Das Mammakarzinom des Mannes - Historie, Epidemiologie, Ätiologie, Genetik und Histopathologie

Estrogens and the risk of breast cancer: A narrative review of literature

In female mammals, the development and regulation of the reproductive system and non-reproductive system are significantly influenced by estrogens (oestrogens). In addition, lipid metabolism is another physiological role of estrogens. Estrogens act through different types of receptors to introduce signals to the target cell by affecting many estrogen response elements. Breast cancer is considered mostly a hormone-dependent disease. Approximately 70% of breast cancers express progesterone receptors and/or estrogen receptors, and they are a good marker for cancer prognosis. This review will discuss estrogen metabolism and the interaction of estrogen metabolites with breast cancer. The carcinogenic role of estrogen is discussed in light of both conventional and atypical cancers susceptible to hormones, such as prostate, endometrial, and lung cancer, as we examine how estrogen contributes to the formation and activation of breast cancer. In addition, this review will discuss other factors that can be associated with estrogen-driven breast cancer.

Male breast cancer and mantle cell lymphoma in a single patient: A case report and literature review

RATIONALE

Although still relatively rare, multiple primary malignant neoplasms (MPMNs) have been increasingly reported in recent years.

PATIENT CONCERNS AND DIAGNOSES

A 65-year-old man was referred to our hospital for a painless, incidental left axillary lump. Ultrasound showed enlarged left axillary lymph nodes. An excisional biopsy was conducted on 3 lymph nodes. The pathological diagnosis was determined to be metastatic adenocarcinoma and mantle cell lymphoma (MCL) in the lymph nodes. Further physical examination of the patient yielded a 1.5-cm hard, left subareolar mass.

INTERVENTIONS AND OUTCOMES

The patient underwent modified radical mastectomy. The diagnosis was grade II invasive ductal carcinoma (stage IIA). The axillary lymph node showed MCL (stage I, group A), but not metastatic ductal carcinoma. The patient received chemotherapy, including 6 courses of CHOP (A chemotherapy protocol consists of cyclophosphamide 1.2 g day 1, doxorubicin 80 mg day 1, vindesine 4 mg day1, and prednisone 90 mg from day 1 to 5) for lymphoma and breast cancer. The patient was also administered endocrine therapy. After a 54-month follow-up, the patient was well with no evidence of disease.

LESSONS

MPMNs are easily misdiagnosed as a primary and metastatic tumor, leading to delayed or erroneous treatment. Male breast cancer in a patient with MCL is rare. Early diagnosis and proper therapy are necessary for an optimal prognosis. Further studies are required to define the mechanisms and risk factors of MPMNs.

Synchronous bilateral male breast cancer: a case report

Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed.

Genotyping of BRCA1, BRCA2, p53, CDKN2A, MLH1 and MSH2 genes in a male patient with secondary breast cancer

BACKGROUND

Some tumour suppressor genes (BRCA2) and mismatch repair genes (MSH2, MLH1) are correlated with an increased risk for male breast cancer.

CASE REPORT

Our patient developed secondary breast cancer after the treatment for Hodgkin's disease in childhood. DNA was isolated from the patients' blood and screened for mutations, polymorphisms and variants in BRCA1, BRCA2, p53, CDKN2A, MLH1 and MSH2 genes. We found no mutations but common polymorphisms, and three variants in mismatch repair genes.

CONCLUSIONS

Nucleotide variants c.2006-6T>C and p.G322D in MSH2 might be correlated with male breast cancer.

Pathological vertebral compression fracture of C3 due to a breast cancer metastasis in a male patient

STUDY DESIGN

A case of vertebral body fracture due to metastatic breast cancer in a male patient and a review of the literature are presented.

OBJECTIVE

To draw attention to the possible adverse skeletal events in breast cancer patients, and the need of a watchful staff within the multidisciplinary team in charge.

SUMMARY OF BACKGROUND DATA

Breast cancer is a rare condition in men, the male/female ratio is 1 of 100 approximately; in both sexes bone metastases are the most common. The pathologic fracture by spinal metastases can cause intense pain with difficult management. Vertebroplasty has been used successfully to treat pain and improve functional status in patients with vertebral compression fractures due to metastases.

METHODS

A 43-year-old male patient was diagnosed of having breast epithelial carcinoma after histologic analysis of a femur fracture. Following reconstruction, the patient started rehabilitative treatment. In a control visit, he referred sudden cervical pain which was initially treated with nonsteroidal anti-inflammatory drugs and rest. The patient was seen in a later visit and complained about poor response to analgesia. For this reason, a radiologic study was carried out, showing signs of fracture of the third cervical vertebral body (C3), and was completed with magnetic resonance imaging where the diagnosis of osteolytic metastasis was confirmed.

RESULTS

After consulting the interventionist radiology team, vertebroplasty was carried out aiming to diminishing the pain. There were no postoperative complications and the patient's recovery from cervicalgia permitted the nonsteroidal anti-inflammatory drugs suspension. Two weeks after the vertebroplasty, the patient resumed his rehabilitative treatment without presenting cervical pain or mobility limitation.

CONCLUSION

Spinal metastases treatment may include combinations of radiotherapy, vertebroplasty, and bisphosphonates, which have proved analgesic effect and a decrease of bone complications; however, out of these options, only vertebroplasty allows rapid stabilization and analgesia.

Breast cancer in a male with ankylosing spondylitis treated with TNFalpha antagonists

A 72-year-old male with a 4-year history of TNFalpha antagonist therapy (infliximab and etanercept) for ankylosing spondylitis was diagnosed with breast cancer. He had a family history of breast cancer. The low incidence and considerable severity of breast cancer in males, genetic risk factors, and potential role for TNFalpha antagonist therapy are discussed.