35-4.65) and submitted to chemotherapy (OR = 0.46; 95% CI: 0.28-0.74). CONCLUSIONS: Male breast cancer diagnosis is often made in the advanced stage. Consequently, patients were subjected to more aggressive treatments, with poorer clinical response.
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Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/patologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/patologia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Brasil/epidemiologia , Neoplasias da Mama Masculina/terapia , Carcinoma Ductal de Mama/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Radioterapia , Sistema de Registros , Procedimentos Cirúrgicos OperatóriosRESUMO
Male breast cancer, which represents only 1% of all breast cancers, is occasionally associated with a family history of breast cancer. Sporadic male breast cancers presenting with another primary breast cancer are extremely rare. In this article, we report on a 70-year-old male patient with bilateral multifocal and synchronous breast cancer and without a family history of breast cancer.
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BACKGROUND: male breast cancer is a disease with low incidence, which is further reduced when it comes to bilateral synchronous presentation. There are few published cases in recent years. The aim is to establish guidelines for the management of this disorder that is so rare. CLINICAL CASE: a 75-year-old with tumors in both breasts, which were completely resected with removal of palpable nodes. The histopathological study reported ductal carcinoma. The indicated treatment was adjuvant tamoxifen and radiotherapy. The patient is currently in a disease-free period. CONCLUSIONS: this is a rare disease, whose main treatment is surgery, hence the importance of early diagnosis. Most cases require adjuvant chemotherapy and radiotherapy because they are usually diagnosed at an advanced stage.
antecedentes: el cáncer de mama en el hombre es una enfermedad con baja incidencia, que se reduce aún más cuando es bilateral sincrónica. Existen pocas publicaciones en los últimos años. Objetivo: establecer pautas para el tratamiento de este cáncer, aunque sea infrecuente. Caso clínico: paciente masculino de 75 años de edad, con tumores en ambas mamas, que se le resecaron completamente con exéresis de ganglios palpables. El estudio histopatológico informó que se trataba de un carcinoma ductal infiltrante no especificado. Se indicó tratamiento adyuvante con tamoxifeno y radioterapia; en la actualidad está libre de enfermedad. Conclusiones: el carcinoma mamario bilateral sincrónico en el varón es una enfermedad poco frecuente. Su tratamiento principal es la cirugía, de ahí la importancia del diagnóstico temprano. En la mayoría de los casos se requiere quimioterapia y radioterapia adyuvante porque suelen diagnosticarse en un estadio avanzado.
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Neoplasias da Mama Masculina , Carcinoma Ductal de Mama , Neoplasias Primárias Múltiplas , Idoso , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama Masculina/tratamento farmacológico , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/patologia , Neoplasias da Mama Masculina/radioterapia , Neoplasias da Mama Masculina/cirurgia , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/cirurgia , Quimioterapia Adjuvante , Terapia Combinada , Moduladores de Receptor Estrogênico/uso terapêutico , Estrogênios , Humanos , Excisão de Linfonodo , Masculino , Mastectomia , Neoplasias Hormônio-Dependentes/tratamento farmacológico , Neoplasias Hormônio-Dependentes/patologia , Neoplasias Hormônio-Dependentes/radioterapia , Neoplasias Hormônio-Dependentes/cirurgia , Neoplasias Primárias Múltiplas/tratamento farmacológico , Neoplasias Primárias Múltiplas/epidemiologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/radioterapia , Neoplasias Primárias Múltiplas/cirurgia , Radioterapia Adjuvante , Tamoxifeno/uso terapêuticoRESUMO
O câncer de mama em homens é uma patologia relativamente incomum. Atinge um homem para cada 1.000 mulheres, representa menos de 1 por cento de todos os cânceres em homens e é responsável por 0,1 por cento da mortalidade por câncer no sexo masculino. Como nas mulheres, o subtipo mais comum é o ductal infiltrativo. No presente trabalho é relatado o caso de um paciente masculino, 67 anos, com nódulo em mama direita com diagnóstico de carcinoma ductal sólido. Apesar de ser incomum, alguns estudos vêm demonstrando um aumento na incidência desses tumores. O exame físico talvez seja a principal ferramenta para o diagnóstico desse tumor. Contudo, a confirmação histopatológica é necessária para avaliação definitiva. Devido à raridade da doença, muitas das atuais modalidades de tratamento são baseadas na experiência com câncer de mama feminino. Este caso evidencia a relevância da conscientização da população sobre essa patologia e ao profissional da saúde em considerar este diagnóstico possível.
Male breast cancer is a fairly uncommon disorder. Affecting only one for a thousand women, it represents less than 1 percent of all male cancers and accounts for 0.1 percent of the male cancer mortality. Just like in women, the most common subtype is the infiltrative ductal. Here we report the case of a 67-year-old male patient with a nodule in the right breast with a diagnosis of solid ductal carcinoma. Although uncommon, a few studies show an increase in the incidence of this tumor. However, histopathologic confirmation is necessary for a definite evaluation. Due to the rarity of the disease, many of the current treatment modalities are based on the experience with female cancer. This case highlights the relevance of raising the awareness of the disease among the general population and health professionals in considering this a potential diagnosis.
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Humanos , Adulto , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Ciclofosfamida/farmacologia , Neoplasias da Mama Masculina/complicações , Neoplasias da Mama Masculina/diagnóstico , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/fisiopatologia , Neoplasias da Mama Masculina/genética , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/etiologia , Carcinoma Ductal de Mama/fisiopatologiaRESUMO
O câncer de mama em homens é uma doença incomum. A cada 150 casos de câncer de mama é esperada a ocorrência de apenas um no sexo masculino. Devido à baixa incidência desta neoplasia, grande parte do seu conhecimento é oriunda do carcinoma de mama no sexo feminino, cujos parâmetros diagnósticos, prognósticos e terapêuticos são bem estabelecidos na literatura. Entretanto, a distribuição dos fenótipos moleculares dos carcinomas da mama masculina é pouco conhecida. Pela análise de dados clínicos eimuno-histoquímicos estudamos os diferentes perfis de uma amostra de 20 casos de tumores invasores de mama em homens. Utilizamos um painel de cinco anticorpos composto por receptor de estrogênio, citoqueratinas 5/6, citoqueratinas 8/18, HER-1 e HER-2. Dos 20 casos examinados, 19 eram carcinomas do tipo ductal não-especial (95%) e um do tipo lobular (5%). A maioria dos casos foi composta pormastectomias (65%), sendo a média de tamanho das neoplasias de 2,8 cm e o grau histológico mais freqüente o II (60%). Do total, 86,6% dos casos apresentaram metástases linfonodais. O número médio de linfonodos comprometidos foi de 5,2 nas amostras com axila positiva. Foram determinados 14 tumores (70%) correspondentes ao fenótipo RE+/luminal, dois (10%) do tipo indeterminado, um único tumor (5%) do fenótipo Basal, e três de mama (15%) correspondendo ao fenótipo HER2-positivo. A imunofenotipagemdos carcinomas de mama no sexo masculino permite traçar paralelos com os tumores de mama feminina, possibilitando a elucidação de fatores intrínsecos à doença em cada um dos sexos.
Male breast cancer (MBC) is a rare disease. One out of 150 cases of breast cancer is expected to occur in the male gender. Due to the low incidence of this neoplasia, most information about it derives from female breast carcinoma, whose diagnostic, prognostic and therapeutical parameters are well established in the medical literature. However, the distribution of molecular phenotypes of male breast carcinomas is little known. We analyzed the clinical and immunohistochemical data of a sample comprising 20 cases of invasivemale breast tumor. We used a panel of five antibodies that encompasses estrogen receptor, cytokeratins 5/6,cytokeratins 8/18, HER1 and HER2. Among these 20 cases, 19 were non-special ductal carcinomas (95%) and one was a lobular carcinoma (5%). Most cases were mastectomies (65%) and the average size of the neoplasias was 2.8 cm. The most frequent histological grade was II (60%). Axillary lymph node metastases were presented by 86.6% of the total cases. The average number of affected lymph nodes was 5.2 in the samples with positive nodes. Fourteen tumors corresponded to ER+/luminal phenotype (70%), two were classified as undetermined (10%), one (5%) belonged to the basal phenotype and three breast tumors (15%) corresponded to HER2-positive phenotype. The immunohistochemical results of the male breast carcinomasallow us to make comparisons with female breast tumors, what may elucidate the intrinsic factors of thedisease in each gender.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Imuno-Histoquímica , Neoplasias da Mama Masculina/diagnóstico , Anticorpos Monoclonais , Expressão Gênica , Invasividade Neoplásica/diagnóstico , FenótipoRESUMO
INTRODUCTION: One of the several metabolic pathways involved in breast carcinogenesis is the human polymorphism in the mitochondrial targeting sequence Ala-9Val of the manganese superoxide dismutase (MnSOD) gene, which has been previously associated with increased risk of breast cancer in females. Since there is no previous report on this polymorphism in male breast cancer, the objective of this study is to analyze MnSOD polymorphism in a population of males and females with breast cancer from the southernmost state of Brazil, compared to healthy controls. METHODS: A case-control study of one hundred patients affected by breast cancer (11 men and 89 women) and 370 healthy age-adjusted database controls was performed. DNA was extracted from paraffin-embedded tumoral tissue. MnSOD polymorphism was determined by PCR-RFLP techniques using restriction enzyme Hae III. Chi-square test was used to compare MnSOD frequency distribution. RESULTS: MnSOD genotypic frequencies in all patients with breast cancer were AA = 15 percent; AV = 56 percent; VV = 29 percent and controls AA = 6.5 percent; AV = 68.1 percent and VV = 25.4 percent. Both male and female patients with breast cancer presented significantly higher AA frequencies compared to controls (p = 0.035), suggesting strong association of this genotype with breast cancer. A 2.15-fold (95 percent confidence interval [CI] 1.393-4.541) risk of breast cancer was found among individuals carrying the MnSOD AA allele-containing genotypes compared with the MnSOD VV and AV genotypes. DISCUSSION: These results confirm the already established association of MnSOD AA genotype with female breast cancer and further indicate a similar frequency distribution and increased risk in the male population.
INTRODUÇÃO: Uma das diversas rotas metabólicas envolvidas no processo de carcinogênese da mama é o polimorfismo Ala-9Val do gene da superóxido dismutase dependente de manganês, cuja associação com o aumento do risco de câncer de mama em mulheres já é bem estabelecida na literatura. Contudo, não existem estudos envolvendo esse polimorfismo no carcinoma de mama em homens, principalmente devido à baixa prevalência dessa neoplasia. O objetivo deste estudo é analisar o polimorfismo da MnSOD em uma população de homens e mulheres com câncer de mama no sul do Brasil, comparando tais achados com controles saudáveis. MÉTODOS: Foi realizado um estudo de caso-controle em cem pacientes com câncer de mama (11 homens e 89 mulheres) e 370 controles saudáveis. O DNA foi extraído do tecido tumoral emblocado em parafina. O polimorfismo da MnSOD foi determinado por técnicas de PCR-RFLP usando a enzima de restrição Hae III. O teste do qui quadrado foi usado para comparar a distribuição das freqüências dos polimorfismos. RESULTADOS: As freqüências genotípicas dos pacientes com câncer de mama foram AA = 15 por cento; AV = 56 por cento; VV = 29 por cento e dos controles AA = 6,5 por cento; AV = 68,1 por cento e VV = 25,4 por cento. Os pacientes com câncer de mama, tanto as mulheres como os homens, apresentaram freqüências significativamente mais elevadas do genótipo AA quando comparadas aos controles (p = 0,035), sugerindo associação forte desse genótipo com o câncer de mama. O intervalo de confiança foi de 1,393-4,541 (95 por cento) e o risco encontrado foi de 2,15 para indivíduos portadores do genótipo AA, quando comparados com os controles que tinham os genótipos VV e AV da MnSOD. DISCUSSÃO: Esses resultados confirmam a associação já estabelecida do genótipo da MnSOD AA com câncer de mama em mulheres e indicam distribuição de freqüência similar e risco aumentado na população masculina.
Assuntos
Humanos , Masculino , Feminino , Neoplasias da Mama/genética , Polimorfismo Genético , Superóxido Dismutase , Estudos de Casos e ControlesRESUMO
Câncer de mama masculino é patologia rara e ainda pouco estudada. O diagnóstico geralmente é tardio e com prognóstico comprometido em virtude da resistência dos homens em procurar auxílio médico. Entretanto, quando diagnosticado precocemente, tem maior probabilidade de cura. Os autores relatam um caso de câncer mamário masculino bilateral assíncrono e fazem uma revisão dos casos semelhantes já publicados.
Male breast cancer pathology is rare and poorly studied. The diagnosis is usually delayed and the prognosis is compromised because of resistance from men to seek medical help. However, when diagnosed early, has a higher probability of cure. The authors report a case of asynchronous bilateral male breast cancer and do a review of similar cases already published cases.
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Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Intraductal não Infiltrante/diagnóstico , Neoplasias da Mama/cirurgia , Diagnóstico Diferencial , Excisão de Linfonodo , Mastectomia RadicalRESUMO
O câncer de mama no homem é doença rara e corresponde a 0,8% de todos os casos de carcinomas mamários. Ocorre com mais freqüência na sétima década de vida e em geral se apresenta como nódulo indolor localizado em região retroareolar. Os fatores de risco incluem idade, disfunção testicular, doença benigna da mama, história familiar positiva, excesso de exposição a hormônios femininos (síndrome de Klinefelter, drogas), radiação, raça negra, obesidade, elevado nível socioeconômico ou cultural, além de ser mais prevalente em famílias judaicas. A mamografia, a ultra-sonografia e a citologia aspirativa fazem parte dos exames complementares. A mutação do BRCA2 encontra-se associada à maior incidência da doença em homens. Devido à escassa quantidade de tecido glandular, o tratamento-padrão consiste em mastectomia radical modificada, radioterapia e, freqüentemente, quimioterapia. Em geral, os receptores de estrogênio e progesterona são positivos e, ainda hoje, o tamoxifeno é considerado o tratamento hormonal de eleição. O prognóstico é semelhante ao do câncer de mama da mulher, quando se equiparam parâmetros como idade, biologia tumoral e estadiamento.
Male breast cancer (MBC) is a rare disease and accounting for 0,8 % of all cases of breast cancer. Occurs more frequently on 7th decade of life and usually it presents painless subareolar lump. Risk factors include advanced age, testicular dysfunction, benign breast conditions, positive family history, excess exposure to female hormones (Klinefelter's syndrome, drugs), irradiation, black race, obesity, higher socioeconomic or educational status, besides to be more prevalent in Jewish origin. Mammography, sonography and aspiration cytology taken part in the complementary exams. BRCA2 mutation is associated with higher incidence of MBC. Due to the paucity of breast tissue in men, the standard treatment consists of modified radical mastectomy, radiotherapy and frequently chemotherapy. Generally estrogen and progesterone receptors are positives and the tamoxifeno still is the hormonal treatment selectioned. The prognostic is similar to the women breast cancer when to put on a level with parameters like age, biology tumor and stage.
Assuntos
Humanos , Masculino , Neoplasias da Mama Masculina/diagnóstico , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/patologia , Mastectomia Radical , Neoplasias da Mama Masculina/terapia , PrognósticoRESUMO
O câncer de mama no homem é doença rara e, como na mulher, a dissecção axilar é uma parte essencial da terapêutica cirúrgica. Sabe-se que homens tratados com esvaziamento axilar têm o mesmo risco que mulheres de desenvolver morbidades associadas a este procedimento e que a biópsia do linfonodo sentinela tem emergido como uma alternativa eficaz. A proporção da positividade dos receptores hormonais é maior que a observada nas mulheres, ampliando-se, assim, o papel da endocrinoterapia. Os autores relatam caso de câncer de mama inicial em homem tratado com mastectomia simples, biópsia do linfonodo sentinela, endocrinoterapia com tamoxifeno e reconstrução tardia do complexo aréolo-papilar. A biópsia do linfonodo sentinela poderia ser considerada para a avaliação linfonodal de homem com carcinoma de mama com axila clinicamente negativa.
Male breast cancer (MBC) is a rare disease and, as in women, axillary dissection is an essential part of surgical therapy. It is well know that men treated by axillary dissection have the same risk as women of developing the morbidities associated with this procedure and that the sentinel lymph node biopsy is emerging as an efficacious alternative. The rate of hormone receptor positivity is higher than that observed in women, enhancing the role of endocrinotherapy. The authors describe a case of male early breast cancer treated by simple mastectomy, sentinel lymph node biopsy, endocrinotherapy with tamoxifen and lately nipple-areolar complex reconstruction. The sentinel lymph node biopsy should be considered for axillary staging in male breast cancer patients with clinically negative axilla.