Male breast cancer specific diagnosis and treatment aspects

1. AUTHORS: Sînziana Ionescu1, Octavia-Luciana Madge1, G. Dicu-Andreescu1, M.
Marincas1, Mirela Gherghe2, Mădălina Radu3, Adina Ene3, Mihai Ceaușu3, L.
Simion1
Affiliation: 1- General and Oncological Surgery Clinic I of the Bucharest Oncological
Institute “Prof.Dr. Al. Trestioreanu ” 2- Department of Nuclear Medicine Discipline
Bucharest Oncological Institute “ Prof.Dr. Al. Trestioreanu ” 3-Pathology Department ,
Bucharest Oncological Institute“ Prof.Dr. Al. Trestioreanu ”
• Literature context: males have less than 1% of all
breast cancers, which makes the disease rare in
the population. Concerning the low incidence of
breast cancer in men and the fact that studies do
not sufficiently characterize the tumor phenotype
or the optimal approach in terms of clinical
management, a retrospective research in the
Clinic of General Surgery and Oncology I of the
Bucharest Oncology Institute between 2011-2021
was performed on a group of 40 male patients
and aimed at tracking the relationship between:
several immunohistochemical markers (ER, PR, ki-
67), in association with: disease-free survival (DFS)
and overall survival (OS ).
• Among the results obtained, the aspect was
found according to which: at presentation, 40% of
patients were in anatomical stage I with invasive
G2 tumors, positive estrogen (ER) and
progesterone (PR) receptors, erbB2 negative
tyrosine kinase receptor, ki67 in high percentage
(> 50%). The conclusion was that: family history,
high percentage of ki67, negative PR expression,
diabetes, high BMI and the presence of
gynecomastia were associated with shorter DFS
and OS compared to patients in the rest of the
group. For better accuracy in the clinical approach
to male breast cancer, both sexes should be
recruited for randomized controlled trials in order
to obtain reliable data that can then be used in
the development of high-specific treatment
guidelines specifically for the disease.
Figure 1.a-f. illustrating PET-CT / CT
aspects in the case of an infiltrative
right breast tumor in a 54-year-old
patient. Increased uptake of the
right mammary gland and right
axillary lymph nodes
SPECIFIC DIAGNOSIS AND
TREATMENT ASPECTS IN
MALE BREAST CANCER
54-year-oldmalepatientwithinfiltrativeright
breasttumor;high18F-FDGuptakeinthebreast
tumorandrightaxillarylymphnodes,suggestive
formalignancy.
FusedPET-CTimagesandlowdoseCTimages
a)
b) c)
d)
e) f)
Figure 2. Biopsy sample from a
breast tumor (male patient, 66
years old): left panel: breast
papillary carcinoma, HE, 100x, top
right panel: positive estrogen
receptor in tumor cell nuclei (score
Allred: 8), lower right panel: Ki-67
positive in ~ 75% of tumor cell
nuclei, IHC, 100x
Figure 3. Surgically resected
specimen, same case: left panel:
invasive breast carcinoma, right
panel: tumor invasion in an axillary
lymph node, HE, 100x.
Acknowledgement: The authors would like to thank Dr. Ariana
Neicu, Head of the Pathological Anatomy Department of the
Bucharest Oncological Institute "Prof. Dr. Al Trestioreanu" for the
support and agreement of the use of microscopy images in this
material.