[Male breast cancer].
As male breast cancer remains rare entity (less than 1% of cases of breast cancer), most of our current knowledge of it has been extrapolated from its female counterpart. The prevalence of male breast cancer increases with age, and the presentation occurs at an average age of approximately 60 years, 10 years older than in females with the disease. The majority of patients present with a painless, firm, subareolar mass, and the tumors are usually larger than 2 cm in diameter. There may be fixation to skin. Mammography and ultrasonography are useful to distinguish between breast cancer and gynecomastia. Pathologically, invasive ductal carcinoma is the predominant subtype, and lobular carcinoma is rare. Modified radical mastectomy is a principal surgical approach, and adjuvant therapy has been advocated in men based on the beneficial results of it in women. Hormonal manipulations constitute an essential part of adjuvant therapy, as male breast cancers have a high rate of hormone-receptor positivity. Although orchiectomy was practiced in the past, today, tamoxifen is the standard hormone therapy. With respect to systemic chemotherapy, the most common regimens are CMF (cyclophosphamide, methotrexate, 5-fluorouracil), or other anthracyclin-based regimens. In cases of disease recurrence, hormonal manipulations, chemotherapy, or radiotherapy can be administered for palliative purposes. Several selective aromatase inhibitors are now available; however, there are limited data regarding their efficacy in men. The prognosis does not seem to be poor compared to that of females when age and stage are matched. Further studies are needed to characterize the biologic and molecular properties of male breast cancer and their prognostic significance, and to devise optimal treatment strategies. However, it is interesting to note that p53 and c-erbB-2, are expressed and angiogenesis occurs in male breast cancer. Moreover, male breast cancer patients can carry BRCA2 mutations.
Kuroi
Katsumasa
K
Dept. of Surgery, Toyosu Hospital, Showa University.
Toi
Masakazu
M
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005472:Fluorouracil / Q000008:administration & dosage; D006177:Gynecomastia / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008327:Mammography; D008727:Methotrexate / Q000008:administration & dosage; D011379:Prognosis; D016217:Ultrasonography, Mammary
D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate