title: Ductal carcinoma in situ of the male breast. Analysis of 31 cases.
abstract: From 1970 to 1992, 31 pure ductal carcinoma in situ (DCIS) of the male breast treated in 19 French Regional Cancer Centres were reviewed. They represent 5% of all breast cancers treated in men in the same period. The median age was 58 years, but 6 patients were younger than 40 years. TNM classification (UICC, 1978) showed 12 T0 (discovered only by bloody nipple discharge), 10 T1, 5 T2 and four unclassified tumours (Tx). 11 patients (35.5%) had clinical gynecomastia, and three (10%) had a family history of breast cancer. 6 patients underwent lumpectomy, and 25 mastectomy. Axillary dissection was performed in 19 cases. 6 cases received postoperative irradiation. 15 out of 31 lesions were of the papillary subtype, pure or associated with a cribriform component. The size of the 12 measured lesions varied from 3 to 45 mm. All lymph nodes sampled were negative. With a median follow-up of 83 months, 4 patients (13%) presented a local relapse (LR), respectively, at 12, 27, 36 and 55 months. 3 of these patients had been initially treated by lumpectomy. In one case LR was still in situ, but already infiltrating in the 3 others. Radical salvage surgery was performed in 3 cases, but one patient developed metastases and died 30 months later. The last patient was treated by multiple local excisions and tamoxifen. One 43-year-old patient developed a contralateral DCIS and three others developed a metachronous cancer. The aetiology and risk factors of male breast cancer remain unknown. Gynecomastia, which implies an imbalance between androgen and oestrogen, may be a predisposing factor. As in women, DCIS in the male breast has a good prognosis. Total mastectomy without axillary dissection is the basic treatment. Frequently, the first symptom is a bloody nipple discharge. The age of occurrence is younger than for infiltrating carcinoma, suggesting that DCIS is the first step in the development of breast cancer.
authors.affiliation: Centre Paul Strauss, Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Cutuli
authors.forename: J M
authors.initials: JM
authors.lastname: Dilhuydy
authors.forename: B
authors.initials: B
authors.lastname: De Lafontan
authors.forename: J
authors.initials: J
authors.lastname: Berlie
authors.forename: M
authors.initials: M
authors.lastname: Lacroze
authors.forename: F
authors.initials: F
authors.lastname: Lesaunier
authors.forename: Y
authors.initials: Y
authors.lastname: Graic
authors.forename: J
authors.initials: J
authors.lastname: Tortochaux
authors.forename: M
authors.initials: M
authors.lastname: Resbeut
authors.forename: T
authors.initials: T
authors.lastname: Lesimple
authors.forename: E
authors.initials: E
authors.lastname: Gamelin
authors.forename: F
authors.initials: F
authors.lastname: Campana
authors.forename: M
authors.initials: M
authors.lastname: Reme-Saumon
authors.forename: V
authors.initials: V
authors.lastname: Moncho-Bernier
authors.forename: J C
authors.initials: JC
authors.lastname: Cuilliere
authors.forename: C
authors.initials: C
authors.lastname: Marchal
authors.forename: G
authors.initials: G
authors.lastname: De Gislain
authors.forename: T D
authors.initials: TD
authors.lastname: N'Guyen
authors.forename: E
authors.initials: E
authors.lastname: Teissier
authors.forename: M
authors.initials: M
authors.lastname: Velten
mesh_terms: D000328:Adult; D000368:Aged; D018567:Breast Neoplasms, Male / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D012189:Retrospective Studies