RESUMO
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.
Assuntos
Humanos , Masculino , Idoso , Neoplasias da Mama Masculina/induzido quimicamente , Inibidores de 5-alfa Redutase/efeitos adversos , Razão de Chances , Inibidores de 5-alfa Redutase/administração & dosagem , Pessoa de Meia-IdadeRESUMO
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.
Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Neoplasias da Mama Masculina/induzido quimicamente , Inibidores de 5-alfa Redutase/administração & dosagem , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Razão de ChancesRESUMO
The majority of breast cancers in male patients are hormone receptor positive. Tamoxifen has proven to be successful in both adjuvant and metastatic settings and remains the standard of care. Given the improved outcomes in female patients with aromatase inhibitors (AI), these drugs have become a potential therapeutic tool for male patients. Preliminary data show effective suppression of oestradiol levels in males treated with AI and some reports have demonstrated objective responses. Here we report a case of a male patient with metastatic breast cancer treated with letrozole who achieved clinical response associated with a decrease in blood oestradiol levels.
Assuntos
Antineoplásicos Hormonais/uso terapêutico , Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama Masculina/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Estrogênios , Neoplasias Hormônio-Dependentes/tratamento farmacológico , Nitrilas/uso terapêutico , Progesterona , Triazóis/uso terapêutico , Neoplasias da Mama Masculina/sangue , Neoplasias da Mama Masculina/induzido quimicamente , Neoplasias da Mama Masculina/enzimologia , Carcinoma Ductal de Mama/sangue , Carcinoma Ductal de Mama/induzido quimicamente , Carcinoma Ductal de Mama/enzimologia , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/secundário , Terapia Combinada , Acetato de Ciproterona/efeitos adversos , Acetato de Ciproterona/uso terapêutico , Estradiol/sangue , Estrogênios Conjugados (USP)/efeitos adversos , Estrogênios Conjugados (USP)/uso terapêutico , Humanos , Letrozol , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Hormônio-Dependentes/sangue , Neoplasias Hormônio-Dependentes/induzido quimicamente , Neoplasias Hormônio-Dependentes/enzimologia , Transtornos Fóbicos/tratamento farmacológico , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Neoplasias da Coluna Vertebral/radioterapia , Neoplasias da Coluna Vertebral/secundário , Testosterona/sangue , Resultado do TratamentoRESUMO
The male breast cancer accounts for nearly 1% of all breast cancer cases and bilateral involvement occurs in less than 2% of the cases. Estrogen treatment for prostate cancer is a risk factor for primary breast cancer. Bilateral breast carcinomas were found in a 79-year-old Brazilian black man, following prostate cancer treatment with estrogen. Prostate cancer metastases could be found in breast tissue, and might be indistinguishable from primary breast tumours on histological evaluation without immunohistochemistry. Coexistence of prostate cancer with breast cancer increases future-longevity concerns.