Breast carcinoma in men is very rare but is a potentially life-threatening neoplasm. The most common form of clinical presentation is a painless, firm, retroareolar mass. However, in some cases, primary focus of the tumor may not be detected but present with metastatic lesions. We report a case of male breast carcinoma presented with axillary lymph node enlargement and subsequent erythematous infiltration of chest wall in a 60-year-old man. Histopathologic examination showed invasive ductal carcinoma of breast, and both estrogen and progesterone receptors were weakly positive.
Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Estrogens ; Humans ; Lymph Nodes* ; Male ; Male* ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; Neoplasm Metastasis* ; Receptors, Progesterone ; Skin* ; Thoracic Wall

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Male breast cancer is a rare type of neoplasm, account for 1 % of all breast tumors. A retrospective review of the clinical and histological characteristics, types of treatment, pathological staging, and adjuvant treatment was completed. The objective of this study was to make an early diagnosis of male breast cancer and reduce the mortality. METHODS: Over a 5-year period, from Oct. 1994 to July 2000, 10 male breast cancer patients were operated on in the breast cancer clinic of the Samsung Medical Center. Their duration of follow up ranged from 6 to 76 months with a mean of 26 months. The clinical and histological characteristics, associations of the risk factors, type of treatment, and results were studied. RESULTS: Their ages ranged from 40 to 67 years with a mean of 51 years, with 5, 3 and 2 cases in their 5th, 6th, and 7th decades, respectively. A palpable breast lump was the most common presenting symptom. A pathological assessment disclosed 8 infiltrating ductal carcinoma, 1 ductal carcinoma in situ, and 1 invasive adenoid cystic carcinoma. The tumor sizes ranged from 0.5 to 3.7 cm (median, 1.9 cm in diameter). Of the 10 patients, there were 3 T1b, 3 T1c, and 4 T2 in the tumor staging. 4 Patients had axillary node involvement (lymph node positivity, 40%), and of these 4, the metastasis involved 2 lymph nodes and more than 3 lymph nodes in 1 and 3 case, respectively. No distant metastasis was observed in any of the patients. Pathological stages of the patients 0, I, IIIA, and IIIB in 1, 5, 1 and 2 cases, respectively. All the patients underwent surgery, 7 with a modified radical mastectomy and 3 with a radical mastectomy, due to gross invasion of the pectoralis major muscle. CONCLUSION: A subareolar palpable breast mass was the most common presenting symptom of the male breast cancer patients. The optimal treatment for male breast cancer patients is a modified radical mastectomy, combined with radiotherapy, chemotherapy, and hormonal therapy, due to the higher hormone receptors positivity.
Breast Neoplasms ; Breast Neoplasms, Male ; Breast* ; Carcinoma, Adenoid Cystic ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Drug Therapy ; Early Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male* ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mortality ; Neoplasm Metastasis ; Neoplasm Staging ; Radiotherapy ; Retrospective Studies ; Risk Factors

The most frequent primary site of metastatic tumors to the choroid is the breast in women and the bronchus in men. Invasive ductal carcinoma is the most common malignant tumor in breast, and it appears bilateral involvement, distant or adjacent lymph node metastasis. Metastatic tumors are more likely to occur multifocally in both eyes and have a definite predilection for the posterior segment and are most commonly located in the macular area. The patient with a metastatic tumor to the choroid may be asymptomatic or may experience painless blurred vision if the small mass or exudative retinal detachment involve the macula. In general, although the prognosis of the metastatic choroidal tumor for vision is usually good, the prognosis for life is poor. We experienced a case of choroidal metastasis with rib metastasis which had been treated with radical mastectomy and chemotherapy 2 years ago, because of multicentric and multifocal invasive ductal carcinoma of left breast. The patient had improvement of visual acuity and diminution of tumor size and extent of retinal detachment by radiotherapy.
Breast Neoplasms ; Breast* ; Bronchi ; Carcinoma, Ductal* ; Choroid* ; Drug Therapy ; Female ; Humans ; Lymph Nodes ; Male ; Mastectomy, Radical ; Neoplasm Metastasis* ; Prognosis ; Radiotherapy ; Retinal Detachment ; Ribs ; Visual Acuity

PURPOSE: Reclassfication of the medullary carcinoma using a strict histologic criteria and analysis of the clinical and pathological characteristics of the medullary carcinoma. MATERIAL & METHODS: Thirty-seven cases of the breast carcinoma originally diagnosed as medullary carcinoma were reviewed. One to ten microscopic slides of each case were reexamined and reclassified using the strictly defined histologic criteria defined by Ridolfi et al. Tumors were excluded from the category of the typical medullary carcinoma (TMC) on the basis of presence of glandular features, focal marginal infiltrations, or sparse mononuclear infiltrations. Tumor with two or more atypical features, or extensive marginal infiltrations, no mononuclear cell infiltration and/or less than 75% syncytial growth were classified as infiltrating ductal carcinoma with medullary feature (IDC). A predominantly syncytial growth pattern (75% or more) was requisite for inclusion in both TMC and atypical medullary carcinomas (AMC). RESULTS: Twenty-two tumors (60%) fulfilled the criteria for TMC, and 12 tumors (32%) were AMC and three tumors (8%) were IDC. TMC occupied 3.1% of breast cancer. The mean age of patients with TMC was 45.4+/-11.2 years and the average size of the tumor in TMC was slightly larger than that of breast cancer in general, although not statistically significant. The frequency of lymph node metastasis in TMC was similar to breast cancer in general. Five year survival of patients with TMC was 95.5% which was significantly better than breast cancer in general. CONCLUSION: The TMC occupied 3.1% of breast cancer. The mean age of patient, tumor size and lymphnode metastasis were not different from that of breast cancer but 5 years survival of patient with TMC was significantly better than breast cancer in general.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Medullary* ; Humans ; Lymph Nodes ; Neoplasm Metastasis

BACKGROUND: The purpose of this study is to determine the value of CD44 and its splice variants as markers for the metastatic potential of infiltrating ductal carcinomas of the breast. METHODS: Tissue samples of infiltrating ductal carcinoma of the breast were examined for the expression of standard CD44 (CD44H) and s CD44 isoforms, v3, v4-5 and v6 in 41 node-positive and 31 node-negative cases. The immunohistochemistry results were correlated with other clinicopathologic parameters, and these results were correlated with accompanying high grade and non-high grade DCIS areas of the tumors in both node-positive and node-negative cases. RESULTS: The expression of CD44 in the invasive tumor areas and in the metastatic foci of the lymph nodes showed a statistically significant correlation. The expression of CD44H in the invasive tumor areas and the DCIS area showed a statistically significant correlation in the lymph node (-) group. There was statistical significance between the CD44 H and CD44v3 expressions and the histologic grade of the invasive tumor in the cases with positive lymph nodes. There was no statistical significance between CD44 expression and lymph node metastasis, tumor size and type of tumor margin. CONCLUSIONS: We conclude that changes in the CD44 expression in breast cancer occur early in breast carcinogenesis, and this is involved in tumor differentiation, but we could not establish any correlation between the expression of the CD44 variant isoforms and the metastasis of breast cancer.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Protein Isoforms

PURPOSE: To analyze the differences in mammographic and pathologic findings between palpable and non-palpable breast carcinoma. MATERIALS AND METHODS: Among 362 patients with surgically proven breast carcinoma, 317, whose chief com-plaint during preoperative evaluation was a palpable mass, Comprised group I, and 45 with no masses com-prised group II. We compared mammographic and pathologic findings between the two groups. RESULTS: As regards the pattern of mammographic presentation, mass alone accounted for 51.4 % of group I and 33.3 % of group II, while calcification alone was seen in 7.6 % of group I and 24.4 % of group II(p<0.05). In group I, 48.6 % of masses were of irregular shape, and in group II, 46.2 % were round. According to ACR-BIRADS, 47.6 % of group I was classified as category 5, and 51.1 % of group II as category 4 (p<0.05). On the other hand, the margin of the mass showed no statistical difference. Among the 362 patients, the mean age of group I was 48.1(range, 28 -79) years, while that of group II was 51. 7(range, 30 -73) years (p<0.05). Histologically, infiltrative ductal carcinoma was seen in 84.9% of group I, and DCIS in 8.5%, while for group II the respective figures were 62.2% and 28.9 % (p<0.05). For group I, mean lesional size was 3.01cm, with 4 7 .9 % lymph node metastasis in the axilla, while for group II the corresponding figures were 1.93 c m ( p < 0 . 0 5 ) and 28.2%(p<0.05). Differences were statistically significant. Under the TMN system, 30% of group I were at stage II, while 35.6 % of group II were at stage I (p<0.05). CONCLUSION: Palpable and non-palpable cancers showed statistically significant differences in mammographic findings such as mass shape and category, but not in the margin of the mass. There were also statistically sig-nificant differences with regard to age, histology, lesion size, axillary lymph node metastasis, and staging.
Axilla ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Hand ; Humans ; Lymph Nodes ; Neoplasm Metastasis

PURPOSE: Cox-2 expression in breast carcinoma has been reported to be related to angiogenesis, lymph node metastasis and Her-2 expression. The aim of this study is to evaluate the clinicopathologic significance of Cox-2 expression in the invasive ductal carcinomas (IDC) and intraductal carcinomas (DCIS) of the breast. METHODS: The materials were 353 IDC cases and 82 DCIS cases. Immunohistochemical stain for Cox-2 was interpreted as 1+ (weak & focal) and 2+ (diffuse), and the relationships between Cox-2 and ER, PR, Her-2, p53, Ki-67 and bcl-2 expressions were analyzed. RESULTS: There was no significant difference of Cox-2 expression between IDC (148/353, 41.9%) and DCIS (38/82, 46.3%). Cox-2 (2+) expression was more frequent in low grade than intermediate and high grade IDC, but the difference was not significant statistically (P=0.0833), and there were no significant differences of Cox-2 expression according to age, tumor size, nuclear grade, lymph node metastasis in IDC and DCIS cases. In IDC cases, Cox-2 (1+ and 2+) expression showed positive relationships with p53 (+) and more than 10% of Ki-67 labeling index (P=0.0029, P=0.0015), and revealed tendencies of positive relationships with ER (+) and bcl-2 (+) (P=0.0750, P=0.0776). However, no significant relationship between Cox-2 and Her-2 expressions was recognized. In DCIS cases, Cox-2 (2+) expression rate was increased in cases showing negative for Her-2 (P=0.0092) and positive for bcl-2 (P=0.0486). CONCLUSION: Cox-2 expression seems to be involved in the development of breast carcinomas, but not related to the invasiveness. Cox-2 expression, especially 2+, in the DCIS cases suggest a possibility of less aggressive biological behavior.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Lymph Nodes ; Neoplasm Metastasis

Pancreatic metastases from primary breast cancer are very rare. We report a case of pancreatic metastasis from invasive ductal carcinoma 13 years after the initial diagnosis of breast cancer. When the pancreatic mass was discovered, it was believed to be a primary pancreatic cancer due to the long interval from the initial diagnosis of breast cancer to metastasis. However, it was confirmed as metastatic breast cancer based on the pathology after surgical removal. Follow-up imaging has shown no recurrence.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Diagnosis ; Follow-Up Studies ; Neoplasm Metastasis* ; Pancreatic Neoplasms ; Pathology ; Recurrence