Cáncer mamario en hombres
Palabras clave:
neoplasias de la mama, carcinoma ductal de mama, diagnóstico, factores de riesgo, masculinoResumen
El cáncer mamario en hombres es una enfermedad infrecuente, ya que representa el 1 % de todos los cánceres de mama y es responsable del 0,1 % de las muertes por cáncer en hombres. La incidencia se ha incrementado en los últimos 25 años.
En la patogenia se han involucrado factores de riesgo genéticos, hormonales y ambientales. La presentación clínica es la de una masa indolora, retroareolar, con inversión del pezón o sin ella. La enfermedad en estadios avanzados (III-IV) ocurre en más del 40 % de los pacientes.
En la mayoría de los casos el diagnóstico se basa en la evaluación clínica, la mamografía, la ecografía y la biopsia.
Cerca de 90 % de todos los tumores son carcinomas ductales invasores, que expresan altos niveles de receptores hormonales. El tratamiento local y regional incluye cirugía y radioterapia, dependiendo de la presentación clínica, y el tratamiento sistémico, hormonal o quimioterapia, acorde con los hallazgos clínicos y biológicos.
En este artículo se presenta el caso de un paciente con la enfermedad y la última información sobre el tema.
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Referencias bibliográficas
1. Delgado B, Palacios L, Petit H, Barrios G, Tejada A, Pacheco C. Carcinoma de mama en el hombre: a propósito un caso. Revista Venezolana de Oncología. 2009;21:165-8.
2. Gómez RC, Zambrana F, Serreno M, López M, Casado E. Male breast cancer. Cancer Treatment Reviews. 2010;36:451-7.
https://doi.org/10.1016/j.ctrv.2010.02.002
3. Jernal A, Siegel K, Ward E. Cancer statistics. CA Cancer J Clin. 2009;59:225.
https://doi.org/10.3322/caac.20006
4. Gradishar W. Male breast cancer. In: Harris J, Lippman ME, Morrow M, Osborne C, editors. Diseases of the breast. Phila- delphia: Lippincont Williams & Wilkins; 2009. p. 749-54.
5. Fentiman IS, Fourquet A, Hortobagyi G. Male breast cancer. Lancet. 2006;367:595-604.
https://doi.org/10.1016/S0140-6736(06)68226-3
6. Ottini L, Palli D, Rizzo S, Federico M, Bazan V, Russo A. Male breast cancer. Crit Rev Oncol Hematol. 2010;73:141-55.
https://doi.org/10.1016/j.critrevonc.2009.04.003
7. Ying MW, Agrawal A, Cheung KL. The other half of breast cancer: A review of male breast cancer. J Mens Health Gend. 2005;2:406-13.
https://doi.org/10.1016/j.jmhg.2005.10.012
8. Giordano SH. A review of the diagnosis and management of male breast cancer. Oncologist. 2005;10:471-9.
https://doi.org/10.1634/theoncologist.10-7-471
9. Onami S, Ozaki M, Mortimer JE, Kumar S. Male breast cancer: An update in diagnosis, treatment and molecular profiling. Maturitas. 2010;65:308-14.
https://doi.org/10.1016/j.maturitas.2010.01.012
10. Dally MB, Axibund J, Buys S, Crawford B, Farrel C, Friedman S, et al. J Natl Compr Canc Netw. 2010;8:562-94.
11. Wernberg JA, Yap J, Murekeyisoni C, Mashtare T, Wilding G, Kulkarni SA. Multiple primary tumors in men with breast cancer diagnoses -A SEER database review. J Surg Oncol. 2009;99:16-9.
https://doi.org/10.1002/jso.21153
12. Bravo M, Adrada A, Bolaños H. Cáncer mamario en el hombre. Presentación de caso y revisión de literatura. Revista Colom- biana de Cirugía. 2004;19:246-53.
13. Morrogh M, King TA. The significance of nipple discharge of the male breast. Breast J. 2009;15:632-8.
https://doi.org/10.1111/j.1524-4741.2009.00818.x
14. Chen L, Chantra P, Larsen L, Barton P, Rohitopakarn M, Zhu EQ, et al. Imaging characteristics of malignant lesions of the male breast. Radiographics. 2006;26:993-1006.
https://doi.org/10.1148/rg.264055116
15. Cooper R, Gunter B, Ramamurthy L. Mamography in men. Radiology. 1994;191:651-6.
https://doi.org/10.1148/radiology.191.3.8037795
16. Mathew J, Perkins GH, Stephens T, Middleton LP, Yang WT. Primary breast cancer in men: Clinical, imaging, and pathologic findings in 57 patients. AJR Am J Roentgenol. 2008;191:1631-9.
https://doi.org/10.2214/AJR.08.1076
17. Taber KA, Morisy LR, Osbhar AJ, Dickinson BD. Male breast cancer: Risks factors, diagnosis, and management. Oncol Rep. 2010;24:1115-20.
https://doi.org/10.3892/or_00000962
18. Korde LA, Zujewski JA, Kamin L, Giordano S, Domchehek S, Anderson WF, et al. Multidisciplinary meeting on male breast cancer: Summary and research recommendations. J Clin Oncol . 2010;28:2114-22.
https://doi.org/10.1200/JCO.2009.25.5729
19. Yang WT, Whitman GJ, Yuhen EH, Tse GM, Stelling C. So- nographic features of primary breast cancer in men. AJR Am J Roentgenol. 2001;176:413-6.
https://doi.org/10.2214/ajr.176.2.1760413
20. Binda MC, Pineda D, Bozo C, Vidal R, Alfonsín L. Cáncer de mama masculino. Un diagnostico a considerar. RAR. 2007;71:65-72.
21. Rosasco M, Centurion D, Carzoglio J. Cáncer de mama mas- culino en Uruguay. Comunicación de 16 casos y revisión de la literatura. Revista Española de Patología. 2004;37:253-61.
22. Morakkabati N, Schild H, Leutner C, Falkenhausen M, Lutter- bey G, Kuhl C. Dynamic control enhanced breast MR imaging in men: Preliminary results. Radiology. 2006;238:438-45.
https://doi.org/10.1148/radiol.2382041312
23. Burga A, Fadare O, Lininger RA, Tavassoli F. Invasive carcino- ma of the male breast : A morphologic study of the distribution of histologic subtypes and metastatic patterns in 778 cases. Virchows Arch. 2006;449:507-12.
https://doi.org/10.1007/s00428-006-0305-3
24. Ge V, Sneige N, Eltorky MA, Wang Z, Lin E, Gong Y, et al. Immunohistochemical characterization of subtypes of male breast carcinoma. British Cancer Research. 2009;11:R28.
https://doi.org/10.1186/bcr2258
25. Chappuis KW, Burger SB, Hurlimann J. Comparison of prog- nostic markers detected by immunohistochemistry in male and female breast carcinoma. Eur J Cancer. 1996;32A:1686-92.
https://doi.org/10.1016/0959-8049(96)00154-2
26. Cutuli B, Cohen SC, Kirova SY, Lemanski C, Lafontan B, Zoubir M, et al. Male breast cancer. Evolution of treatment and prognosis factors. Analysis of 489 cases. Crit Rev Oncol Hematol. 2010;73:246-54.
https://doi.org/10.1016/j.critrevonc.2009.04.002
27. Guinee VE, Shallenberger RC, Moller T, Olson H, Blink JW, Peter Z, et al.The prognosis of breast cancer in male. A report of 335 cases. Cancer. 1993;71:154-61.
https://doi.org/10.1002/1097-0142(19930101)71:1<154::AID-CNCR2820710125>3.0.CO;2-#
28. Hill AD, Borgen PL, Cody HS. Sentinel node biopsy in male breast cancer. Eur J Surg Oncol. 1999;25:442-3.
https://doi.org/10.1053/ejso.1999.0674
29. Flynn LW, Park J, Patil S, Cody H, Port ER. Sentinel lymph node biopsy is successful and accurate in male breast carcinoma. J Am Coll Surg. 2008;206:616-21.
https://doi.org/10.1016/j.jamcollsurg.2007.11.005
30. Lyman G, Giuliano AE, Somerfield MR, Benson AL, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology Guideline, recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol . 2005;23:7703-20.
https://doi.org/10.1200/JCO.2005.08.001
31. Gennari R, Curigliano G, Jereczec F. Male breast cancer: A special therapeutic problem. Anything new? Int J Oncol. 2004;24:663-70.
https://doi.org/10.3892/ijo.24.3.663
32. Cutuli B, Velten M, Dilhuydy JM. Male breast cancer: Results of the treatments and prognostic factors in 690 cases. Int J Radiat Oncol Biol Phys. 1998;42:2056.
https://doi.org/10.1016/S0360-3016(98)80363-5
33. Ribeiro G, Swindell R, Harris M, Banerjee S, Cramer A. A review of the management of the male breast carcinoma based on an analysis of 420 treated cases. Breast. 1996;5:141-6.
https://doi.org/10.1016/S0960-9776(96)90058-2
34. Hayes T. Pharmacologic treatment of male breast cancer. Expert Opin Pharmacother. 2009;10:2499-505.
https://doi.org/10.1517/14656560903200634
35. Ribeiro G, Swindell R. Adjuvant tamoxifen for male breast cancer. Brit J Cancer. 1992;65:252-4.
https://doi.org/10.1038/bjc.1992.50
36. Bagley CS, Wesley MN, Young RC, Lippman ME. Adjuvant chemotherapy in males with cancer of the breast. Am J Clin Oncol. 1987;10:55-60.
https://doi.org/10.1097/00000421-198702000-00013
37. Yildrim E, Berberoglu U. Male breast cancer: A 22 year expe- rience. Eur J Surg Oncol. 1998;24:548-52.
https://doi.org/10.1016/S0748-7983(98)93608-3
38. Giordano S, Perkins GH, Broglio K, García SG, Middleton LP, Buzdar A, et al. Adjuvant systemic therapy for male breast carcinoma. Cancer. 2005;104:2359-64.
https://doi.org/10.1002/cncr.21526
39. Masci G, Gandini C, Zuradelli M, Pedrazzoli P, Torrisi R, Lutman R, et al. Fulvestrant for advanced male breast cancer patients: A case series. Ann Oncol. 2011;22:985-93.
https://doi.org/10.1093/annonc/mdr005
40. Doyen J, Italiano A, Largillier R, Ferrero JM, Fontana X, Thyss A. Aromatase inhibition in male breast cancer patients: Biolo- gical, and clinical implications. Ann Oncol. 2010;21:1243-5.
https://doi.org/10.1093/annonc/mdp450
41. Czene K, Bergqvist J, Per H, Bergh J. How to treat male breast cancer. Breast. 2007;16:S147-54.
https://doi.org/10.1016/j.breast.2007.07.024
2. Gómez RC, Zambrana F, Serreno M, López M, Casado E. Male breast cancer. Cancer Treatment Reviews. 2010;36:451-7.
https://doi.org/10.1016/j.ctrv.2010.02.002
3. Jernal A, Siegel K, Ward E. Cancer statistics. CA Cancer J Clin. 2009;59:225.
https://doi.org/10.3322/caac.20006
4. Gradishar W. Male breast cancer. In: Harris J, Lippman ME, Morrow M, Osborne C, editors. Diseases of the breast. Phila- delphia: Lippincont Williams & Wilkins; 2009. p. 749-54.
5. Fentiman IS, Fourquet A, Hortobagyi G. Male breast cancer. Lancet. 2006;367:595-604.
https://doi.org/10.1016/S0140-6736(06)68226-3
6. Ottini L, Palli D, Rizzo S, Federico M, Bazan V, Russo A. Male breast cancer. Crit Rev Oncol Hematol. 2010;73:141-55.
https://doi.org/10.1016/j.critrevonc.2009.04.003
7. Ying MW, Agrawal A, Cheung KL. The other half of breast cancer: A review of male breast cancer. J Mens Health Gend. 2005;2:406-13.
https://doi.org/10.1016/j.jmhg.2005.10.012
8. Giordano SH. A review of the diagnosis and management of male breast cancer. Oncologist. 2005;10:471-9.
https://doi.org/10.1634/theoncologist.10-7-471
9. Onami S, Ozaki M, Mortimer JE, Kumar S. Male breast cancer: An update in diagnosis, treatment and molecular profiling. Maturitas. 2010;65:308-14.
https://doi.org/10.1016/j.maturitas.2010.01.012
10. Dally MB, Axibund J, Buys S, Crawford B, Farrel C, Friedman S, et al. J Natl Compr Canc Netw. 2010;8:562-94.
11. Wernberg JA, Yap J, Murekeyisoni C, Mashtare T, Wilding G, Kulkarni SA. Multiple primary tumors in men with breast cancer diagnoses -A SEER database review. J Surg Oncol. 2009;99:16-9.
https://doi.org/10.1002/jso.21153
12. Bravo M, Adrada A, Bolaños H. Cáncer mamario en el hombre. Presentación de caso y revisión de literatura. Revista Colom- biana de Cirugía. 2004;19:246-53.
13. Morrogh M, King TA. The significance of nipple discharge of the male breast. Breast J. 2009;15:632-8.
https://doi.org/10.1111/j.1524-4741.2009.00818.x
14. Chen L, Chantra P, Larsen L, Barton P, Rohitopakarn M, Zhu EQ, et al. Imaging characteristics of malignant lesions of the male breast. Radiographics. 2006;26:993-1006.
https://doi.org/10.1148/rg.264055116
15. Cooper R, Gunter B, Ramamurthy L. Mamography in men. Radiology. 1994;191:651-6.
https://doi.org/10.1148/radiology.191.3.8037795
16. Mathew J, Perkins GH, Stephens T, Middleton LP, Yang WT. Primary breast cancer in men: Clinical, imaging, and pathologic findings in 57 patients. AJR Am J Roentgenol. 2008;191:1631-9.
https://doi.org/10.2214/AJR.08.1076
17. Taber KA, Morisy LR, Osbhar AJ, Dickinson BD. Male breast cancer: Risks factors, diagnosis, and management. Oncol Rep. 2010;24:1115-20.
https://doi.org/10.3892/or_00000962
18. Korde LA, Zujewski JA, Kamin L, Giordano S, Domchehek S, Anderson WF, et al. Multidisciplinary meeting on male breast cancer: Summary and research recommendations. J Clin Oncol . 2010;28:2114-22.
https://doi.org/10.1200/JCO.2009.25.5729
19. Yang WT, Whitman GJ, Yuhen EH, Tse GM, Stelling C. So- nographic features of primary breast cancer in men. AJR Am J Roentgenol. 2001;176:413-6.
https://doi.org/10.2214/ajr.176.2.1760413
20. Binda MC, Pineda D, Bozo C, Vidal R, Alfonsín L. Cáncer de mama masculino. Un diagnostico a considerar. RAR. 2007;71:65-72.
21. Rosasco M, Centurion D, Carzoglio J. Cáncer de mama mas- culino en Uruguay. Comunicación de 16 casos y revisión de la literatura. Revista Española de Patología. 2004;37:253-61.
22. Morakkabati N, Schild H, Leutner C, Falkenhausen M, Lutter- bey G, Kuhl C. Dynamic control enhanced breast MR imaging in men: Preliminary results. Radiology. 2006;238:438-45.
https://doi.org/10.1148/radiol.2382041312
23. Burga A, Fadare O, Lininger RA, Tavassoli F. Invasive carcino- ma of the male breast : A morphologic study of the distribution of histologic subtypes and metastatic patterns in 778 cases. Virchows Arch. 2006;449:507-12.
https://doi.org/10.1007/s00428-006-0305-3
24. Ge V, Sneige N, Eltorky MA, Wang Z, Lin E, Gong Y, et al. Immunohistochemical characterization of subtypes of male breast carcinoma. British Cancer Research. 2009;11:R28.
https://doi.org/10.1186/bcr2258
25. Chappuis KW, Burger SB, Hurlimann J. Comparison of prog- nostic markers detected by immunohistochemistry in male and female breast carcinoma. Eur J Cancer. 1996;32A:1686-92.
https://doi.org/10.1016/0959-8049(96)00154-2
26. Cutuli B, Cohen SC, Kirova SY, Lemanski C, Lafontan B, Zoubir M, et al. Male breast cancer. Evolution of treatment and prognosis factors. Analysis of 489 cases. Crit Rev Oncol Hematol. 2010;73:246-54.
https://doi.org/10.1016/j.critrevonc.2009.04.002
27. Guinee VE, Shallenberger RC, Moller T, Olson H, Blink JW, Peter Z, et al.The prognosis of breast cancer in male. A report of 335 cases. Cancer. 1993;71:154-61.
https://doi.org/10.1002/1097-0142(19930101)71:1<154::AID-CNCR2820710125>3.0.CO;2-#
28. Hill AD, Borgen PL, Cody HS. Sentinel node biopsy in male breast cancer. Eur J Surg Oncol. 1999;25:442-3.
https://doi.org/10.1053/ejso.1999.0674
29. Flynn LW, Park J, Patil S, Cody H, Port ER. Sentinel lymph node biopsy is successful and accurate in male breast carcinoma. J Am Coll Surg. 2008;206:616-21.
https://doi.org/10.1016/j.jamcollsurg.2007.11.005
30. Lyman G, Giuliano AE, Somerfield MR, Benson AL, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology Guideline, recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol . 2005;23:7703-20.
https://doi.org/10.1200/JCO.2005.08.001
31. Gennari R, Curigliano G, Jereczec F. Male breast cancer: A special therapeutic problem. Anything new? Int J Oncol. 2004;24:663-70.
https://doi.org/10.3892/ijo.24.3.663
32. Cutuli B, Velten M, Dilhuydy JM. Male breast cancer: Results of the treatments and prognostic factors in 690 cases. Int J Radiat Oncol Biol Phys. 1998;42:2056.
https://doi.org/10.1016/S0360-3016(98)80363-5
33. Ribeiro G, Swindell R, Harris M, Banerjee S, Cramer A. A review of the management of the male breast carcinoma based on an analysis of 420 treated cases. Breast. 1996;5:141-6.
https://doi.org/10.1016/S0960-9776(96)90058-2
34. Hayes T. Pharmacologic treatment of male breast cancer. Expert Opin Pharmacother. 2009;10:2499-505.
https://doi.org/10.1517/14656560903200634
35. Ribeiro G, Swindell R. Adjuvant tamoxifen for male breast cancer. Brit J Cancer. 1992;65:252-4.
https://doi.org/10.1038/bjc.1992.50
36. Bagley CS, Wesley MN, Young RC, Lippman ME. Adjuvant chemotherapy in males with cancer of the breast. Am J Clin Oncol. 1987;10:55-60.
https://doi.org/10.1097/00000421-198702000-00013
37. Yildrim E, Berberoglu U. Male breast cancer: A 22 year expe- rience. Eur J Surg Oncol. 1998;24:548-52.
https://doi.org/10.1016/S0748-7983(98)93608-3
38. Giordano S, Perkins GH, Broglio K, García SG, Middleton LP, Buzdar A, et al. Adjuvant systemic therapy for male breast carcinoma. Cancer. 2005;104:2359-64.
https://doi.org/10.1002/cncr.21526
39. Masci G, Gandini C, Zuradelli M, Pedrazzoli P, Torrisi R, Lutman R, et al. Fulvestrant for advanced male breast cancer patients: A case series. Ann Oncol. 2011;22:985-93.
https://doi.org/10.1093/annonc/mdr005
40. Doyen J, Italiano A, Largillier R, Ferrero JM, Fontana X, Thyss A. Aromatase inhibition in male breast cancer patients: Biolo- gical, and clinical implications. Ann Oncol. 2010;21:1243-5.
https://doi.org/10.1093/annonc/mdp450
41. Czene K, Bergqvist J, Per H, Bergh J. How to treat male breast cancer. Breast. 2007;16:S147-54.
https://doi.org/10.1016/j.breast.2007.07.024
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2011-10-01
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Mesa, G.; Matute, G.; Estrada, M.; Ocampo, A.; Restrepo, C.; Estrada, J. Cáncer Mamario En Hombres. Rev Colomb Cir 2011, 26, 293-307.
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