Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship

Male breast cancer is rare, accounting for 1% of all breast cancer diagnoses in the USA. Because of its rarity, most major breast cancer trials have included only female patients. This has resulted in limited prospective data to guide the clinical management of men with breast cancer. As a result, treatment decisions are typically extrapolated from data generated in female patients. This approach may be suboptimal, particularly considering the differing hormonal milieus between men and women with respect to both breast cancer development and treatment. Herein, we summarize current knowledge of the biology and clinicopathology of male breast cancer and review current approaches to locoregional and systemic management of this rare disease.

A contemporary review of male breast cancer: current evidence and unanswered questions.

BACKGROUND Fine-needle aspiration cytology (FNAC) of lymph nodes (LNs) is routinely used for staging canine malignant solid tumors, but studies evaluating its efficacy are limited. OBJECTIVES The primary objectives of this study were to evaluate the sensitivity/specificity of FNAC and the significance of nondiagnostic FNAC when staging canine malignant tumors. A secondary objective was to determine the prevalence of multiple nodal metastases. METHODS Lymph nodes draining malignant solid tumors assessed with FNAC and histopathology were included. The sensitivity/specificity of FNAC was determined for LNs with diagnostic FNAC, using histopathology as the gold standard. The proportion of nondiagnostic FNAC and associated histopathologic prevalence of metastasis were determined. Among the tumors with multiple LNs assessed, the prevalence of multiple nodal metastases was determined. RESULTS The sensitivity of FNAC (194 LNs) was 67% for sarcomas, 100% for carcinomas, 63% for melanomas, 75% for mast cell tumors, and 100% for other round cell tumors. The specificity varied between 83% and 96%. Nondiagnostic FNAC was reported in 25% of LNs sampled (65/259), most of which were nonenlarged and/or difficult to access, and 20% of which were metastatic on histopathology. When several LNs were assessed (88/189 tumors), the prevalence of multiple nodal metastases was 24%. CONCLUSIONS Histopathologic LN evaluation cannot be robustly substituted with FNAC when staging selected canine solid tumors. When a diagnostic FNAC is elusive, the histopathologic assessment remains ideal. Finally, staging should not always be limited to the assessment of a single LN.

/pdf/investigation-of-the-utility-of-lymph-node-fine-needle-2m39he2vyf.pdf

Investigation of the utility of lymph node fine-needle aspiration cytology for the staging of malignant solid tumors in dogs.

Evaluation of Breast Silicone Implants

Male breast carcinomas (MBCs) are rare neoplasms that account for 0.1% of all male cancers. Still, there are 2000 new cases of MCB diagnosed annually in the United States. Because of its rarity, data regarding the etiology, risk factors, diagnosis, management, and prognosis of MBC are limited. MBC shares some similarities with female breast carcinoma (FBC). This review will address the important clinical, histopathological, immunohistochemical and molecular features, genetics, management, and prognosis of MBC.

Male Breast Carcinoma: A Clinical and Pathological Review.

Male breast cancer: a multicentric study.

Background: The axillary nodal status is essential to determine the stage of disease at diagnosis. Our aim was to prospectively assess the diagnostic accuracy of ultrasonography-guided fine-needle aspiration (US-FNA) for the detection of metastasis in axillary lymph nodes in patients with breast cancer (BC) and its impact on the therapeutic decision. Materials and Methods: Ultrasonography (US) was performed in 407 axillae of 396 patients who subsequently underwent surgery. US-FNA was conducted when lymph nodes were detected by US. Axillary dissection (AD) was performed when US-FNA was positive for metastasis. Patients with negative US-FNA and breast tumors of 30 mm in size were candidates for selective sentinel lymph node biopsy (SLNB). The anatomopathological results of AD or SLNB were used as reference tests. Results: Lymph nodes were detected by US in 207 (50.8%) axillae. Of these, US-FNA was performed on 180 (86.9%). 94 axillae (52.2%) were positive for carcinoma and 79 women received AD. US-FNA had 77.5% sensitivity, 100% specificity, 100% positive predictive value, 69.3% negative predictive value, and 85.1% diagnostic accuracy. US-FNA avoided SLNB in 18.1% of patients who underwent AD. Conclusions: Axillary US-FNA is an accurate technique in the staging of patients with BC. It allows reducing the number of SLNB and, when positive, offers a fast and useful tool.

/pdf/diagnostic-accuracy-and-impact-on-management-of-57elhljg9l.pdf

Diagnostic Accuracy and Impact on Management of Ultrasonography-Guided Fine-Needle Aspiration to Detect Axillary Metastasis in Breast Cancer Patients: A Prospective Study.

Resumen Introduccion El conocimiento del estado ganglionar es el factor pronostico mas importante en el cancer de mama. La tecnica del ganglio centinela, desarrollada inicialmente para evitar vaciamientos innecesarios en los melanomas, ha demostrado su capacidad para predecir el estado axilar en el cancer de mama. La dificultad en aplicar la tecnica en hospitales sin servicio de medicina nuclear ha estimulado la existencia de equipos itinerantes que han permitido aplicarla en dichos hospitales. Objetivo Comprobar la aplicabilidad de la tecnica del ganglio centinela en nuestro hospital que carece de servicio de medicina nuclear. Pacientes y metodo Coincidiendo con la validacion de la tecnica del ganglio centinela en el Hospital Universitari Germans Trias i Pujol de Badalona (Barcelona) en noviembre de 1999, se empezo a aplicarla en el Centre Hospitalari de Manresa (Barcelona) bajo su tutela. En 2002, se generalizo su uso en todos los hospitales de ALTHAIA-Xarxa Assistencial de Manresa. De noviembre de 1999 a junio de 2005, se estudio el ganglio centinela de un total de 163 pacientes. Resultados En el 97,55% de las 163 pacientes, la tecnica se realizo con exito. En un 98% de los casos, el ganglio centinela se encontro en la axila. En un 10,7% de los casos, habia ganglio centinela en la cadena de la mamaria interna. El 26% de las axilas tenian metastasis de mas de 2 mm y el 16% tenia micrometastasis. Se pudo ahorrar el vaciamiento axilar a 105 pacientes. Conclusiones La tecnica del ganglio centinela se puede practicar en un hospital que no disponga de servicio de medicina nuclear, mejora y simplifica la tecnica quirurgica y reduce la estancia hospitalaria y las secuelas.

Técnica del ganglio centinela en la cirugía del cáncer de mama en un hospital sin servicio de medicina nuclear

assessment and diagnosis. Percutaneous bone biopsy is a safe, minimally invasive procedure which is routinely performed using conscious sedation and local anesthesia under imaging guidance often with CT or fluoroscopy. Both, fine needle aspiration and core biopsy techniques are utilized with low nondiagnostic rates and few major complications of significant bleeding, neuropathy or fracture reported. Obtaining tissue diagnosis is important in the staging work up in patient care, and should be pursued.

Illegal injection of industrial silicone oil for breast augmentation: risks, solutions and results.

Fístula periareolar recidivante: técnica del setón

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