MALE BREAST CANCER: A RETROSPECTIVE ANALYSIS OF SINGLE CENTER RESULTS
Yıl 2023,
Cilt: 56 Sayı: 2, 103 - 108, 30.09.2023
Hakan Baysal
,
Ayşegül Ergün
,
Begümhan Baysal
,
Zeynep Çağla Tarcan
,
Mehmet Sait Özsoy
,
Fatih Büyüker
,
Orhan Alimoğlu
Öz
AIM
Male breast cancers (MBC), constituting less than 1% of all breast carcinomas, are relatively rare. The average age of diagnosis is between 60-70 years and can affect males of all ages. In this study our aim was to present the clinicopathological characteristics, treatment, and survival outcomes of patients who were treated and followed up for ten years in out clinic, in accordance with literature.
MATERIAL AND METHOD
Records of MBC patients who were followed and treated at our clinic between January 2014 and January 2023 were examined retrospectively using the hospital database. Clinicopathological characteristics, treatments performed, overall and disease-free survival rates were analyzed.
RESULTS
A total of 19 patients were included in the study (mean age: 75.9±11.5, range: 57-96). Four patients with distant metastasis and other system malignancies at the time of diagnosis were excluded. The mean follow-up period was 43.8 months. The most common location of the tumor was to be the retroareolar region (63.2%). BRCA2 gene mutation analysis was positive in three patients. Eleven patients (57.9%) were at Stage 3. Eleven patients had invasive ductal carcinoma. Twelve patients belong to the luminal B subtype. Among the 13 patients who underwent axillary dissection 9 (69.2%) had lymph node involvement. Patients who developed distant metastasis had higher overall mortality and cancer-specific mortality. The body mass index (BMI) of deceased patients was lower than that of surviving patients during the follow-up period. Age group above 75 years had lower overall survival (log-rank p=0.0064) and cancer-specific survival (log-rank p=0.011).
CONCLUSION
In our study, we found that distant metastasis significantly affected the survival. Although male breast cancers are rare, early diagnosis, as in women, positively influences overall and disease-free survival.
Kaynakça
- 1. Zheng G, Leone JP. Male Breast Cancer: An Updated Review of Epidemiology, Clinicopathology, and Treatment. J Oncol. 2022;2022:1734049. doi:10.1155/2022/1734049
- 2. Garreffa E, Arora D. Breast cancer in the elderly, in men and during pregnancy. Surgery. 2022;40:139–46.
- 3. Brinton LA, Carreon JD, Gierach GL, McGlynn KA, Gridley G. Etiologic factors for male breast cancer in the U.S. Veterans Affairs medical care system database. Breast Cancer Res Treat. 2010;119(1):185-192. doi:10.1007/s10549-009-0379-0
- 4. Giordano SH. Breast Cancer in Men. N Engl J Med. 2018;378(24):2311-2320. doi:10.1056/NEJMra1707939
- 5. Agrawal A, Ayantunde AA, Rampaul R, Robertson JF. Male breast cancer: a review of clinical management. Breast Cancer Res Treat. 2007;103(1):11-21. doi:10.1007/s10549-006-9356-z
- 6. Dyussenbayev, A. Age Periods Of Human Life. Advances in Social Sciences Research Journal, 2017; 4(6): 258-63. DoI:10.14738/assrj.46.2924.
- 7. Ferzoco RM, Ruddy KJ. The Epidemiology of Male Breast Cancer. Curr Oncol Rep. 2016;18(1):1. doi:10.1007/s11912-015-0487-4
- 8. Ding YC, Steele L, Kuan CJ, Greilac S, Neuhausen SL. Mutations in BRCA2 and PALB2 in male breast cancer cases from the United States. Breast Cancer Res Treat. 2011;126(3):771-778. doi:10.1007/s10549-010-1195-2
- 9. Brinton LA, Richesson DA, Gierach GL, Lacey JV Jr, Park Y, Hollenbeck AR, et al. Prospective evaluation of risk factors for male breast cancer. J Natl Cancer Inst. 2008;100(20):1477-1481. doi:10.1093/jnci/djn329
- 10. Johansen Taber KA, Morisy LR, Osbahr AJ 3rd, Dickinson BD. Male breast cancer: risk factors, diagnosis, and management (Review). Oncol Rep. 2010;24(5):1115-1120. doi:10.3892/or_00000962
- 11. Expert Panel on Breast Imaging:; Niell BL, Lourenco AP, Moy L, Baron P, Didwania AD, et al. ACR Appropriateness Criteria® Evaluation of the Symptomatic Male Breast. J Am Coll Radiol. 2018;15(11S):S313-S320. doi:10.1016/j.jacr.2018.09.017
- 12. Ionescu S, Nicolescu AC, Marincas M, Madge OL, Simion L. An Update on the General Features of Breast Cancer in Male Patients-A Literature Review. Diagnostics (Basel). 2022;12(7):1554. doi:10.3390/diagnostics12071554
- 13. Korde LA, Zujewski JA, Kamin L, Giordano S, Domchek S, Anderson WF, et al. Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol. 2010;20;28(12):2114-22. doi:10.1200/JCO.2009.25.5729
- 14. Doebar SC, Slaets L, Cardoso F, Giordano SH, Bartlett JM, Tryfonidis K, et al. Male breast cancer precursor lesions: analysis of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Mod Pathol. 2017;30(4):509-18. doi:10.1038/modpathol.2016.229
- 15. Cutuli B. Strategies in treating male breast cancer. Expert Opin Pharmacother. 2007;8(2):193-202. doi:10.1517/14656566.8.2.193
- 16. Sarmiento S, McColl M, Musavi L, Gani F, Canner JK, Jacobs L, et al. Male breast cancer: a closer look at patient and tumor characteristics and factors that affect survival using the National Cancer Database. Breast Cancer Res Treat. 2020;180(2):471-79. doi:10.1007/s10549-020-05556-y
- 17. Pensabene M, Von Arx C, De Laurentiis M. Male Breast Cancer: From Molecular Genetics to Clinical Management. Cancers (Basel). 2022;14(8):2006. doi:10.3390/cancers14082006
- 18. Sauder CAM, Bateni SB, Davidson AJ, Nishijima DK. Breast Conserving Surgery Compared With Mastectomy in Male Breast Cancer: A Brief Systematic Review. Clin Breast Cancer. 2020;20(3):e309-14. doi:10.1016/j.clbc.2019.12.004
- 19. De La Cruz LM, Thiruchelvam PTR, Shivani J, Trina J, Blankenship SA, Fisher CS. Saving the Male Breast: A Systematic Literature Review of Breast-Conservation Surgery for Male Breast Cancer. Ann Surg Oncol. 2019;26(12):3939-44. doi:10.1245/s10434-019-07588-1
- 20. Flynn LW, Park J, Patil SM, Cody HS 3rd, Port ER. Sentinel lymph node biopsy is successful and accurate in male breast carcinoma. J Am Coll Surg. 2008;206(4):616-21. doi:10.1016/j.jamcollsurg.2007.11.005
- 21. Grenader T, Goldberg A, Shavit L. Second cancers in patients with male breast cancer: a literature review. J Cancer Surviv. 2008;2(2):73-8. doi:10.1007/s11764-008-0042-5
- 22. Yadav S, Karam D, Bin Riaz I, Xie H, Durani U, Duma N, et al. Male breast cancer in the United States: Treatment patterns and prognostic factors in the 21st century. Cancer. 2020;1;126(1):26-36. doi:10.1002/cncr.32472
- 23. Strnad V, Ott OJ, Hildebrandt G, Kauer-Dorner D, Knauerhase H, Major T, et al. 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet (London, England). 2016;387:229–38. doi:10.1016/S0140-6736(15)00471-7
- 24. Wang F, Shu X, Meszoely I, Pal T, Mayer IA, Yu Z, et al. Overall Mortality After Diagnosis of Breast Cancer in Men vs Women. JAMA Oncol. 2019;1;5(11):1589-96. doi:10.1001/jamaoncol.2019.2803
- 25. Miao H, Verkooijen HM, Chia KS, Bouchardy C, Pukkala E, Larønningen S, et al. Incidence and outcome of male breast cancer: an international population-based study. J Clin Oncol. 2011;20;29(33):4381-6. doi:10.1200/JCO.2011.36.8902
- 26. Adams SJ, Kanthan R. Paget's disease of the male breast in the 21st century: A systematic review. Breast. 2016;29:14-23. doi:10.1016/j.breast.2016.06.015
ERKEK MEME KANSERLERİ: TEK MERKEZLİ SONUÇLARIN RETROSPEKTİF ANALİZİ
Yıl 2023,
Cilt: 56 Sayı: 2, 103 - 108, 30.09.2023
Hakan Baysal
,
Ayşegül Ergün
,
Begümhan Baysal
,
Zeynep Çağla Tarcan
,
Mehmet Sait Özsoy
,
Fatih Büyüker
,
Orhan Alimoğlu
Öz
GİRİŞ
Tüm meme karsinomlarının %1’den azını oluşturan erkek meme kanserleri (EMK) oldukça nadirdir. Ortalama tanı 60-70 yaş arasında olup, her yaştan erkek hastalıktan etkilenebilir. Bu çalışmada on yıl boyunca tedavi ve takip edilen hastaların klinikopatolojik özelliklerini, tedavi ve sağkalım sonuçlarını literatür bilgisi ışığında sunmayı amaçladık.
GEREÇ VE YÖNTEM
Ocak 2014-Ocak 2023 tarihleri arasında kliniğimizce takip ve tedavi edilen EMK‘li hastaların retrospektif kayıtları hastane veri tabanından incelendi. Kliniko-patolojik özellikler, yapılan tedaviler, genel ve hastalıksız sağkalım sonuçları analiz edildi.
BULGULAR
Çalışmaya 19 hasta dahil edildi (yaş ortalaması: 75.9±11.5, range:57-96). Tanı anında uzak metastaz ve diğer sistem malignitesi olan 4 hasta dışlandı. Ortalama takip süresi 43.8 aydır. Tümör en sık retroareolar bölgeydi (%63.2). 3 hastada BRCA 2 gen mutasyon analizi pozitif bulundu. 11 hasta (%57.9) Evre 3’tü. 11 hasta invazif duktal karsinomlu idi. 12 hasta Luminal B alt grubunu oluşturmaktaydı. Aksiller diseksiyon yapılan 13 hastanın 9’ da (%69.2 ) tutulum mevcuttu. Uzak metastaz gelişenlerde tüm nedenlere bağlı ve kansere bağlı mortalite daha yüksekti. Ölen hastaların vücut kitle indexi (BMI), izlem süresi içinde sağ olan hastaların BMI’sinden daha düşüktü. 75 yaş ve üstü olan grubun genel sağkalım (log-rank p=0.0064) ve kansere özgü sağkalım (log-rank p=0.011) süresinin belirgin olarak daha kısa olduğu izlenmiştir.
SONUÇ
Çalışmamızda sağkalım üzerine etkide uzak metastaz anlamlı bulunmuştur. Erkeklerde meme kanserleri nadir görülmekle beraber kadınlarda olduğu gibi erken teşhis genel ve hastalıksız sağkalımı olumlu yönde etkilemektedir.
Kaynakça
- 1. Zheng G, Leone JP. Male Breast Cancer: An Updated Review of Epidemiology, Clinicopathology, and Treatment. J Oncol. 2022;2022:1734049. doi:10.1155/2022/1734049
- 2. Garreffa E, Arora D. Breast cancer in the elderly, in men and during pregnancy. Surgery. 2022;40:139–46.
- 3. Brinton LA, Carreon JD, Gierach GL, McGlynn KA, Gridley G. Etiologic factors for male breast cancer in the U.S. Veterans Affairs medical care system database. Breast Cancer Res Treat. 2010;119(1):185-192. doi:10.1007/s10549-009-0379-0
- 4. Giordano SH. Breast Cancer in Men. N Engl J Med. 2018;378(24):2311-2320. doi:10.1056/NEJMra1707939
- 5. Agrawal A, Ayantunde AA, Rampaul R, Robertson JF. Male breast cancer: a review of clinical management. Breast Cancer Res Treat. 2007;103(1):11-21. doi:10.1007/s10549-006-9356-z
- 6. Dyussenbayev, A. Age Periods Of Human Life. Advances in Social Sciences Research Journal, 2017; 4(6): 258-63. DoI:10.14738/assrj.46.2924.
- 7. Ferzoco RM, Ruddy KJ. The Epidemiology of Male Breast Cancer. Curr Oncol Rep. 2016;18(1):1. doi:10.1007/s11912-015-0487-4
- 8. Ding YC, Steele L, Kuan CJ, Greilac S, Neuhausen SL. Mutations in BRCA2 and PALB2 in male breast cancer cases from the United States. Breast Cancer Res Treat. 2011;126(3):771-778. doi:10.1007/s10549-010-1195-2
- 9. Brinton LA, Richesson DA, Gierach GL, Lacey JV Jr, Park Y, Hollenbeck AR, et al. Prospective evaluation of risk factors for male breast cancer. J Natl Cancer Inst. 2008;100(20):1477-1481. doi:10.1093/jnci/djn329
- 10. Johansen Taber KA, Morisy LR, Osbahr AJ 3rd, Dickinson BD. Male breast cancer: risk factors, diagnosis, and management (Review). Oncol Rep. 2010;24(5):1115-1120. doi:10.3892/or_00000962
- 11. Expert Panel on Breast Imaging:; Niell BL, Lourenco AP, Moy L, Baron P, Didwania AD, et al. ACR Appropriateness Criteria® Evaluation of the Symptomatic Male Breast. J Am Coll Radiol. 2018;15(11S):S313-S320. doi:10.1016/j.jacr.2018.09.017
- 12. Ionescu S, Nicolescu AC, Marincas M, Madge OL, Simion L. An Update on the General Features of Breast Cancer in Male Patients-A Literature Review. Diagnostics (Basel). 2022;12(7):1554. doi:10.3390/diagnostics12071554
- 13. Korde LA, Zujewski JA, Kamin L, Giordano S, Domchek S, Anderson WF, et al. Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol. 2010;20;28(12):2114-22. doi:10.1200/JCO.2009.25.5729
- 14. Doebar SC, Slaets L, Cardoso F, Giordano SH, Bartlett JM, Tryfonidis K, et al. Male breast cancer precursor lesions: analysis of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Mod Pathol. 2017;30(4):509-18. doi:10.1038/modpathol.2016.229
- 15. Cutuli B. Strategies in treating male breast cancer. Expert Opin Pharmacother. 2007;8(2):193-202. doi:10.1517/14656566.8.2.193
- 16. Sarmiento S, McColl M, Musavi L, Gani F, Canner JK, Jacobs L, et al. Male breast cancer: a closer look at patient and tumor characteristics and factors that affect survival using the National Cancer Database. Breast Cancer Res Treat. 2020;180(2):471-79. doi:10.1007/s10549-020-05556-y
- 17. Pensabene M, Von Arx C, De Laurentiis M. Male Breast Cancer: From Molecular Genetics to Clinical Management. Cancers (Basel). 2022;14(8):2006. doi:10.3390/cancers14082006
- 18. Sauder CAM, Bateni SB, Davidson AJ, Nishijima DK. Breast Conserving Surgery Compared With Mastectomy in Male Breast Cancer: A Brief Systematic Review. Clin Breast Cancer. 2020;20(3):e309-14. doi:10.1016/j.clbc.2019.12.004
- 19. De La Cruz LM, Thiruchelvam PTR, Shivani J, Trina J, Blankenship SA, Fisher CS. Saving the Male Breast: A Systematic Literature Review of Breast-Conservation Surgery for Male Breast Cancer. Ann Surg Oncol. 2019;26(12):3939-44. doi:10.1245/s10434-019-07588-1
- 20. Flynn LW, Park J, Patil SM, Cody HS 3rd, Port ER. Sentinel lymph node biopsy is successful and accurate in male breast carcinoma. J Am Coll Surg. 2008;206(4):616-21. doi:10.1016/j.jamcollsurg.2007.11.005
- 21. Grenader T, Goldberg A, Shavit L. Second cancers in patients with male breast cancer: a literature review. J Cancer Surviv. 2008;2(2):73-8. doi:10.1007/s11764-008-0042-5
- 22. Yadav S, Karam D, Bin Riaz I, Xie H, Durani U, Duma N, et al. Male breast cancer in the United States: Treatment patterns and prognostic factors in the 21st century. Cancer. 2020;1;126(1):26-36. doi:10.1002/cncr.32472
- 23. Strnad V, Ott OJ, Hildebrandt G, Kauer-Dorner D, Knauerhase H, Major T, et al. 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet (London, England). 2016;387:229–38. doi:10.1016/S0140-6736(15)00471-7
- 24. Wang F, Shu X, Meszoely I, Pal T, Mayer IA, Yu Z, et al. Overall Mortality After Diagnosis of Breast Cancer in Men vs Women. JAMA Oncol. 2019;1;5(11):1589-96. doi:10.1001/jamaoncol.2019.2803
- 25. Miao H, Verkooijen HM, Chia KS, Bouchardy C, Pukkala E, Larønningen S, et al. Incidence and outcome of male breast cancer: an international population-based study. J Clin Oncol. 2011;20;29(33):4381-6. doi:10.1200/JCO.2011.36.8902
- 26. Adams SJ, Kanthan R. Paget's disease of the male breast in the 21st century: A systematic review. Breast. 2016;29:14-23. doi:10.1016/j.breast.2016.06.015