Bilateral breast cancer in a 65-year-old man

Abstract Globally, breast cancer in men is exceedingly uncommon. The misinterpretation of signs and symptoms and lack of a proper medical history can lead to the progression of rare conditions to advanced stages. We report the case of a 65-year-old man who presented to the clinic complaining about progressive bilateral dull breast pain. He had been diagnosed with bilateral grade II invasive ductal carcinoma three months prior, and he underwent bilateral mastectomy followed by chemotherapy as a part of his treatment plan.

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925 Utilizing multiplex immunofluorescence to explore the epithelial-mesenchymal transition in breast, ovarian cancers

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2021-sitc2021.925 ◽

2021 ◽

Vol 9 (Suppl 3) ◽

pp. A970-A970

Author(s):

Danielle Fails ◽

Michael Spencer

Keyword(s):

Breast Cancer ◽

Invasive Ductal Carcinoma ◽

Poor Prognosis ◽

Epithelial Mesenchymal Transition ◽

Ductal Carcinoma ◽

Beta Catenin ◽

Mesenchymal Transition ◽

Cell Counts ◽

Grade Ii ◽

E Cadherin

BackgroundEpithelial-mesenchymal transition (EMT) is instrumental during embryonic development—assisting in extensive movement and differentiation of cells. However, during metastasis and tumorigenesis, this process is hijacked. The disruption of this developmental process, and subsequent acquisition of a mesenchymal phenotype, has been shown to increase therapeutic resistance and often leads to poor prognosis in breast cancer.1 Using bioinformatic resources and current clinical data, we designed a panel of biomarkers of value to specifically observe this epithelial/mesenchymal transition.MethodsHuman breast cancer FFPE tissue samples were stained with Bethyl Laboratories IHC-validated primary antibodies, followed by Bethyl HRP-conjugated secondary antibodies, and detected using Akoya Opal™ Polaris 7-color IHC kit fluorophores (Akoya Biosciences [NEL861001KT]). The panel consisted of beta-Catenin, E-Cadherin, Ki67, CD3e, PD-L1, and FOXP3. Antibody staining order was optimized using tissue microarray serial sections, three slides per target, and stained in either the first, third, or sixth position via heat-induced epitope retrieval (HIER) methods. Exposure time was maintained for all three slides/target and cell counts, signal intensity, background, and autofluorescence were analyzed. The final optimized order was then tested on the breast cancer microarray in seven-color mIF. Whole slide scans were generated using the Vectra Polaris® and analyses performed using InForm® and R® Studio.ResultsTwo integral EMT targets, E-Cadherin and beta-Catenin, were used to observe a key occurrence in this transition. Under tumorigenic circumstances, when released from the complex they form together (E-cadherin-B-catenin complex), Beta-catenin can induce EMT. This disjunction/activation of EMT can be seen in the invasive ductal carcinoma below (figure 1).The disorganized E-cadherin cells are in direct contrast to normal, non-cancerous cells in similar tissue. Total CD3e cell counts were down (2%), with 35% cells restricted to the stroma vs. the 1% seen intra-tumorally. Coupled with the elevated presence of Ki67 (10%), a level of rapid cancer growth and potential metastasis (Invasive Ductal Carcinoma Grade II) can be observed.Abstract 925 Figure 1Invasive ductal carcinoma, grade II stained with a 6-plex mIF panel designed to show the epithelial-mesenchymal transitionConclusionsThe presence of EMT in breast cancers is often indicative of a poor prognosis, so the need for reliable markers is imperative. E-Cadherin and beta-Catenin are both up-and-coming clinical targets that can serve to outline this transition within the tumor microenvironment. By utilizing these markers in mIF, closer spatial examination of proteins of interest can be achieved. The application of this mIF panel has the potential to provide invaluable insights into how tumor infiltrating lymphocytes behave in cancers exhibiting the hallmarks of EMT.AcknowledgementsWe would like to acknowledge Clemens Deurrschmid, PhD, Technical Applications Scientist Southeast/South Central, Akoya Biosciences for his assistance with image analysis.ReferencesHorne HN, Oh H, Sherman ME, et al. E-cadherin breast tumor expression, risk factors and survival: pooled analysis of 5,933 cases from 12 studies in the breast cancer association consortium. Sci Rep 2018;8:6574.

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Breast Cancer in Men: Clinical and Pathological Analysis of 817 Cases

American Journal of Men s Health ◽

10.1177/1557988320908109 ◽

2020 ◽

Vol 14 (4) ◽

pp. 155798832090810

Author(s):

Fernanda Servidoni Spreafico ◽

Cassio Cardoso-Filho ◽

Cesar Cabello ◽

Luis Otávio Sarian ◽

Luiz Carlos Zeferino ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Prevalence Ratio ◽

Breast Cancer Diagnosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Histological Types ◽

The Mean ◽

Breast Cancer In Men

The objective of the current study was to describe breast cancer cases in men according to age, stage, and histology, calculating risks compared to women. It is a retrospective cross-sectional study of all breast cancer cases of the Hospital Cancer Registry of São Paulo state, Brazil, 2000–2015. Variables were age, sex, stage, and histology. Absolute numbers and proportions, Mann–Whitney test and prevalence ratio with 95% confidence interval were used. The study included 93,737 cases, of which 817 were males. The mean age at diagnosis was 60.3 years in men and 56.2 years in women ( p < .001). Stage II was the most common in both sexes (33.9% in men and 36.5% in women). Men had a higher frequency of stage III than women (PR 1.18, 95% CI 1.01–1.37). Stage 0 was significantly more common in women (PR 0.69, 95% CI 0.51–0.94). Ductal carcinoma and its variants were the most common histological types in both sexes (88.7% in men and 89.0% in women). Men had a higher frequency of rarer histological types such as papillary (PR 2.17, 95% CI 1.36–3.44) and sarcomas (PR 4.10, 95% CI 1.86–9.01). In conclusion, in men, breast cancer diagnosis occurred in more advanced ages and stages. Invasive ductal carcinoma was the primary histological type observed, although rarer types were more frequent.

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Cowden Syndrome Diagnosed by Bilateral Breast Cancer with Lhermitte-Duclos Disease: A Case Report

Case Reports in Oncology ◽

10.1159/000506979 ◽

2020 ◽

Vol 13 (1) ◽

pp. 419-423

Author(s):

Tamami Morisaki ◽

Shinichiro Kashiwagi ◽

Rika Kouhashi ◽

Akimichi Yabumoto ◽

Yuka Asano ◽

...

Keyword(s):

Breast Cancer ◽

Relevant Literature ◽

Bilateral Breast Cancer ◽

Cowden Syndrome ◽

Thyroid Tumor ◽

Cerebellar Hemisphere ◽

Bilateral Mastectomy ◽

Pten Gene ◽

Early Detection Of Disease ◽

Increased Risk

Cowden syndrome is extremely rare and is characterized by multiple hamartomas in various tissues, including the skin, mucous membranes, gastrointestinal tract, breast, thyroid, and brain, and has an increased risk of breast, thyroid, and uterine cancers. Here, we report a case of Cowden syndrome diagnosed following presentation with bilateral breast cancer and provide a discussion of the relevant literature. A 47-year-old woman with a tumor in her right breast was referred to our hospital. She was diagnosed with bilateral breast cancer upon imaging and underwent a bilateral mastectomy and sentinel lymph node biopsy. Previously, she had undergone total thyroidectomy to treat a thyroid tumor. Approximately 3 years later, she was diagnosed with Lhermitte-Duclos disease affecting her left cerebellar hemisphere. As her sister and mother had also been diagnosed with breast cancer, we suspected that she might have an inherited disease. Since 80% of individuals with Cowden syndrome have a mutation in the phosphatase and tension homolog (PTEN) gene, we did not perform any genetic testing. Instead, we used the syndrome’s pathognomonic criteria and major criteria (breast cancer, thyroid tumor, and Lhermitte-Duclos disease) to diagnose our patient with Cowden syndrome. While treatment of Cowden syndrome is currently limited to strategies that can manage the symptoms, patients are at an increased risk of certain cancers and require regular screening to allow for early detection of disease.

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RETROSPECTIVE ANALYSIS OF BREAST CANCER CASES AND SURGICAL TREATMENT IN A PERIOD OF TEN YEARS

Journal of Nepal Medical Association ◽

10.31729/jnma.826 ◽

2003 ◽

Vol 40 (139) ◽

pp. 112-119 ◽

Cited By ~ 2

Author(s):

Prakash Sayami ◽

B M Singh ◽

Y Singh ◽

R Timila ◽

U Shrestha ◽

...

Keyword(s):

Breast Cancer ◽

Retrospective Analysis ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

False Negative ◽

False Negative Rate ◽

Axillary Lymph ◽

Duration Of Symptoms ◽

Tubular Carcinoma ◽

Advanced Stages

Retrospective analysis of 321 cases of breast cancer diagnosed in T. U Teaching Hospitalin a period of 10 years, from May, 1991 to April, 2000 was carried out. There were317 cases (98.8%) females and 4 cases males (1.2%). The youngest patient was 22year old female and oldest patient was 92 year old female. The most common agegroup according to frequency was in forties (34.6%) followed by in thirties (25.5 %).Mean duration of symptoms before coming to doctor was 8.3 months and mean size oftumor was 6 cm. Out of 317 females, 310(97.2%) were married and average numberof children was 3. Out of 289 cases diagnosed as malignancy with fine needle aspirationcytology (FNAC) 279 (96.5%) was also diagnosed as malignancy in biopsy and theremaining 10 cases as non malignant diseases were diagnosed as malignancy in biopsywith a false negative rate of 3.5%. The histological types of breast cancer cases wereInfiltrating Ductal Carcinoma 280 cases (87.2%), Medullary Carcinoma 11 cases(3.4%), Infiltrating Lobular Carcinoma 5 cases (1.6%), Mucinous Carcinoma 4 cases(1.2%), Sarcoma 4 cases (1.2%), Squamous Cell Carcinoma 4 cases (1.2%), PapillaryCarcinoma 3 cases (0.9%), Tubular Carcinoma 2 cases, Adenosquamous Carcinoma2 cases (0.6%), Intraductal Carcinoma 2 cases (0.6%) and Non-Hodgkins Lymphoma1 case. Out of 305 operated cases, the types of operation performed was ModifiedRadical Mastectomy in 208 cases (68 %) and palliative mastectomy in 72 cases (23.5%),only lumpectomy in 24 cases (7.9%) and others in 2 cases. Among 246 cases withavailable axillary lymph node biopsy, there was metastatic diseases in 146 cases (60%)of cases. The Breast cancer was diagnosed in advanced stages in 63% of cases. StageIIIA (24%), Stage IIIB (21.5%) and Stage IV (17.4%). Breast cancers were diagnosedin advanced stages in below 40 age group in 65 out of 90 cases (72.2 % ) comparedto137 out of 231 cases ( 59.3 % ) in above 40 age group.Key Words: Breast cancer, Advanced stage, FNAC, Surgery.

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Breast Cancer Development in a Transgender Male Receiving Testosterone Therapy

Case Reports in Endocrinology ◽

10.1155/2018/3652602 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Nadia Barghouthi ◽

Jennifer Turner ◽

Jessica Perini

Keyword(s):

Breast Cancer ◽

Invasive Ductal Carcinoma ◽

Breast Biopsy ◽

Ductal Carcinoma ◽

Growth Factor Receptor ◽

Premenopausal Women ◽

Left Breast ◽

Bilateral Mastectomy ◽

Testosterone Therapy ◽

Increased Risk

Context. To describe a case of invasive ductal carcinoma of the breast in a transgender male receiving testosterone therapy for gender-affirming treatment. Case Description. A 28-year-old transgender male receiving intramuscular testosterone was found to have a breast mass on ultrasound after self-exam revealed a palpable breast lump. Ultrasound-guided breast biopsy revealed estrogen receptor/progesterone receptor (ER/PR) negative, human epidermal growth factor receptor-2 (HER-2) positive, invasive ductal carcinoma of the left breast. He underwent neoadjuvant and adjuvant chemotherapy along with bilateral mastectomy. At patient request, his testosterone injections were permanently discontinued. Conclusion. Fewer than 20 cases of breast cancer in transgender male patients have been reported in medical literature. While studies have shown increased risk of breast cancer in postmenopausal women with higher testosterone levels, data regarding premenopausal women is conflicting and little is known about breast cancer risk in transgender individuals receiving gender-affirming hormone therapy (GAHT), with inconclusive results regarding correlation between testosterone therapy and breast cancer. More research is required to evaluate whether a possible increased risk of breast cancer exists for transgender men receiving gender-affirming therapy.

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CDH-1 germ line mutations in diffuse gastric and infiltrating ductal breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e22218 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e22218-e22218

Author(s):

A. P. Efremidis ◽

F. Fostira ◽

C. Panopoulos ◽

K. Papademitriou ◽

N. Pistalmazian ◽

...

Keyword(s):

Breast Cancer ◽

Gastric Cancer ◽

Positive Family History ◽

Bilateral Breast Cancer ◽

Hereditary Diffuse Gastric Cancer ◽

Bilateral Mastectomy ◽

Diffuse Gastric Cancer ◽

Cancer Type ◽

Diffuse Type ◽

Cdh1 Gene

e22218 Background: Hereditary Diffuse Gastric Cancer (HDGC) syndrome is characterized by the predisposition to gastric cancer of the diffuse type and to breast cancer of the lobular type. The autosomal dominantly inherited germline mutations of the E- cadherin (CDH1) gene are the defects underlying the HDGC syndrome. The median age of onset for diffuse gastric cancer is 38 years. CDH1 mutations are highly penetrant, conferring a cumulative risk of diffuse gastric cancer of 75%. Methods: Genomic DNA was purified from peripheral blood leukocytes following standard chloroform extraction. The complete coding sequences of the CDH1-gene, including splice junctions, were amplified by Polymerase Chain Reaction (PCR) and electrophorized in an ABI Prism 310 Genetic Analyzer. Results: A pathogenic mutation located on exon 7 of the CDH1 gene was identified in a female patient diagnosed with bilateral breast cancer at the age of 36. She underwent bilateral mastectomy for an infiltrating ductal adenocarcinoma of the left breast and in situ lobular of the right breast. At the age of 45 the patient underwent gastrectomy for diffuse type gastric adenocarcinoma. She had a positive family history for breast and gastric cancer from both sides, but without meeting the absolute clinical criteria for hereditary diffuse gastric cancer syndrome. The nonsense mutation found was probably maternally inherited, since the maternal grandmother was diagnosed with breast cancer at the age of 38. Conclusions: The selection process of patients for genetic testing for the HDGC syndrome is not quite clear at the moment, as it is apparent that more types of breast cancer and not only lobular, can be associated with the syndrome. Criteria should be more flexible in respects to the histopathology of the cancer type. This is the first CDH1 mutation identified in a Greek patient. No significant financial relationships to disclose.

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Tubular carcinoma of the breast: A single institution's experience of prognosis.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.28_suppl.37 ◽

2015 ◽

Vol 33 (28_suppl) ◽

pp. 37-37

Author(s):

William P Boyan ◽

Michael Farr ◽

Brian Shea ◽

Manpreet Kohli ◽

Ernest Ginalis

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Treatment Plan ◽

Endocrine Treatment ◽

Breast Cancers ◽

Carcinoma Of The Breast ◽

Tubular Carcinoma ◽

Care Givers ◽

One Year ◽

Evidenced Based

37 Background: Tubular carcinoma is a less aggressive form of breast cancer which emcompasses 1-4% of invasive breast cancer. Prior studies have shown a nearly 100% 15 year survival rate for tubular carcinoma compared to the 89.2% five year survival of all breast cancers. The question asked is if these two cancers should be treated the same. The goal of oncologic treatment is to maximize survival while limiting side effects. At the very least, care givers should be able to give prognostic encouragement to patients based on this less aggressive histological subtype. Methods: A retrospective study of charts for tubular carcinoma of the breast from 2000 to 2015 were analyzed. A total of 57 patients were captured. All relevant aspects of the patients history, as well as therapies rendered and outcomes were documented. The aim of our study was compare treatment outcomes in our group of tubular carcinomas to that of breast cancer as a whole. Results: A total of 57 patients were diagnosed and treated for tubular carcinoma of the breast between 2000 and 2015 from a single institution. Of the 57 patients, local recurrence was seen in two patients. The first patient underwent lumpectomy, endocrine and radiation therapy then recurred as an invasive ductal carcinoma 12 years later. A second patient underwent lumpectomy with endocrine treatment but refused radiation, recurring as a tubular carcinoma 10 months later. In our 16 year sample the recurrence rate was 3.5% or 1.75% recurring as tubular. This is lower than the rates of recurrence of all breast cancer. To this date there were no cancer related mortalities in our group. Conclusions: A look into our institution’s data supported the notion that tubular carcinoma of the breast is a less aggressive histological type. Of our 57 cases and mean follow up time of six years ranging from one year to fifteen, only two recurrences (3.5%) were noted and there was no cancer related mortalities. Interestingly only one (1.75%) recurred as tubular carcinoma. Without controlling for adjuvant therapy, recommendations cannot be made for a less aggressive treatment plan at this point. Based on this study and others like it physicians can give evidenced based favorable prognosis when the diagnosis of tubular carcinoma is made.

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Synchronous Bilateral Breast Cancer Diagnosed as Invasive Lobular and Invasive Ductal Carcinoma

Acta Medica Anatolia ◽

10.15824/actamedica.23984 ◽

2014 ◽

Vol 3 (4) ◽

pp. 152

Author(s):

Emrah Çağlar ◽

Fatma Tuba Kızıltepe ◽

Zehra Sumru Çoşar ◽

Elif Aktaş ◽

Bilgin Kadri Arıbaş ◽

...

Keyword(s):

Breast Cancer ◽

Invasive Ductal Carcinoma ◽

Ductal Carcinoma ◽

Bilateral Breast Cancer ◽

Synchronous Bilateral Breast Cancer

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Mammography in asymptomatic women aged 40-49 years

Revista de Saúde Pública ◽

10.1590/s0034-8910.2014048005349 ◽

2014 ◽

Vol 48 (6) ◽

pp. 931-939 ◽

Cited By ~ 3

Author(s):

Flávio Xavier Silva ◽

Leila Katz ◽

Alex Sandro Rolland Souza ◽

Melania Maria Ramos Amorim

Keyword(s):

Breast Cancer ◽

Mammography Screening ◽

Breast Imaging ◽

Ductal Carcinoma ◽

Cross Sectional Study ◽

Northeastern Brazil ◽

Cross Sectional ◽

Increased Risk ◽

Grade Ii ◽

Asymptomatic Women

OBJECTIVE To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer. METHODS This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded. RESULTS The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies. CONCLUSIONS Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality.

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