Male breast cancer

男性乳腺癌
  • 文章类型: Case Reports
    背景:睾酮替代疗法(TRT)可以改善性腺功能减退症男性的生活质量。然而,在有前列腺癌或乳腺癌病史的患者中,由于风险存在不确定性,因此通常避免使用这种疾病。该病例说明了TRT后同步转移性前列腺癌和男性乳腺癌的例子。
    方法:一名72岁男性曾接受过治疗的中危前列腺腺癌患者在自我给予睾酮替代治疗时,前列腺特异性抗原(PSA)逐渐升高。后来发现他患有复发性转移性前列腺癌,并且在开始雄激素剥夺治疗(ADT)之前,他还被诊断出患有男性乳腺癌。他的治疗包括继续ADT治疗转移性去势敏感性前列腺癌(mCSPC)以及手术切除乳腺癌。
    结论:ADT在男性乳腺癌和前列腺癌的治疗中起作用。TRT在有这些恶性肿瘤病史的患者中仍然相对禁忌,但支持这一建议的证据有限.
    结论:该病例强调了TRT后同步前列腺复发和新发男性乳腺癌的潜在风险。需要进一步的研究来更好地阐明这些恶性肿瘤与TRT的风险增加。
    BACKGROUND: Testosterone replacement therapy (TRT) can improve quality of life for men with hypogonadism. However, it is generally avoided in patients with a history of prostate cancer or breast cancer as there is uncertainty about risks. This case illustrates an example of synchronous metastatic prostate cancer and male breast cancer following TRT.
    METHODS: A 72-year-old man with previously treated intermediate-risk prostate adenocarcinoma experienced a gradual rise in prostate-specific antigen (PSA) while self-administering testosterone replacement. He was later found to have recurrent metastatic prostate cancer and prior to initiating androgen deprivation therapy (ADT), he was also diagnosed with male breast cancer. His treatment has consisted of continued ADT for metastatic castration-sensitive prostate cancer (mCSPC) as well as surgical resection of his breast cancer.
    CONCLUSIONS: ADT plays a role in treatment of male breast cancer and prostate cancer. TRT remains relatively contraindicated in patients with a history of these malignancies, but the evidence supporting this recommendation is somewhat limited.
    CONCLUSIONS: This case highlights the potential risk for synchronous recurrent prostate and new male breast cancer following TRT. Further studies are needed to better elucidate the increased risks of these malignancies with TRT.
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  • 文章类型: Case Reports
    这是一名76岁的菲律宾男性的病例报告,他有六年的左乳房肿块稳步增长的历史。该肿块最终被诊断为浸润性导管癌,解剖和预后IIIB期(T4bcN0M0),三级,管腔A,随后,患者接受了阿霉素/环磷酰胺和紫杉醇的新辅助化疗,然后进行改良根治术和腋窝淋巴结清扫术,通过乳房切除术后放射治疗结束。患者对这种三联疗法有完全的临床反应。这种情况的罕见性与男性乳腺癌的现有文献并列并结合。
    This is a case report of a 76-year-old Filipino male who presented with a six-year history of a steadily growing left breast mass. The mass was eventually diagnosed to be Invasive Ductal Carcinoma, Anatomic and Prognostic Stage IIIB (T4b cN0 M0), Grade 3, Luminal A. Subsequently, the patient underwent neoadjuvant chemotherapy of doxorubicin/cyclophosphamide and paclitaxel, followed by modified radical mastectomy with axillary lymph node dissection, concluded by post-mastectomy radiation therapy. The patient had complete clinical response to this trimodality therapy. The rarity of this case is juxtaposed and integrated with the present literature on male breast cancer.
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  • 文章类型: Case Reports
    男性患者的乳腺癌是公众已知的罕见疾病,但与女性患者同样关注。
    方法:一名64岁男性,有25年的右乳房进行性肿胀病史,接受了超声引导活检,发现SBRI级粘液性癌,进行了右乳房切除术和淋巴结清扫术。他的术后时期平安无事,患者在术后第7天还活着。正在考虑化疗和放疗。
    稀有,应全面评估和调查男性乳腺癌,以避免相关的发病率和死亡率。
    结论:男性乳腺癌虽然罕见,但其治疗遵循与女性相同的原则。尽管性别不同,但仍需要进行基因测试以识别有风险的患者并指导预防措施,以防乳房肿胀。
    UNASSIGNED: Breast cancer in a male patient is an uncommon condition known by the general public yet of the same concern as in a female patient.
    METHODS: A 64-year-old male with a 25 years history of a progressive swelling in the right breast, underwent an ultrasound guided biopsy which revealed a mucinous carcinoma of grade SBR I, right mastectomy with lymph-node dissection were done. His postoperative period was uneventful and patient was a live on 7th post-operative day. Chemotherapy and radiotherapy are being considered.
    UNASSIGNED: Being rare, breast cancer in males should be fully evaluated and investigated to avoid the associated morbidity and mortality.
    CONCLUSIONS: Male breast cancer though rare exists and its management follows the same principles as in women. There is a need to do genetic tests to identify patients at risk and guide preventive measures in case of any breast swelling despite the gender.
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  • 文章类型: Case Reports
    实性乳头状癌(SPC)约占所有乳腺癌病例的1%,主要发生在绝经后妇女中。我们报告了一种罕见的SPC,并侵入了男性乳房。
    一名73岁的日本男子出现流血的乳头溢液和明显的左乳房肿块。乳房X光检查显示出明确的高浓度质量。超声扫描显示左乳头下10mm囊内肿块,无腋窝淋巴结肿大。芯针活检显示导管癌,核1级,排除了浸润性癌。磁共振成像显示左乳房有7mm强烈的早期增强。进行了左乳房切除术和前哨淋巴结活检。患者诊断为病理分期IA(T1bN0M0)乳腺癌,无神经内分泌标志物的侵入性纯SPC型。患者口服他莫昔芬治疗,存活12个月无复发。
    男性乳房的侵入性SPC可在老年男性中表现为明显的肿块或乳头溢液,预后良好。
    UNASSIGNED: Solid papillary carcinoma (SPC) accounts for approximately 1% of all breast cancer cases and occurs primarily in postmenopausal women. We report a rare SPC with invasion in the male breast.
    UNASSIGNED: A 73-year-old Japanese man presented with bloody nipple discharge and a palpable left breast mass. Mammography revealed a well-defined high-concentration mass. Ultrasonography scans demonstrated an intracystic 10 mm mass under the left nipple without enlarged axillary lymph nodes. A core needle biopsy revealed a ductal carcinoma with nuclear grade 1, which excluded an invasive carcinoma. Magnetic resonance imaging exhibited a 7 mm intense early enhancement in the left breast. A left mastectomy and sentinel lymph node biopsy were performed. The patient was diagnosed with pathological stage IA (T1b N0 M0) breast carcinoma, an invasive pure SPC type without neuroendocrine markers. The patient was treated with oral tamoxifen and survived without any recurrence for 12 months.
    UNASSIGNED: Invasive SPC of the male breast may occur as a palpable mass or nipple discharge in older men and has a good prognosis.
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  • 文章类型: Case Reports
    未知原发癌(CUP)是一组异质性肿瘤,其特征是诊断困难。原始肿瘤仍然未知,而转移是最常见的表现。隐匿性男性乳腺癌是非常罕见的CUP类型。本研究描述了一名64岁男子受假定为乳腺起源的CUP影响的病例。本文和本审查的目的是侧重于他们的管理。据我们所知,文献中只报道了13例。因为没有具体的指导方针,已经应用了各种方法,影响CUP患者的治疗和预后。
    Cancers of unknown primary (CUPs) are a heterogeneous group of tumors characterized by a difficult diagnosis. The primitive tumor remains unknown, whereas metastases are the most common manifestation. Occult male breast cancers are very rare types of CUPs. The present study describes the case of a 64-year-old man affected by a CUP of presumed mammary origin. The aim of the article and the present review was to focus on their management. To the best of our knowledge, only thirteen cases have been reported in the literature. Because no specific guidelines are available, various approaches have been applied, influencing the treatment and the prognosis of patients with CUP.
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  • 文章类型: Case Reports
    乳腺癌是男性的一种罕见疾病,在有效管理方面存在许多障碍,例如有限的研究和治疗方式。虽然目前的护理标准采用乳房切除术和腋窝清扫联合化疗,临床医生必须遵循女性乳腺癌治疗方案,因为没有既定的男性治疗方案。在这种情况下,我们报告了一名43岁男性,既往有ER阳性浸润性导管癌(IDC)病史,并出现乳腺复发性病变.该患者先前曾接受左乳乳房切除术,前哨淋巴结活检,切缘阴性。初次解剖后,患者拒绝辅助化疗和他莫昔芬治疗。初次解剖三年后,患者出现乳腺病变和双侧腋窝淋巴结转移,肺,和脊柱。诊断得到右腋窝活检的支持,该活检显示ER阳性和PR阳性病变。我们希望阐明对男性原发性IDC进行全面彻底治疗的重要性,同时强调不完全治疗的含义。我们希望此临床病例将为医生在男性IDC原发肿瘤切除后促进辅助治疗提供指导。
    Breast cancer is a rare disease in men with many barriers to effective management such as limited research and treatment modalities. While the current standard of care utilizes mastectomy and axillary dissection with chemotherapy, clinicians must follow the female-staged breast cancer protocol, as there is no established regimen for men. In this case presentation, we report a 43-year-old male with a prior history of ER-positive invasive ductal carcinoma (IDC) who presented with a recurrent breast lesion. The patient had previously undergone left breast mastectomy with sentinel node biopsy with negative margins. The patient declined adjuvant chemotherapy and tamoxifen therapy after the initial dissection. Three years after the primary dissection, the patient presents with a breast lesion and metastasis to bilateral axillary lymph nodes, lungs, and spine. The diagnosis was supported by a right axillary biopsy which revealed an ER-positive and PR-positive lesion. We want to shed light on the importance of complete and thorough treatment of primary IDC in men while highlighting the implications of incomplete treatment. We hope that this clinical case will serve as a guide for physicians in promoting adjuvant treatments after primary tumor removal in male IDC.
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  • 文章类型: Review
    乳腺癌通常被视为一种发生在女性身上的疾病,但它也可以以很小的比例出现在男性中,低于1%。与女性相比,男性的乳房组织数量最少,有可能以类似于女性的方式变得恶性,虽然不太频繁。一名患者由于乳腺组织含量低而出现晚期局部侵袭,肿瘤迅速侵入邻近的结构。组织病理学和免疫组织化学检查在乳腺癌的病理学中具有极其重要的作用。鉴于男性乳腺癌是罕见的,并且在我国没有足够的外科医生专门从事乳腺手术,缺乏这种类型癌症的管理和早期诊断的经验,这将在本文中强调。
    Breast cancer is often seen as a disease that occurs in women, but it can also appear in men in a very small percentage, below 1%. Men have a minimal amount of breast tissue compared to women, which has the potential to become malignant in a similar way to women, although much less frequently. A patient presented with advanced local invasion due to the low amount of breast tissue, with the tumor quickly invading the adjacent structures. Histopathological and immunohistochemical examinations have an extremely important role in the pathology of breast cancer. Given that male breast cancer is rare and there are not enough surgeons specializing in breast surgery in our country, there is a lack of experience in the management and early diagnosis of this type of cancer, which will be highlighted in this article.
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    文章类型: Case Reports
    由于罕见,同步双侧男性乳腺癌(BC)的基因突变特征报道甚少。在这里,我们介绍了一名55岁的男性患者,他被诊断患有双侧乳腺癌(BBC),并携带不同的基因突变.同步双侧乳腺癌(SBBC)的诊断采用超声检查,磁共振成像(MRI),乳房X线照相术和芯针活检。随后,进行双侧改良根治术,组织病理学检查显示浸润性导管癌。为了进一步调查患者的遗传特征,对来自两个乳房的活检组织和血液样本进行靶向下一代测序(NGS).左乳腺(LB)样品的基因组图谱显示两个拷贝数变异(CNVs),MCL1和DAXX的扩增,右乳(RB)样本无明显突变。我们正在报告这个病例以及它的临床病理发现和基因调查,由于SBBS很少发生,尤其是男人。在这种情况下观察到的基因突变的异质性可能表明不同的发病机理和需要不同的治疗策略。
    Genetic mutational characterization of synchronous bilateral male breast cancer (BC) has been poorly reported due to its rarity. Herein, we present a 55-year-old male patient who was diagnosed with bilateral breast cancer (BBC) and harbored different gene mutations. The diagnosis of synchronous bilateral breast cancer (SBBC) was made using ultrasonography, magnetic resonance imaging (MRI), mammography and core-needle biopsy. Subsequently, bilateral modified radical mastectomies were performed, and histopathologic examination revealed invasive ductal carcinoma. To further investigate the genetic profile of the patient, the biopsy tissue from both breasts and a blood sample were subjected to targeted next generation sequencing (NGS). The genomic profile of the left breast (LB) sample revealed two copy number variations (CNVs), amplification of MCL1 and DAXX, while the right breast (RB) sample showed no obvious mutation. We are reporting this case along with its clinicopathologic findings and genetic investigations, since SBBS occurs extremely rarely, especially in men. The heterogeneity in gene mutations observed in this case may suggest a different pathogenesis and the need for different therapy strategies.
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  • 背景:男性乳腺癌(MBC)占全球诊断的所有乳腺癌的0.5%-1%。然而,其生物学特性可与女性乳腺癌(FBC)相鉴别。
    方法:由于缺乏男性乳腺癌相关研究,MBC的诊断和治疗方法主要与FBC相似。临床试验,和文学。已经进行了越来越多的回顾性和前瞻性研究,以阐明MBC的个性化护理。在这里,我们报告了三例晚期MBC来描述诊断方法,处理过程,和生存预后。
    结论:MBC患者年龄较大,在最初诊断的后期,激素受体的高表达,预后不良。进行了文献综述以确定发生率,危险因素,疾病特征,诊断,治疗,生存,和MBC的管理。
    Male breast cancer (MBC) accounts for 0.5%-1% of all breast cancers diagnosed worldwide. However, its biological characteristics can be distinguished from that of female breast cancer (FBC).
    The diagnostic and treatment approaches for MBC are mainly similar to that of FBC due to the lack of male breast cancer-related studies, clinical trials, and literature. An increasing number of retrospective and prospective studies have been conducted to clarify the individualized care for MBC. Herein, we report three cases of advanced MBC to describe the diagnostic approaches, treatment process, and survival prognosis.
    MBC patients had older age, later stage at first diagnosis, higher expression of hormone receptors, and poor prognosis. A literature review was conducted to determine the incidence, risk factors, disease features, diagnosis, treatment, survival, and management of MBC.
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  • 文章类型: Journal Article
    背景:BRCA1/2基因中的生殖系致病变异(PVs)与女性和男性的乳腺癌(BC)风险相关。多基因面板测试越来越多地用于BC风险评估,允许在BRCA1/2以外的基因中鉴定PVs。虽然其他癌症易感基因中可操作的PV的数据现在在女性BC中可用,男性BC(MBC)仍缺乏可靠数据。本研究旨在提供模式,MBC非BRCA1/2基因中与PVs相关的患病率和风险估计,以改善男性患者的BC预防.
    方法:我们在意大利人群中进行了一项大型病例对照研究,包括767个BRCA1/2阴性MBCs和1349个男性对照,所有使用自定义的50癌症基因组进行筛查。
    结果:与对照组相比,MBCs中BRCA1/2以外的基因中的PVs明显更频繁(4.8%vs1.8%,分别)并与MBC风险增加三倍相关(OR:3.48,95%CI:1.88-6.44;p<0.0001)。PV携带者更可能有个人(p=0.03)和家族(p=0.02)癌症病史,不限于BC。PALB2PV与MBC风险增加7倍相关(OR:7.28,95%CI:1.17-45.52;p=0.034),和ATMPVs的MBC风险增加五倍(OR:4.79,95%CI:1.12-20.56;p=0.035)。
    结论:本研究强调了PALB2和ATMPV在MBC易感性中的作用,并提供了人群水平的风险估计。这些数据可能有助于在MBC患者中实施多基因小组测试,并为患者及其家人提供针对性别的BC风险管理和决策。
    Germline pathogenic variants (PVs) in BRCA1/2 genes are associated with breast cancer (BC) risk in both women and men. Multigene panel testing is being increasingly used for BC risk assessment, allowing the identification of PVs in genes other than BRCA1/2. While data on actionable PVs in other cancer susceptibility genes are now available in female BC, reliable data are still lacking in male BC (MBC). This study aimed to provide the patterns, prevalence and risk estimates associated with PVs in non-BRCA1/2 genes for MBC in order to improve BC prevention for male patients.
    We performed a large case-control study in the Italian population, including 767 BRCA1/2-negative MBCs and 1349 male controls, all screened using a custom 50 cancer gene panel.
    PVs in genes other than BRCA1/2 were significantly more frequent in MBCs compared with controls (4.8% vs 1.8%, respectively) and associated with a threefold increased MBC risk (OR: 3.48, 95% CI: 1.88-6.44; p < 0.0001). PV carriers were more likely to have personal (p = 0.03) and family (p = 0.02) history of cancers, not limited to BC. PALB2 PVs were associated with a sevenfold increased MBC risk (OR: 7.28, 95% CI: 1.17-45.52; p = 0.034), and ATM PVs with a fivefold increased MBC risk (OR: 4.79, 95% CI: 1.12-20.56; p = 0.035).
    This study highlights the role of PALB2 and ATM PVs in MBC susceptibility and provides risk estimates at population level. These data may help in the implementation of multigene panel testing in MBC patients and inform gender-specific BC risk management and decision making for patients and their families.
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