MALE BREAST CANCER: A REPORT OF 34 CASES

Objective： To study the biological characteristics, the therapeutic procedure and the prognosis of male breast cancer. Methods： 34 patients with male breast cancer were retrospectively analyzed, who were diagnosed and treated in the First Hospital of Jilin University between 1980 and March 2005. Results： Clinical TNM stage of the patients were stage Ⅰ, 6 patients, stage Ⅱ, 24 patients and stage Ⅲ, 4 patients＇. Positive lymph nodes were found in 35.3% of the patients. All these patients received modified radical mastectomy. The 5-year survival rate was 65.3%. Postoperation recurrence rate was 11.8%. Conclusions： Patients with male breast cancer should receive surgical treatment, assisted with adjuvant treatment, such as radiotherapy, chemotherapy, endocrine therapy and so on. TNM stage and expression of hormone receptor may be the main factors affecting the prognosis.

HER2 Type Male Breast Cancer Successfully Treated with Pertuzumab, Trastuzumab, and Eribulin Therapy: A Case Report

Background:?Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases;hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-negative and human epithelial growth factor Receptor type 2-positive breast cancer is?extremely low among male breast cancer.?A patient with advanced HER2 type breast cancer, a rare male breast cancer, was successfully treated with pertuzumab, trastuzumab, and eribulin therapy. Case Presentation:?A 75-?year-old man presented to our hospital with induration of the right anterior chest and lymphoedema of the right upper limb. Based on the results of core needle biopsy, he was diagnosed with HER2 type invasive ductal carcinoma associated with bone metastasis (stage IV). Chemotherapy with pertuzumab, trastuzumab, and eribulin was started. The drugs were remarkably effective, and his lymphoedema tended to improve.?Conclusion:?We reported a successful case of chemotherapy and targeted therapy for a rare male breast cancer of HER2 positive and hormone negative type.

Male Breast Cancer Clinical Features, Risk Factors, and Current Diagnostic and Therapeutic Approaches

Objective: To review presentation, diagnosis, treatment and prognosis of male breast cancer. Method: A systematic review of the English language literature between 1990 and 2013 was conducted to identify studies relevant to the objective. Searches were carried out on the database PubMed, by using the title term “male breast cancer”. Results: The majority of male patients present with a painless, firm, subareolar lump. Experience of male breast imaging is good but limited. However, there is no definitive therapeutic algorithm. Men are often treated with mastectomy instead of breast conserving surgery and mostly tamoxifen is used as an adjuvant therapy. The most important prognostic factors are tumor size and lymph node status in the armpit. Conclusion: More increased awareness and further research are needed to improve the diagnosis and treatment of this disease.

Echo-Mammographic and Anatomo-Pathological Aspects of Male Breast Cancer in Togo

Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lomé. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.

Study of the Expression of ALDH1 and CD44 Stem Cell Markers in Male Breast Cancers

Aims: Male breast cancer represents - mor aggressiveness and drug resistance. CSCs are characterized by CD44 and/or ALDH1 expression. In this study, we investigated their expression in male breast cancer. Method: Two in situ ductal carcinoma (DCIS) and 18 invasive duc- tal carcinoma (IDC) male breast cancer cases were studied with Jefferson IRB approval. Membrane staining of CD44 was scored by the percentage of positivity. Cytoplasmic expression of ALDH1 was considered positive. Results: Ten cases had high CD44 expression, which were all IDC. Both DCIS and in situ component of IDC were CD44 low. ALDH1 was only positive in 15 IDCs. ALDH1+ cells were mostly in the invasive component. Both DCIS cases were negative for ALDH1. Among the 15 ALDH1+ IDCs, five with only invasive component had a higher percentage (aver- age 4.4%) of positive cells compared to the other eight with in situ components (average 2.0%). Metastatic cells in sen- tinel lymph nodes had a similar expression pattern of CD44 and ALDH1 as their primary tumor. Conclusion: CD44 and ALDH1 are expressed in male breast cancers and they are overexpressed in invasive cancer compared to carcinoma in situ. These findings suggest that CSCs play an important role in the progression to invasive carcinoma.

Male Breast Cancer: Diagnostic and Prognostic Features in Mali

Introduction: Male breast cancer is rare;representing 1% of breast cancers and less than 1% of all male neoplasia worldwide. We here analyzed the clinical, histological, therapeutic and prognostic characteristics of male breast cancer in Bamako, Mali. Patients and methods: A retrospective descriptive study was conducted on 14 male patients with breast cancer who visited two university hospitals in Bamako (Hospital Gabriel TOURE and Hospital du Point G) in Mali, from January 2005 to December 2018. Results: Male breast cancer represented 0.63% of all breast cancers and 0.23% of all male cancers. The following was observed: the mean age of 53 years (range: 23 - 82);a family history of cancer in 2;breast pain in 9;the average time to consultation of 8 years (6 - 24);gynecomastia found in 1;the tumor palpable in all 14 (size of 5 cm [3 - 10]);ulceration in 5. The most common histological type was non-specific infiltrating carcinoma with 92.8%. SBR II grade was found in 78.5% of cases. Of 8 patients with immunohistochemistry, hormone receptor positive was in 13 and Her2 positive was in 5. Metastases were found in 4, 2 pulmonary and 2 hepatic. Treatment: Neoadjuvant chemotherapy in 21.4%;radical surgery in 13 cases;surgery + radiotherapy in 2;surgery + hormonal therapy in 4. After an average follow-up of 36 months, 1 patient developed a lung metastasis and another patient had a lymph node recurrence. Conclusion: Male breast cancer was detected at relatively later stages. Physicians must be aware of this condition.

A meta-analysis based on case-control studies shows the similar prognosis between male and female patients with breast cancer

Objective： Male breast cancer （MBC） is a rare disease, and studies to compare the prognosis between the MBC and female breast cancer （FBC） available now were case-control studies and population-based studies, however, with controversial outcomes. To further investigate whether sex affects the prognosis of breast cancer, we performed a meta-analysis based on all the peered papers. Methods： The PubMed database was screened. Subsequently, the hazard ratios （HRs） for overall survival （OS） and disease special survival （DSS）, were pooled using the Review Manager 5.0 package. Results： This study comprised of 254 MBC and 733 FBC patients enrolled in six case-control studies. There was no statistically significant heterogeneity among the trials for either outcome variable. The pooled HR showed that there was no significant difference in 5-year or 10-year DSS （HR： 1.25, 95% CI： 0.76-2.08; HR： 1.04, 95% CI： 0.68-1.5g） and 5-year or 10-year OS （HR： 0.76, 95% CI： 0.51-1.14; HR： 0.74, 95% CI： 0.54-1.02） between MBCs and FBCs. Conclusion： MBC and FBC with similar prognosis are found in this meta-analysis based on only case-control studies which matched main potential prognostic factors such as age, clinical stage, and time at diagnosis.

Chinese female breast cancer patients show a better overall survival than their male counterparts

Backgroud It is not clear if there is a difference in prognosis between male breast cancer （MBC） and female breast cancer （FBC） patients. The aim of this study was to compare the prognosis of MBC and FBC patients in China and the prognosis of MBC and their corresponding postmenopausal FBC patients.Methods Thirty-five MBC patients who were treated at the Sun Yat-sen University Cancer Center between 1969 and 2004 were enrolled in the study. Seventy FBC patients who were matched with the MBC patients for TNM stage, year of diagnosis, and age at diagnosis were simultaneously enrolled in the study. A second group comprising 18 MBC patients and their corresponding 36 matched postmenopausal FBC patients were also enrolled. The whole group and the postmenopausal groups were compared for five- and ten-year survivals. Results All the factors that could potentially affect prognosis were comparable among the groups except more FBC than MBC patients underwent endocrine therapy and a modified radical mastectomy. The 5- and 10-year survivals in the whole group were 81.6% and 60.3% for men and 90.7% and 73.5% for women （P=0.02）. The 5- and 10-year survival in the postmenopausal group was 82.5% and 100% for men and 66.0% and 85.9% for women （P=0.159）.Conclusions Chinese FBC patients had a better prognosis than Chinese MBC patients. However, MBC patients and their corresponding postmenopausal FBC patients had a similar prognosis.

Characteristics of Chinese male patients with breast cancer:summary of the published papers

Objective:The extremely low incidence of male breast cancer (MBC) leads to lack of prospective randomized phase III studies worldwide. Especially in China,all studies on Chinese patients with MBC were based on small sample size and single institute experience. The aim of this study was to provide overall view of characteristics of Chinese patients with MBC by means of summarizing all related papers published in Chinese journals. Methods: An online search was made in CBM,VIP,CNKI,and CBA databases to find all published articles of interest on Chinese patients with MBC. And eight subjects including the proportion of MBC in all breast cancer,age,tumor location,clinical stages,pathological subtypes,treatment modalities,ER/PR expression,and 5-year survival rate were selected to calculate the proportion and their 95% interval confidence. Results: There were 122 papers with 2584 patients enrolled. The basic features of Chinese patients with MBC included:(1) MBC only with a proportion of 1.06% of all the breast cancer; (2) The mean age at diagnosis was 57.6 years old; (3) Tumor mainly located in the areolar region (74.83%) with obvious nipple and/or skin involvement; (4) Nearly 62.62% patients were in early stage before accepting treatment; (5) Infiltrating ductal carcinoma accounted for 79.05% of all pathological subtypes; (6) ER/PR expression rate was 65.86%; (7) Radical resection was up to 86.06% in all surgical modalities; (8) The 5-year survival rate was 57.33%. Conclusion: The results showed in this study were an overall view of Chinese patients with MBC whose characteristics were similar to that reported in the West. Though this study provided a little bit stronger confidence than a single study collected in this paper,studies with more powerful evidence are urgently demanding in China.

Breast Cancer in Males (BCM), Does It Really Differ? National Cancer Institute Experience (NCI), Cairo University, Egypt

Background: Carcinoma of the male breast is relatively a rare disease accounting for about 1% of all cancer in men. Its treatments are based mainly on those of Female Breast Cancer (BCF). Materials and Methods: This is a single institution retrospective study including all presenting to the NCI, Cairo University with Breast Cancer in a Male (BCM) in the last 11 years between Jan. 2005 until Jan. 2016. Data were collected from patient’s files from the statistical department then analyzed. Aims: To study the clinico-pathological characteristics, the presentation, workup, surgical approaches and postoperative complications and outcome of management, with addressing similarities and difference from BCF. Results: 64 patients were included in this cohort. The mean age was 58.6 & the median age was 59 years (range: 31 - 87 years). The main presenting symptomatology was retroareolar breast lump (50 cases, 78.1%). Most of our cases were advanced;22 cases (34.3%) were stage III & 16 cases (25%) were stage IV. Surgery was performed for 50 patients;MRM for 26 cases (40.6%), RM for 18 cases (28.1%) & toilet mastectomy for 6 cases (9.3%). Primary closure was feasible in 34 patients (68%) while 16 cases (32%) required reconstruction by local or pedicled flaps. Tamoxifen is the most important non-surgical treatment. It was given to all our cases (64 cases, 100%) either postoperatively as adjuvant management (36 cases, 56.2%) or as palliation for metastatic disease (28 cases, 43.8%). Chemotherapy was given to 32 patients (100%) as an adjuvant for 24 cases (75%) and as a palliation for 8 cases (25%). Radiotherapy was given to 26 patients (100%) as adjuvant therapy for 20 cases (76.9%) and as a palliation for 6 cases (23.1%). The only significant factor determining the overall 5 years survival was the stage of the disease. LN status & surgery type were of border line significance (better survival with negative LN & with MRM). The 5-year Overall Survival (OS) & Disease Free Survival (DFS) for the whole group were 66% & 52% respectively. Within the DFS there was no significant variable;however, the stage and type of surgery were of borderline significance, with better survival with early stage disease (I & II) and with MRM (both were 61%). Conclusion: BCM has many similarities to BCF, but it harbours many different genetic and pathologic features. They obtain similar prognostic factors and similar stage-for-stage survival. They are always advanced to T4 stage rapidly due to the lack of breast parenchyma with higher ER expression in BCM than BCF patients.

Male papillary breast cancer treated by wide resection and latissimus dorsi flap reconstruction: A case report and review of the literature

Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors(both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical(non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; p T3(10 cm), p N0(0/15), M0,R0; Oncotype DX Recurrence Score indicated low risk(RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.

Males at High Risk for Breast Cancer: Who Are They and How Should We Screen Them?

Background: It is estimated that 2240 males in the United States will develop invasive breast cancer (BC) in 2013, resulting in 410 deaths. Overall, male breast cancers (MBCs) are diagnosed with larger tumor size, more frequent lymphatic invasion, and advanced tumor stage compared to their female counterparts. Several risk factors have been elucidated for the development of MBC, and this paper aims to critically review the existing literature on at-risk populations and provide screening recommendations. Methods: A comprehensive search for all published studies on populations at risk for MBC using PubMed, EBSCOhost, and Google Scholar was performed (1982- 2013). The search focused specifically on genetic and epidemiologic risk factors, and screening for MBC. Keywords searched included “male breast cancer risk factors”, “male breast cancer epidemiology”, and “male breast cancer genetics”. A total of 34 studies involving 4,865,819 patients were identified. Results: Five studies (N = 327,667) focused primarily on family history of breast cancer as a risk factor for MBC. 15% - 20% of men with BC have a family history of breast or ovarian cancer, and a family history of BC among first-degree relatives confers a 2-to 3-fold increase in MBC risk (odds ratio = 3.3). Seventeen studies (N = 5451) analyzed associations between several heritable genes and MBC. Lifetime MBC risk among BRCA1 mutation carriers is 1% - 5%, while MBC risk in BRCA2 mutation carriers is higher and varies between 4% - 40%. Less clear associations between MBC and PALB2, Androgen Receptor gene, CYP17, and CHEK2 mutations have also been documented. Five studies (N = 16,667) have addressed occupational risk factors for MBC. An 8-fold increase in MBC is reported in males working in the cosmetic cream manufacturing, and the motor vehicle industries. A meta-analysis of 18 trials also identified electromagnetic field exposure as a potential MBC risk, though causation remains undocumented. Eleven studies (N = 4,843,598) analyzed the role of abnormalities in the androgen-to-estrogen ratio as a risk factor for MBC. Conditions associated with increased MBC risk include Klinefelter’s syndrome (relative risk, RR = 29.64), obesity (RR = 1.98), orchitis/epididymitis (RR = 1.84), and gynecomastia (RR = 5.86). Conclusion: Routine screening for MBC should be considered in all high risk male populations, including those with a prior history of breast carcinoma, a strong family history of BC (defined as an affected mother or sister), a positive BRCA2 mutation status (regardless of family history), and men diagnosed with Klinefelter’s syndrome, or those in the chemical or motor vehicle industries. Genetic testing for BRCA2 should be recommended for all MBC patients. Increased public and physician education on MBC is necessary to raise awareness about this rare disease and the need for screening of at-risk populations.

Male Breast Nodules in Ouagadougou (Burkina Faso): Radiological and Histopathological Aspects

Objective: To describe the radiological and histological aspects of breast nodules among men in our practice setting. Methodology: This is a descriptive and retrospective study conducted from January 2014 to October 2017. The study included male patients with breast nodules classified ACR3, 4 or 5 after a mammographic and ultrasound scan. These lesions were explored through an ultrasound-guided breast microbiopsy. The following are the variables collected: age, family history of breast cancer, medical history, ACR classification, nodule size, and anatomopathologic diagnosis. Results: 13 breast nodules were explored among 13 male subjects. Mammography and breast ultrasound enabled to identify one ACR3 lesion, 10 ACR4 lesions and 2 ACR5 lesions. The average age was 56.53 ± 14.63 years and the average size of the nodules 28.91 ± 13.62 mm. As for histology, there were seven malignant tumors and six benign tumors. The average age of patients with malignancy was 61.45 ± 13.62 years. The malignant nodules average size was 29.45 ± 12.54 mm. Malignant tumors exclusively consisted of invasive breast carcinomas while Benign ones consisted of dystrophic and inflammatory lesions. Conclusion: Most often Breast lesions among men had an indeterminate appearance on imaging and were predominantly malignant in histopathology.

男性乳腺癌转移模式的研究及远处转移预测模型的构建和验证

目的探究男性乳腺癌(MBC)的远处转移模式,分析MBC发生远处转移的危险因素,进一步构建并验证MBC发生远处转移的预测模型。方法回顾性分析美国监测、流行病学和结果(SEER)数据库中2010—2020年MBC患者的临床病理学数据,按照7∶3随机分为训练集和测试集,选取2010—2020年就诊于哈尔滨医科大学附属肿瘤医院的MBC患者125例作为外部验证集。训练集采用单因素和多因素分析筛选出MBC远处转移的独立影响因素,进一步构建Logistic回归预测模型,通过绘制受试者工作特征曲线(ROC)、校准曲线以及临床决策曲线(DCA)对模型进行评价。开发基于Web的网页计算器使该模型在线使用。结果在SEER数据库中的3592例MBC患者,有354例患者在初始诊断时即发生了远处转移,占病例数的9.86%,其中骨是最常见的转移部位(3.81%)。多因素Logistic回归分析结果显示:婚姻状态、诊断到治疗的时间、病理学类型、T分期、N分期和分子分型是MBC发生远处转移的独立危险因素。基于这些独立影响因素构建Logistic回归预测模型并进行验证:训练集的曲线下面积(AUC)为0.838,测试集AUC值为0.836,外部验证集AUC值为0.717,模型具有很好的预测能力;校准曲线显示预测模型对MBC患者发生远处转移的预测结果与实际结果之间具有较高的一致性;DCA曲线显示该模型可以使患者有更高的临床获益。结论男性乳腺癌远处转移模式的预测模型对患者发生远处转移具有较好的预测性能,有助于临床医师对于高危患者的早期识别并为患者制定个体化的治疗方案。

基于SEER数据库构建和验证男性乳腺癌预后模型

目的探究男性乳腺癌(male breast cancer,MBC)患者的预后因素,构建MBC患者生存预后列线图并预测3年和5年生存率。方法纳入监测、流行病学和最终结果(Surveillance,Epidemiology,and End Results,SEER)癌症登记数据库的MBC患者,同时纳入川北医学院附属医院、遂宁市中心医院和德阳市人民医院的MBC患者,获取患者完整的临床基线资料及生存信息。以SEER数据库中患者数据作为训练集,3家医院中的患者数据作为验证集,通过单因素和多因素Cox回归分析确定与总生存期(overall survival,OS)相关的独立预后因素,并构建预测MBC患者3年及5年生存率的列线图,运用校准曲线、一致性指数(CI)、受试者工作特征曲线(ROC)和决策分析曲线来评估模型的准确程度和实际应用价值。结果共纳入3387名MBC患者,其中训练集3307例,验证集80例。通过对训练集进行单因素和多因素Cox回归分析后发现,诊断年龄、组织学分级、T分期、N分期、M分期、孕激素受体状态、手术、化疗和放疗是影响MBC患者OS的独立预后因素。将这些因素纳入并构建列线图模型并进行验证,训练集CI为0.711,验证集CI为0.787。训练集中,3年OS的AUC为0.744,5年OS的AUC为0.720;验证集中,3年OS的AUC为0.835,5年OS的AUC为0.858。ROC曲线表明模型区分能力较好,校准曲线显示模型预测性能良好,决策分析曲线表明模型的临床应用价值较高。结论开发的列线图为预测MBC患者的预后提供了一种可靠且实用的方法,有助于个性化治疗决策,改善患者的治疗效果。

超声BI-RADS对男性乳腺癌的诊断效能及不同临床经验超声医师的诊断一致性分析

目的:评估超声乳腺影像报告和数据系统(BI-RADS)对男性乳腺癌(MBC)的诊断效能及不同临床经验超声医师的诊断一致性分析。方法:回顾分析2017年1月—2023年7月在浙江大学医学院附属第二医院接受手术的90例接受手术的男性乳腺疾病患者资料,患者均进行BI-RADS评估,并由6名超声科医师进行诊断,根据资历将6名医师分为三组。比较受试者工作特征(ROC)曲线下面积(AUC)、灵敏度、特异度、准确率、阳性预测值(PPV)和阴性预测值(NPV),并评估不同组别观察者间一致性。结果:第3组的AUC、灵敏度、准确率及PPV最高,分别为0.904、97.2%、62.9%、76.7%;第2组特异度及NPV最高,分别为75.9%、100.0%。组内相关系数在BIRADS 2类和BI-RADS 3类表现为优秀到良好水平,在4a类结节表达为较差水平,在4b、4c和5类均表现为一般水平。三组间仅第1组和第3组诊断效果差异有统计学意义(P<0.05)。结论:超声BI-RADS对MBC具有较高应用价值,超声医师的临床经验与BI-RADS的诊断效能显著相关。

男性乳腺癌内分泌治疗研究进展

内分泌治疗是乳腺癌的重要治疗方式,对于大部分为激素受体阳性的男性乳腺癌(MBC)来说更是重要。随着科技的发展,技术的进步,对于男性乳腺癌内分泌治疗的研究,虽然在不断深入,但大部分治疗方式仍是参照女性。目前他莫昔芬仍是男性乳腺癌内分泌治疗的首选,芳香化酶抑制剂(AIs)联合促性腺激素释放激素、ER下调剂氟维司群,以及周期蛋白依赖性激酶(CDK)4/6抑制剂等靶向药物也慢慢投入临床应用。但对于男性乳腺癌内分泌治疗的研究仍需针对性、多方面的进行,以期改善患者生存及预后。

78例男性乳腺癌患者的临床病理特征和预后分析

目的探讨男性乳腺癌的临床病理特点及治疗方法,分析影响预后的因素。方法本研究纳入78例男性乳腺癌患者。观察并分析患者的临床病理特点及治疗方法,并对所有患者进行长时间随访。采用单因素分析影响患者生存的因素。结果患者平均年龄为60.5岁,激素受体阳性率高达91%,HER-2阳性率仅为12.8%,Ki-67低表达患者比例为74.5%。所有患者总的5年生存率为80.8%。T1、T2期患者的生存预后优于T3、T4期患者(P=0.023)。有淋巴结转移的患者总生存期较无淋巴结转移的患者低(P=0.027);Ⅰ、Ⅱ期患者总生存期较Ⅲ、Ⅳ期患者好(P<0.001)。结论男性乳腺癌患者相对年龄较大,激素受体阳性率较高,HER-2、Ki-67表达较低。肿瘤大小、淋巴结状态和TNM分期是影响总生存的重要因素。

《中国男性乳腺癌临床诊治实践指南(2023 版)》 诊疗解读

男性乳腺癌发病罕见,预后较差,以往只能参考女性乳腺癌相关指南进行诊疗。中华医学会外科学分会乳腺外科学组共同制定的《中国男性乳腺癌临床诊治实践指南(2023版)》于2023年2月4日首次发布,该指南结合中国国情对男性乳腺癌管理的各个环节进行了详细阐述并作出相应推荐,是国内首部男性乳腺癌诊疗指南。本文通过查阅相关文献,对该指南中男性乳腺癌的诊疗内容进行详细解读。

男性隐匿性乳腺癌甲状腺转移1例并文献复习

目的男性隐匿性乳腺癌(male occult breast cancer,MOBC)在临床上罕见,发病率远低于女性乳腺癌,占全部乳腺癌患者的0.5%~1%。对本病认识不足常导致延误诊治,因此需重视MOBC的临床病理特征、治疗策略及生存情况。方法本文报道2022年7月菏泽市牡丹人民医院收治的1例57岁MOBC。回顾性分析该患者的诊断及治疗过程和生存情况,并复习相关文献,供临床医师参考。结果患者57岁,临床上表现为右颈部肿块,行双侧甲状腺肿瘤切除术,术后病理为乳腺浸润性癌(TxN3M1Ⅳ期,HR阴性HER-2阳性),术后进展制订方案“曲妥珠单抗+帕妥珠单抗+紫杉醇脂质体”6周期,HP维持,4周期评估大PR。结论MBC病因尚未明确,迄今尚无标准的筛查指南。MBC与乳腺癌家族史、BRCA2基因突变及体内雌激素失衡等因素密切相关,检查方法首选超声检查及钼靶检查,对高度可疑癌变的肿瘤应尽早行穿刺活检明确诊断,病理类型多为浸润性导管癌。早发现治疗预后较好,对于MBC治疗依据女性乳癌治疗方案,以手术、放化疗、靶向、内分泌等多种手段在治疗中综合应用。