Synchronous bilateral primary male breast carcinoma with hyperprolactinemia

Male breast cancer--an andrological disease: risk factors and diagnosis

Gynaecomastia, the enlargement of the male breast, is considered as an andrological disease. To date, a review on male breast cancer (MBC) has not been published in an andrological journal. The papers underlying this review were published from authors of different institutions: Clinical Genetics, Dermatology, Gynaecology, Internal Medicine, Oncology, Pathology, Psychiatry, Radiology and Surgery. MBC accounts for approximately 1% of breast cancer patients. A total of 182 men died of breast cancer in 1999, in Germany. In the US, 1500 new cases per year occur. MBC accounts for <5% of surgically removed breast lumps. Diseases with increased oestrogen action increase the risk of MBC. Mutations of distinct genes are estimated to account for up to roughly 10% of MBC. BRCA1 and BRCA2 gene mutations are responsible for approximately 80% of the families with hereditary breast cancer. The diagnosis of MBC is not possible without histological examination. Different diagnostic procedures such as clinical diagnosis, sonography, mammography, fine-needle biopsy and core needle facilitate the decision whether a biopsy is necessary.

Bilateral Synchronous Carcinoma of the Male Breast in a Patient Receiving Estrogen Therapy for Carcinoma of the Prostate: Cause or Coincidence?

An unusual case of bilateral, synchronous breast cancer in a male patient who had a history of long-term estrogen therapy for prostate cancer is presented. The possible role of estrogen in the development of male breast cancer is revisited.

Synchronous bilateral noninvasive ductal carcinoma of the male breast: a case report

A 45-year-old man developed a bloody discharge from his right nipple. Physical examination revealed bloody discharge from his left nipple also but no swelling, breast mass, or axillary lymph nodes. He then underwent bilateral total glandectomy without axillary dissection. Histological examination revealed low-grade ductal carcinoma in situ (DCIS) with a low-papillary and cribriform pattern measuring about 4 mm in diameter in the breast bilaterally. To our knowledge, this is the first report of synchronous bilateral DCIS in a male. Since this patient's hormonal profile showed a relatively high blood level of prolactin, the causative relationship between hyperprolactinemia and male breast cancer is discussed. Including our case, 5 of 6 cases reported thus far have been bilateral, and 4 of the 6 cases have been synchronous. We emphasize that the contralateral breast should also be tested or followed in male breast cancer patients with hyperprolactinemia.

Relationship between serum prolactin levels and histology of benign and malignant breast lesions: a detailed study of 153 consecutive cases

This study was aimed at investigating the relationship between serum prolactin levels and the morphology of operable female breast lesions. One hundred fifty-three consecutive patients with operable benign and malignant breast lesions in whom preoperative serum prolactin levels had been determined were stratified into five groups according to their serum prolactin levels. The histologic findings in these groups were analyzed and compared. Most patients (93%) had serum prolactin levels within the normal limits. Of the 54 patients with benign lesions, only 4(7%) had slightly elevated serum prolactin levels. Two of these patients had fibroadenomas, one had a phyllodes tumor and one had fibrocystic change. Of the 99 patients with carcinoma, 7 (7%) had hyperprolactinemia. Five of the seven tumors were invasive and two were in situ. All seven tumors were of low or intermediate grade of malignancy. The two cases with the highest prolactin levels (3057 and 1822 mU/L) were both intermediate-grade ductal carcinoma in situ (DCIS). It is concluded that the great majority of patients presenting with operable breast lesions have normal serum prolactin levels, and that elevated levels, when present, occur with equal frequency in patients with benign and malignant breast lesions. Hyperprolactinemic patients presenting with carcinoma in this study, none of whom had a history of recent pregnancy or lactation, tended to have histologically low- or intermediate-grade tumors, but this needs to be confirmed by investigating more cases.