|March 26, 2016|
Male breast cancer is a relatively rare cancer in men that originates from the breast. As it presents a similar pathology as female breast cancer, assessment and treatment relies on experiences and guidelines that have been developed in female patients. The optimal treatment is currently not known.
About one percent of breast cancer develops in males. The tumor can occur over a wide age range, but typically appears in men in their sixties and seventies. Known risk factors include radiation exposure, exposure to female hormones ( estrogen), and genetic factors. High estrogen exposure may occur by medications, obesity, or liver disease, and genetic links include a high prevalence of female breast cancer in close relatives. Male BRCA mutation carriers are thought to be at higher risk for breast cancer.
As in females, infiltrating ductal carcinoma is the most common type. While intraductal cancer, inflammatory carcinoma, and Paget's disease of the nipple have been described, lobular carcinoma in situ has not been seen in men.
Size of the lesion and lymph node involvement determine prognosis; thus small lesions without lymph node involvement have the best prognosis. Estrogen receptor and progesterone receptor status and HER2/neu gene amplification need to be reported as they may affect treatment options. About 85% of all male breast cancers are estrogen receptor???positive, and 70% are progesterone receptor???positive.
Typically self-examination leads to the detection of a lump in the breast which requires further investigation. Other less common symptoms include nipple discharge, nipple retraction. swelling of the breast, or a skin lesion such as an ulcer. Ultrasound and mammography may be used for its further definition. The lump can be examined either by a needle biopsy where a thin needle is placed into the lump to extract some tissue or by an excisional biopsy where under local anesthesia a small skin cut is made and the lump is removed. Not all palpable lesions in the male breast are cancerous, for instance a biopsy may reveal a benign fibroadenoma. In a larger study from Finland the average size of a male breast cancer lesion was 1.8 cm.
Male breast cancer can recur locally after therapy, or can become metastatic .
In addition to TNM staging surgical staging for breast cancer is used; it is the same as in female breast cancer and facilitates treatment and analysis.
There are significant differences between male and female breast cancer. Lesions are easier to find in men due to the smaller breast size, however, lack of awareness may postpone seeking medical attention. The presence of gynecomastia may mask the condition. The diagnosis is made later in men???at age 67 on average???than in women with their average at 63. Indeed, almost half of male breast cancer patients are stage III or IV.
Treatment largely follows patterns that have been set for the management of postmenopausal breast cancer. There are no controlled studies in men comparing adjuvant options. In the vast majority of men with breast cancer hormone receptor studies are positive, and those situations are typically treated with hormonal therapy.
Locally recurrent disease is treated with surgical excision or radiation therapy combined with chemotherapy. Distant metastases are treated with hormonal therapy, chemotherapy, or a combination of both. Bones can be affected either by metastasis or weakened from hormonal therapy; bisphosphonates may be used to counterbalance this process and strengthen bones.
Chemotherapeutic and hormonal options in male breast cancer
Chemotherapeutic options include:
Hormonal options include:
Adjusted for age and stage the prognosis for breast cancer in men is similar to that in women. Prognostically favorable are smaller tumor size and absence or paucity of local lymph node involvement. Hormonal treatment may be associated with hot flashes and impotence.
GNU Free Documentation License. It uses material from the Wikipedia article "Male breast cancer".
All informatin on the site is © www.diseases-diagnosis.com 2002-2011. Last revised: January 2, 2011|
Are you interested in our site or/and want to use our information? please read how to contact us and our copyrights.
To let us provide you with high quality information, you can help us by making a more or less donation: