Cases Of Male Breast Cancer Research Articles

Ecological correlation, a matter of confounding: The case of male breast cancer and prostate cancer

Ecological correlation, a matter of confounding: The case of male breast cancer and prostate cancer

Male breast cancer.

This study comprises 27 cases of male breast cancer treated at the University Hospital from 1966 through 1978. Its incidence was 0.53% of all cancer in males and 3.2% of all mammary cancers. Mean age was 52 years old. Lump in the breast was the commonest presenting feature in all patients followed by skin ulceration in 44.4% of cases. The average duration of symptoms was 16 months. Twenty-five patients had infiltrating duct carcinoma and two had papillary carcinoma. Two cases were in stage I, 10 in stage II, 11 in stage III, and 4 in stage IV. Of the 12 patients in stages I and II who underwent radical mastectomy, the axillary lymph nodes were pathologically negative in stage I and positive in stage II. The nodes were clinically involved in stages III and IV. Simple mastectomy followed by radiotherapy were used in stage III cancer and all patients in stage IV cancer had only biopsy and palliative chemotherapy. Bilateral orchidectomy followed by estrogen gave only marginal benefit in terms of survival and objective regression. Only four patients, two each in stages I and II, are alive and well for more than five years. These include two cases of papillary carcinoma. Poor prognosis in this series was exclusively determined by axillary lymph node involvement, although other factors such as shorter span of symptoms, younger age group, higher incidence of skin involvement, and invasive nature of carcinoma also appear to be significant.

The simultaneous occurrence of cytoplasmic receptors for various steroid hormones in male breast carcinoma and gynaecomastia.

Abstract Using a dextran-coated charcoal (DCC) technique, the cytoplasmic receptors for estradiol-17β, dihydrotestosterone-5α(DHT), progesterone and cortisol have been quantified in 14 cases of male gynaecomastia, and in two cases of male breast cancer. Estradiol-17β and progesterone receptors were found to be present in both cases of male breast cancer when the values of 3 fmol/mg protein and 0.03 fmol/μg DNA were chosen as the cutoff points between high and low binding capacity. In gynaecomastic tissue, the occurrence of steroid hormone receptors was the following: estradiol-17β 75%, DHT 73%, progesterone 14% and cortisol 100% of the cases tested. The pattern of estradiol-17β and progesterone receptors found in gynaecomastic specimens was similar to that observed in normal female breast and in fibroadenoma: however, the single and simultaneous occurrence of these receptors were lower in the male gynaecomastic group than in female cystic disease and breast cancer tissues.

Estrogen receptor concentrations in 269 cases of histologically classified human breast cancer.

This report provides a histological review of 264 female primary breast cancers analyzed for estrogen receptor protein (ER). We also describe 5 cases of male breast cancer all of which bound estradiol specifically. Generally the ER concentrations were lower in the tumors of premenopausal women than in those of postmenopausal women. Three types of cancer with specific morphological features were shown to have ER concentrations that differed significantly from the other types of cancer. Medullary and comedo carcinoma had very low and papillary carcinoma very high levels of ER. No obvious trend in ER concentration was found in unspecified ductal carcinoma, colloid carcinoma, nor in lobular carcinoma. A positive correlation was demonstrated between ER content and degree of differentiation in ductal carcinoma. Cancer with lymphoid infiltration generally showed low ER levels.

Male breast cancer: a natural history study.

Eighty-seven cases of male breast cancer seen over a 30-year period were reviewed. The overall observed and corrected five-year survival rates of 42% and 53% correspond well with the results in other series. Factors predicting disease-free interval and survival included size of primary lesion, ipsilateral axillary status, and presence of ulceration, which appear to be similar to those observed for female breast cancer. Eighteen patients (21%) had a second primary tumor (seven with cutaneous malignancies) and were of an older age group with a higher incidence of positive family history of breast cancer as well as other tumors. The overall prognosis of breast cancer in males does not appear to be less favorable than that in females.

Multiple steroid receptors in human breast cancer. II. Estrogen and progestin receptors in 672 primary tumors.

Estrogen (E) and progestin (P) receptors (R) were investigated in 672 human primary breast tumors (664 from women and 8 from men). Premenopausal patients have both a lower frequency of ER positive tumors (64%) and a lower ER content (80±63 fmol/mg protein) than postmenopausal women (74% and 249±351 fmol/mg protein). All eight cases of male breast cancer were ER-positive. PR was found in 45% of the tumors. In contrast to ER, the presence of PR and the absolute PR level are not related to patient age. Except for the month of March, the mean monthly ER values do not fluctuate in postmenopausal patients: A peak is observed in the ER content of breast cancer from patients who underwent surgery during the month of March. Absolute ER content appears to be statistically unrelated to the tumorous cellular density (TCD); expression of the results as femtomoles per milligram of protein gives an underestimate of the actual receptor concentration. TCD must thus be considered in interpretation of the ER content. The results are in agreement with the idea that the steroid receptors are a characteristic of a population of cancer cells within a breast tumor and that ovarian factors are implicated in the steroid receptor content.

Carcinoma of the male breast: Report of a series of 88 cases

A series of 88 cases of male breast cancer was compared with 241 cases of female breast cancer randomly selected from Departmental records. Cases of male breast cancer differed significantly from control female cases with regard to stage of the disease, age of onset and liability to the development of a second carcinoma. In 11 of the 88 cases (12.5%) of male breast cancer another primary malignant tumour developed. In seven instances the large bowel or rectum was the site of the other carcinoma. When correction was made for age and for the stage of the disease the prognosis of breast cancer in men and women was found to be similar. Only minor histological differences were found between male and female cases. Two of 54 cases examined for X-chromatin proved to be Barr-positive.

Breast cancer in brothers: case reports and a review of 30 cases of male breast cancer.

Two brothers with breast cancer are presented. One died 8 years after diagnosis and the other is presently living at 1 year with metastatic disease. The courses of 28 other previously unreported male patients with carcinoma of the breast are reviewed, and the possibility of male breast carcinoma being metastatic disease from the prostate is discussed. Useful etiologic information might be obtained from following the offspring of male breast cancer patients to see if they are at increased risk of developing the disease.

Male breast cancer.

42 cases of male breast cancer were studied. The disease is diagnosed in males at a later stage than in females. The prognosis of this disease in males is more favorable than in females: in stage I there is an 83% 5-year survival, while in stage II there is 62% 5-year survival. Male breast cancer shows a high hormone dependency: 80% of patients are improved following orchiectomy and 64% following stilbestrol therapy. Data is reported regarding age, family status, community origin, histology, treatment and survival.

MALE BREAST CANCER

Thirty male patients with breast carcinoma were examined for sex chromatin. One of them was found to be sex chromatin positive. Chromosome analysis of peripheral blood revealed the chromosomal constitution normally found in the Klinefelter syndrome. By pooling series of cases of male breast cancer, in which systematical screening for sex chromatin was made, it was found that 9 out of 242 patients were sex chromatin positive, which is a higher number than that found in the normal male population. Calculated on the basis of the incidence of breast cancer in women and men, and of the incidence of sex chromatin positive individuals in the normal male population, the incidence of breast cancer among patients with the Klinefelter syndrome was found to be about one fifth of the incidence of breast cancer in women and about twenty times the incidence of breast cancer in normal men. The breast carcinoma found in the sex chromatin positive patient in our material presented no special histological features. Testicular histology showed a pattern different from that normally found in the Klinefelter syndrome, since no totally hyalinized a‐cellular tubules, which are considered pathognomonic for the Klinefelter syndrome, could be demonstrated.

MALE BREAST CANCER

In order to elucidate the question of whether or not gynecomastia is a premalignant state, a Danish series comprising 265 cases of male breast cancer was reviewed with regard to a previous history of gynecomastia and the finding of clinical gynecomastia on admission. Furthermore, preparations from 187 cases of the same series were assessed with a view to the presence of histologically verified gynecomastia. In 10 patients there was a history of gynecomastia; only one patient presented clinical gynecomastia on admission. In 79 cases there was sufficient breast tissue for a histological study; this revealed gynecomastia in 21 cases, 6 of which were of florid type (type I) and 15 of quiescent fibrous type (type II). In 2 cases ducts with severe atypia of the epithelium were found, but in spite of investigations of serial sections no transition into invasive growth was revealed. It is concluded that the following features seem to support the theory that gynecomastia, may be a premalignant state: A, the finding of severe atypia of the epithelium in the ducts in concurrent gynecomastia and breast cancer; B. lower mean age in cases of breast cancer with concurrent gynecomastia; C. the higher ratio of male to female breast cancer and the low mean age of the male patients in an area with a high frequency of gynecomastia; D. heavily increased frequency of breast cancer in patients with the Klinefelter syndrome.

Male breast cancer in LAUTECH Teaching Hospital Osogbo, South Western Nigeria

To assess the prevalence, presentation, treatment and outcome of management of male breast cancer (MBC) in Osogbo, Nigeria. A review of all cases of MBC seen at LAUTECH Teaching Hospital Osogbo between January 2004 and December 2006 was done. The age, presenting symptoms and signs, stage, histology, associated co-morbid illnesses, treatment and outcome of care were all retrieved and analysed. Seven (8.86%) out of seventy nine cases of breast cancers seen are males. Ages ranged between 38 and 80 years (mean 60.5 median 65 years). They all presented with advanced lesions after a 6 -36 months delay (mean-11.57 months). All were invasive ductal carcinoma. All the four with significant co-morbid illnesses died of them within one week to seven months. Only one patient had mastectomy. MBC constitutes 8.86% of all breast cancer, all presented late with advanced lesions and co-morbid illnesses contributed significantly to mortality.

Serous and serosanguineous discharge from the male nipple.

A case of male breast cancer preceded by six years' intermittent bleeding from the nipple was described in 1830 by Mercier and Stanski.* As in the succeeding reports and case studies, nipple discharge in this case was clearly caused by a lesion contained within the breast and not by ulceration due to invasion of the skin by the cancer. Velpeau46(1854), in his book, Traite' des maladies du sein et de la region mammaire, discussed quite fully the significance of nipple discharge in women but failed to mention it in his chapters on breast lesions in men, remarking that his observations of male breast tumors for 30 years disclosed so little difference between them and lesions of the female breast that further discussion was superfluous. Axelrod,3writing exactly 100 years later, like Velpeau, recorded a great difference of opinion as to the importance of nipple discharge but concluded