外科ジャーナル

Particularities of Primary Breast Cancer in Men.

Abstract

Eugen Târcoveanu, Cristian Lupașcu, Alin Vasilescu, Nuțu Vlad, Ionela Negoiță, Delia Ciobanu, Corina Andriescu, Felicia Crumpei and Ștefan Georgescu

Background: Breast cancer in men is rare (1% of all breast cancers) and shows some particularities. Methods: We performed a retrospective study analyzing patients admitted and treated in First Surgical Clinic, Emergency Hospital “St. Spiridon” Iasi from 1 January 2008 to 31 December 2015 with malignant breast tumors. Patients included in the study were diagnosed with breast cancer after pathological examination. We followed the clinical data, laboratory and postoperative follow-up of patients.

Results: Between 2008 to 2015 in our clinic were treated 319 breast cancers, of which only 11 men, so 3.4%, higher rate to literature data. Most of the patients were aged and with an advance clinical stage. The mean age of men with breast cancer was 67 years, ten years older than women with same disease. The favoring factors in the study group, were smoking, alcohol consumption in 10 patients, obesity present in 9 patients, blood type IIA, Rh + in 8 patients, periurethral adenoma in 7 patients, diabetes in 6 patients. Neoplastic family histories were recorded in 3 patients, one of Lynch syndrome type II, with BRCA2 mutation. In three cases the breast cancer was the 2nd or 3rd cancer after skin cancer after cancer urothelium and sarcoma soft tissue and in one case with colon cancer, 4 years after breast cancer surgery, with chemotherapy and radiotherapy (Lynch syndrome). We performed radical mastectomy with axillar lymphadenectomy in 9 cases and whiteout lymphadenectomy (sentinel lymphnode negative) in 2 cases. Median survival was 4.2 years (range 1-8 years).

Conclusion: Men have a particular form of breast cancer. Unlike women, this cancer is found in men at an older age, with a higher rate of lymphatic invasion and hormone receptor positivity. Treatment should be personalized by a multidisciplinary team.