Breast Cancer In Men Research Articles

Male breast cancer - a review on risk factors, tumor characteristics, diagnostics and treatment

Introduction and purpose:
 Male breast cancer (MBC) is estimated to less than 1% of all breast cancer cases worldwide. A lifetime risk of developing MBC amounts to 1:1000. The data on breast cancer in men is limited. This review aims to analyze information on risk factors, diagnostics and treatment in men suffering from breast cancer. 
 Material and method:
 This review was based on available data collected in PubMed and published in the years 2001-2022. The research was done by looking through keywords as follows: “breast cancer”, “male breast cancer”, “risk factors” and “treatment”.
 Results:
 Male breast cancer usually manifests as a painless, retroareolar mass in the breast. Risk factors include advanced age, hormonal imbalance, exposure to radiation and a positive family history. A significant risk increase in MBC development occurs in BRCA2, CHEK2, PALB2 and ATM genes mutations. G2 ductal carcinoma with no special type is most often diagnosed. Dominating subtype is luminal A cancer, while HER2 protein overexpression is extremely rare. Radical mastectomy or breast conserving therapy remain surgical therapeutic options. The most preferred endocrine therapy is tamoxifen. The choice of chemotherapy in men is based on the same criteria as in women. 
 Conclusions:
 Delayed diagnosis and tumor characteristics are associated with a much worse prognosis for men compared to women. Therefore, further clinical research is crucial in order to improve the diagnostic possibilities and treatment targeted at men with this type of cancer.

Breast Cancer in Men

Breast Cancer in Men

Second Cancer after Breast Cancer in Men

Abstract: Breast cancer is relatively rare in men; however, the overall prevalence of breast cancer in men is steadily increasing. Due to the increasing prevalence of the disease, the final consequences of these patients have become more important. One of the major adverse outcomes in surviving patients is secondary cancer following primary breast cancer. The aim of this study was to evaluate the second cancer in men who have survived primary breast cancer. The risk of developing primary second cancers is higher in men with primary breast cancer than in women. Few studies have evaluated the risk of secondary cancers, other than breast cancer, in men with breast cancer. Men who had a history of breast cancer are 10 to 20 times more likely to develop second breast cancer than women, which increases with aging. The association of prostate and breast cancer in the family has been suggested in specific populations, and some studies have shown an increase in prostate cancer in men surviving breast cancer. Lung cancer has also increased in men after breast cancer, but the risk is lower than in women, which is affected by age and gender survival. Melanoma is the second cancer in older survivor men of certain races after one year of follow-up. Gastric cancer after breast cancer showed an increasing prevalence in younger men and surviving more than ten years and familial accumulation of cancer. Pancreatic cancer also increased in men with a family history of breast cancer and mutated genes after primary breast cancer. The risk of second cancer in men with primary breast cancer, like the first cancer, is multifactorial, and genetic and environmental factors can influence its prevalence. Therefore, more extensive research is needed to better understanding of interrelationship of etiological factors and to provide screening and early detection strategies in affected men.

Breast Cancer In Men

Breast cancer in males is a relatively rare entity. In the sub-region, several reports indicate a higher incidence rate compared to other regions in the world. For many years, management strategies were derived from evidence based protocols established for managingfemale breast cancer. There are however, differences in the epidemiology, presentation, molecular profiles and response to therapies including chemotherapy, hormonal and targeted therapies. Outcomes even though mirroring female breast cancer may actually exhibit differences dependent on stage, race, prognostic and economic variables. The lack of large randomized trials on this subject has resulted in ad hoc management practices across the globe. With new information from renewed interest in the subject, screening and diagnostic guidelines are being established for high-risk groups and we expect to see improvements in outcomes for patientswith male breast cancer. This article attempts to bring to light a summary of the current interest, recommendations and controversies in the management of male breast cancer.

Infertility and risk of breast cancer in men: a national case–control study in England and Wales

PurposeBreast cancer is uncommon in men and its aetiology is largely unknown, reflecting the limited size of studies thus far conducted. In general, number of children fathered has been found a risk factor inconsistently, and infertility not. We therefore investigated in a case–control study, the relation of risk of breast cancer in men to infertility and number of children.Patients and methodsWe conducted a national case–control study in England and Wales, interviewing 1998 cases incident 2005–17 and 1597 male controls, which included questions on infertility and offspring.ResultsRisk of breast cancer was statistically significantly associated with male-origin infertility (OR = 2.03 (95% confidence interval (CI) 1.18–3.49)) but not if a couple’s infertility had been diagnosed as of origin from the female partner (OR = 0.86 (0.51–1.45)). Risk was statistically significantly raised for men who had not fathered any children (OR = 1.50 (95% CI 1.21–1.86)) compared with men who were fathers. These associations were statistically significantly present for invasive tumours but not statistically significant for in situ tumours.ConclusionOur data give strong evidence that risk of breast cancer is increased for men who are infertile. The reason is not clear and needs investigation.

Breast cancer in men. A case report

Malignant breast tumors in men are quite rare and require deeper investigation. Men are 100 times less likely to develop breast cancer than women. However, its incidence among men has grown over the last few years. In this article, we describe own observations of breast cancer in males and report a case of ст1сN0M0 stage 1A cancer of the left breast in a man and provide the details of clinical and morphological disease characteristics, tumor immunohistochemistry, and treatment outcome.

CLO22-055: Breast Cancer in Men: Experiences of Men With Breast Cancer in One of the Largest Hospital in Riyadh, KSA

CLO22-055: Breast Cancer in Men: Experiences of Men With Breast Cancer in One of the Largest Hospital in Riyadh, KSA

Breast Cancer in Men: Risk Factors, Treatment Options, Quality of Life: Systematic Review

Objective: The aim was to systematically examine the risk factors that have a role in the development and prognosis regarding the breast cancer among men and patients’ survival rate, and the studies performed to determine the treatment methods and patients’ quality of life. Methods: The databases of PubMed, Scopus, Cochrane Library, OVID-LWW, Medline Complete, Science Direct, Taylor&Francis, ULAKBIM, Ethos, OpenThesis, Open Dissertation, ProQuest Dissertations & Theses Global, and National Center of Theses were used to screen the literature. Case-control and cohort studies published between 2000 and 2020 were included. Following the screening activity, 14 studies were included in the systematic review. Results: This study involved seven cohort and seven case-control studies. Most of the patients were followed with invasive carcinoma diagnosis. These studies aimed to examine the genetic mutations and impacts of environmental, anthropometric and hormonal factors in regard to the risk factors. The factors such as the molecular classification of cancer, presence of genetic mutation, cancer stage and treatment methods affected the prognosis and survival rate. Mastectomy was used as the first treatment option, and this process had adverse impacts on patients’ quality of life physically, mentally and emotionally. Conclusion: This study indicated that many risk factors played a role in the development and prognosis of breast cancer among men and their survival rate, that mastectomy was the primary treatment option, and that patients’ quality of life was adversely affected during/following the disease.

Endocrine adherence in male versus female breast cancer: a seer-medicare review.

Breast cancer in men (BC-M) is almost exclusively hormone receptor positive. We conducted a large review of the SEER-Medicare linked database to compare endocrine therapy adherence, discontinuation, and survival outcomes of male versus female patients with breast cancer. Study data were obtained through the SEER-Medicare linked database. The study included patients age ≥ 65years-old diagnosed with breast cancer between 2007 and 2015. The primary endpoints were rates of adherence and discontinuation of endocrine therapy (ET). Adherence was defined as a gap of less than 90days in-between consecutive Medicare prescriptions. Discontinuation was defined as a gap of greater than 12months in-between Medicare prescriptions. Secondary endpoint was the association of use of ET with overall survival (OS). Of the 363 male patients on ET, 214 patients (59.0%) were adherent to the therapy, and 149 patients (41.0%) were nonadherent. Of the 20,722 females on ET, 10,752 (51.9%) were adherent to the therapy, and 9970 (48.1%) were nonadherent. 39 male patients (10.7%) discontinued therapy, while 324 (89.3%) did not discontinue therapy. 1849 female patients (8.9%) discontinued therapy, while 18,873 (91.1%) patients did not. Men were significantly more adherent than women (p = 0.008), but there was no significant difference in discontinuation among men and women (p = 0.228). Survival was significantly improved in both men (HR 0.77, 95% CI 0.60-0.99, p = 0.039) and women (HR 0.84, 95% CI 0.81-0.87, p < 0.001) on ET. Identification of contributing factors impacting adherence and discontinuation is needed to allow physicians to address barriers to long term use of ET.

Risk of breast cancer in men in relation to weight change: A national case-control study in England and Wales.

Breast cancer is uncommon in men and knowledge about its causation limited. Obesity is a risk factor but there has been no investigation of whether weight change is an independent risk factor, as it is in women. In a national case‐control study, 1998 men with breast cancer incident in England and Wales during 2005 to 2017 and 1597 male controls were interviewed about risk factors for breast cancer including anthropometric factors at several ages. Relative risks of breast cancer in relation to changes in body mass index (BMI) and waist/height ratios at these ages were obtained by logistic regression modelling. There were significant trends of increasing breast cancer risk with increase in BMI from age 20 to 40 (odds ratio [OR] 1.11 [95% confidence interval (CI) 1.05‐1.17] per 2 kg/m2 increase in BMI; P < .001), and from age 40 to 60 (OR 1.12 [1.04‐1.20]; P = .003), and with increase in self‐reported adiposity compared to peers at age 11 to BMI compared with peers at age 20 (OR 1.19 [1.09‐1.30]; P < .001). Increase in waist/height ratio from age 20 to 5 years before diagnosis was also highly significantly associated with risk (OR 1.13 [1.08‐1.19]; P < .001). The associations with increases in BMI and waist/height ratio were significant independently of each other and of BMI or waist/height ratio at the start of the period of change analysed, and effects were similar for invasive and in situ tumours separately. Increases in BMI and abdominal obesity are each risk factors for breast cancer in men, independently of obesity per se. These associations might relate to increasing oestrogen levels with weight gain, but this needs investigation.

Bilateral Breast Cancer in a 65-Year-Old Man

Globally, breast cancer in men is exceedingly uncommon. The misinterpretation of signs and symptoms and lack of a proper medical history can lead to the progression of rare conditions to advanced stages. We report the case of a 65-year-old man who presented to the clinic complaining about progressive bilateral dull breast pain. He had been diagnosed with bilateral grade II invasive ductal carcinoma three months prior, and he underwent bilateral mastectomy followed by chemotherapy as a part of his treatment plan.

RELEVANCE OF DIAGNOSTICS AND TREATMENT OF BREAST CANCER IN MEN

Breast cancer in men is a rare disease, accounting for approximately 0.1% of all malignant breast tumors in men and from 0.6% to 1% of all malignant breast tumors. The incidence of breast cancer in men increases with age for unknown reasons: the average age of men at the time of diagnosis is 67 years, compared with women, whose similar indicator is 57 years. Despite advances in the diagnostics and treatment of breast cancer in women, understanding and strategy for the treatment of breast cancer in men are limited and generally extrapolated from existing knowledge about breast cancer in women. In particular, the molecular subtypes of breast cancer in men have not been studied, although these subtypes have been associated with both biological and clinical features of breast cancer in women. It has been proven that molecular subtypes have an important prognostic value in breast cancer in women. Molecular assessment of tumors plays a significant role in the 22 prescriptions of adjuvant chemotherapy, and therefore the role of genetic testing increases.

Real-World Data of Palbociclib in Combination With Endocrine Therapy for the Treatment of Metastatic Breast Cancer in Men.

This report examined the benefits and risks of palbociclib plus endocrine therapy (ET) in men with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC). Palbociclib was evaluated using three independent data sources: real-world data from pharmacy and medical claims, a de-identified real-world data source derived from electronic health records (EHRs), and a global safety database. From medical and pharmacy records, 1,139 men with MBC were identified; in the first-line setting, median duration of treatment was longer with palbociclib plus ET (n=37, 8.5months, 95% confidence interval (CI), 4.4-13.0) than ET alone (n=214, 4.3months, 95% CI, 3.0-5.7) and specifically, was longer with palbociclib plus letrozole (n=26, 9.4months, 95% CI, 4.4-14.0) than letrozole alone (n=63, 3.0months, 95% CI, 1.8-4.8). In the EHR-derived database, 59 men received treatment for MBC; real-world response across all lines of therapy in the metastatic setting was reported in 4 of 12 patients (33.3%) in the palbociclib plus ET group vs. 1 of 8 (12.5%) patients in the ET group. Review of the global safety database did not identify any new safety signals in palbociclib-treated men. Real-world data indicated that men with MBC benefit from palbociclib plus ET, with a safety profile consistent with previous observations in women with MBC. Collective data on palbociclib in women and men in this report, including clinical trial data, real-world data, and a well-established risk/benefit profile, led to US approval of an expansion of the palbociclib indication to include men with MBC.

Analysis of Knowledge About Male Breast Cancer Among Higher Education Male Students.

Breast cancer is the most common cancer among women, both in Brazil and worldwide. Breast cancer can also affects men but this constitutes only 1% of cases and is thus considered rare, and for this reason is little studied. Statistics indicate an increase in its incidence with an estimate of new cases in recent years. This study aims to analyze the knowledge of higher education students in relation to breast cancer in men. the knowledge of higher education students in relation to breast cancer in men. Exploratory study with a quantitative approach. 299 male students participated in the study. Data collection took place through semi-structured questionnaires, completed by students from pure science, human sciences and health at a higher education institution. Regardless of the area of undergraduate study, 65.9% of the volunteers reported not knowing about breast cancer in men. Regarding predisposing factors for the development of breast cancer, 77.3% reported not knowing about these while 68.9% reported not knowing about breast self-examination. However, 67.6% believe that breast cancer in men can be prevented. Worryingly, 62.5% reported that they only seek medical assistance when becoming ill. Evidence from this study suggests that higher level undergraduates have limited knowledge about breast cancer in men. Only one third knew that male breast cancer was possible. Even smaller proportions knew of the predisposing factors for breast cancer, how to perform self-examination and about diagnosis. These latter factors, when combined with a tendency to seek medical help only when ill, suggests a short-fall in health knowledge which should be corrected.

Obesity and Breast Cancer Risk in Men: A National Case-Control Study in England and Wales.

BackgroundBreast cancer is rare in men, and information on its causes is very limited from studies that have generally been small. Adult obesity has been shown as a risk factor, but more detailed anthropometric relations have not been investigated.MethodsWe conducted an interview population-based case-control study of breast cancer in men in England and Wales including 1998 cases incident during 2005-2017 at ages younger than 80 years and 1597 male controls, with questions asked about a range of anthropometric variables at several ages. All tests of statistical significance were 2-sided.ResultsRisk of breast cancer statistically significantly increased with increasing body mass index (BMI) at ages 20 (odds ratio [OR] = 1.07, 95% confidence interval [CI] = 1.02 to 1.12 per 2-unit change in BMI), 40 (OR = 1.11, 95% CI = 1.07 to 1.16), and 60 (OR = 1.14, 95% CI = 1.09 to 1.19) years, but there was also an indication of raised risk for the lowest BMIs. Large waist circumference 5 years before interview was more strongly associated than was BMI with risk, and each showed independent associations. Associations were similar for invasive and in situ tumors separately and stronger for HER2-positive than HER2-negative tumors. Of the tumors, 99% were estrogen receptor positive.ConclusionsObesity at all adult ages, particularly recent abdominal obesity, is associated with raised risk of breast cancer in men, probably because of the conversion of testosterone to estrogen by aromatase in adipose tissue. The association is particularly strong for HER2-expressing tumors.

Paper mill-derived cancer research: the improbability of prostate cancer in women, and ovarian and breast cancer in men

There has been a recent burst of discovery of cancer-related papers apparent derived from paper mills. From dozens or more papers with multiple integrity concerns, three papers were selected to show what could be perceived as “unusual” findings, specifically the detection of prostate cancer in women, as well as ovarian and breast cancer in men. While the incidence of the former two is most likely impossible in biological females and males, respectively (i.e., absent transgender individuals), the last case is possible, but likely at a very low (~1%) incidence. However, all three papers, published in PubMed-indexed European Review for Medical and Pharmacological Sciences, display unusually high (> 50%) incidence rates of these cancers. Apart from the implausibility of these findings, one of the papers has already been retracted for integrity-related concerns, reducing the reliability of those findings. Paper mill-derived papers are a cancer in academic publishing, and absent industry knowledge of the sources of these paper mills, and their interaction with editors, journals and publishers, such instances will likely continue to increase. There should be serious civil and criminal penalties for such activities that purposefully defraud readers, other cancer researchers, and the public, by introducing information that could offer misleading clues about medical or health solutions to the dynamics and cure of cancer.

Differences in ultrasonographic features between males and females with breast cancer of the luminal A and luminal B molecular subtypes.

To analyze the relationships between the ultrasonographic features and the molecular subtypes of breast cancer in men and women. Data were collected from 43 males and 80 females with breast cancer who were treated at our hospital. The following ultrasonographic characteristics of the tumors were evaluated: shape, orientation, margin, echo pattern, posterior features, calcifications, Color Doppler Flow Imaging, and Breast Imaging Reporting and Data System (BI-RADS) category. On ultrasound, a nonparallel orientation, noncircumscribed margin, and attenuating posterior features were associated with luminal A lesions. A parallel orientation (P=0.002), circumscribed margin (P=0.04), no change in posterior features (P<0.001), and the BI-RADS 4 category (P=0.001) were significantly associated with luminal B lesions. In the group with luminal A lesions, male patients were older (P=0.001) and a greater number of the tumors exhibited a regular shape (P=0.009), circumscribed margin (P<0.001), no change in posterior features (P<0.001), and the BI-RADS 4 category (P<0.001) than those in female patients. Male patients were older (P<0.001) and a greater number showed a no change in posterior features (P<0.001), spotty blood flow (P=0.002), and the BI-RADS 4 category (P<0.001) than female patients with masses of the luminal B subtype. Obvious differences in the ultrasonographic and pathological features were noted between breast cancer in males and females, which provided the theoretical basis for the individualized treatment of breast cancer, particularly breast cancer in males.

Abstract 2561: Tumorigenic and metabolomic impacts of adipose-derived monocyte chemotactic protein-1 in a model of obesity-enhanced, male breast cancer

Abstract Breast cancer is a rare but aggressive disease in men. Approximately, 90% of all breast cancer in men are invasive carcinomas, 25% of which have distant metastasis at the time of clinical presentation. Obesity is a risk factor for breast cancer. Monocyte chemotactic protein-1 (MCP-1) is an adipose-derived cytokine whose concentrations are elevated by obesity. This study tested the hypothesis that adipose-derived MCP-1 contributes to male breast cancer. In a 2x2 design, male MMTV-PyMT mice with or without adipose specific Mcp-1 knockdown [designated as Mcp-1-/- or wild-type (WT)] were fed the standard AIN93G diet or an obesogenic, high-fat diet (HFD) for 25 weeks. The AIN93G diet and HFD contained 16% and 45% of energy from soybean oil, respectively. Mcp-1-/- mice had lower adipose Mcp-1 expression than WT mice. Adipose Mcp-1 deficiency reduced plasma concentrations of MCP-1 in mice fed the HFD. Mice fed the HFD had a greater tumor progression rate than mice fed the AIN93G diet (4679% vs 2430%), regardless of genotype. Mcp-1-/- mice, compared to WT mice, had a longer tumor latency (25.2 weeks vs 18.0 weeks) and lower tumor incidence (19% vs 56%), tumor progression rate (2317% vs 4792%), and tumor weights (0.23 g vs 0.64 g). Metabolomic analysis of plasma identified 87 metabolites, 56 of which differed among the four groups, including 24 that differed between the diets and 22 that differed between the genotypes. Sparse partial least squares-discriminant analysis identified 10 major metabolites that were altered the most among the four groups. These included amino acids (alanine, isoleucine, leucine, phenylalanine, threonine, and valine) and carbohydrate metabolites (fumaric acid, glucuronic acid, hexuronic acid, and malic acid). The integrated pathway analysis of the 87 identified metabolites showed that protein biosynthesis and carbohydrate metabolism pathways are the most disturbed in MMTV-PyMT mice. In conclusion, adipose-derived MCP-1 contributes to mammary tumorigenesis and alters metabolism in male MMTV-PyMT mice. Citation Format: Lin Yan, Sneha Sundaram, Bret M. Rust, Matthew J. Picklo, Michael R. Bukowski. Tumorigenic and metabolomic impacts of adipose-derived monocyte chemotactic protein-1 in a model of obesity-enhanced, male breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2561.

Educational interventions on breast cancer in men and women: a necessity in primary healthcare.

Breast cancer (BC) is one of the most common diseases in the global population. It most commonly presents in women; however, there has been an increase in the number of men diagnosed with the disease, although at a lower rate. Its specific characteristics and associated risk factors mean that preventative measures are considered to be one of the most important methods of avoiding BC. Therefore, education is a fundamental part of this process. The objective of this study is to report on the educational interventions on BC carried out in healthcare between 2016 and 2021. To this end, an integrative review was carried out using the following databases: PubMed (NCBI), Science Direct, Scopus, SciELO and Google Scholar, using the keywords ‘breast cancer’, ‘intervention education’, ‘prevention’ and the Boolean operator ‘AND’. Quantitative, full-text articles in English, Spanish or Portuguese were included. Finally, 19 articles were selected for analysis and it was found that, with regard to educational interventions on BC carried out in healthcare, one article included men and women and the remaining 18 included only women, with interventions carried out in sessions, workshops, in stages and using dynamic techniques. Therefore, there is a pressing need for educational interventions on BC for men and women at all stages of life; however, priority should be given to the young population in order to allow for early prevention. These interventions do not generate costs for the health sector, but they have a positive effect by increasing knowledge and promoting self-care.

Lupus mastitis in men

To analyze the pathophysiological aspects of lupus mastitis (LM), clinical presentation, epidemiology, radiological and histological findings, and treatment, to disseminate it to the academic community and draw attention to this pathology as one of the differential diagnoses in the management of breast lesions in males, especially in the case of breast cancer in men. A literature review was done by searching scientific studies in the PubMed / Medline, Scopus, Scielo, Embase, Web of Science, and Google Scholar databases. Relevant scientifically validated studies related to lupus mastitis in men were selected. The analysis, review and selection of articles carried out in pairs, blindly and separately, based on the reading of the title and abstract, with a third reviewer in case of disagreement. The LM should be suspect in patients known to have lupus erythematosus who present painful breast nodules associated with skin changes. However, LM can be the initial manifestation of lupus and mimic, both clinically and imaging, malignant neoplasms. The histopathological diagnostic criteria are well-established, finding mainly hyaline fat necrosis and lymphoplasmacytic infiltrate. Treatment must be drug-based as invasive procedures can exacerbate the injury. Due to physiological and anatomical aspects, this condition can appear and evolve differently in men. The knowledge of this pathology is necessary to carry out the correct approach since the non-identification of the disease and its erroneous management can lead to complications and irreversible sequelae to the patient.