كاتب الموضوع :
dr khalid
المنتدى :
المنتدى الطبي - Medical Forum
CARCINOMA MALE BREAST
Introduction
Accounts for 1% of all breast carcinomas-
Similar to breast cancer in females when considering etiology, family history, staging, and treatment
30% positive family history (BRCA2 gene)
Five-year survival rates range from 30-85%
More advanced disease state is found more commonly than in women
delayed detection-
Small breast size allowing for earlier chest wall and skin invasion-
Age: median age at diagnosis is 65 years
Majority are ductal CA
Risk factors
Klinefelter syndrome-
Estrogen-containing creams-
Previous gonadal injury-
Radiation-
Clinical features
Typical presentation with a painless retroareolar mass, usually hard irregular-
Early fixity and skin involvement is a feature
Gynecomastia, the chief entity in the differential, presents as smooth disk centered immediately behind the nipple
Investigations
Mammography with a sensitivity and specificity of 90%.
U/S - hypoechoic mass with irregular, ill-defined margins
fine-needle aspiration and/or True cut biopsy
Investigations to look for metastasis
Management
Classify as early/operable, locally advanced, and metastatic
Early carcinoma male breast: Modified radical mastectomy / or the classical radical mastectomy with postop radiotherapy to the chest wall.
if node-positive - chemotherapy plus hormonal therapy
In case of advanced disease or Distant Metastases, then treat with Hormonal therapy, chemotherapy, or a combination of both
Hormonal modalities
Orchiectom-
LHRH agonist +/- antiandrogen-
Tamoxifen-
Progesterone-
Aromatase inhibitors e.g anastrazol-
hemotherapy options
CMF: cyclophosphamide plus methotrexate plus fluorouracil-
CAF: cyclophosphamide plus adriamycin plus fluorouracil-
Others-
Prognosis
Some studies (Heller and colleagues series) document survival figures comparable to that of female breast CA with a 5-year survival rate of 76% overall
Others (Crichlow's collective series) reported poorer prognosis, with an overall 5-year survival rate of 49%
Because it usually has infiltrated the pectoral muscles and chest wall at time of presentation
Prepared by:
Science Club Young Doctors
Supervised by:
Dr.M Ezzedien
ASSIST. PROFESSOR OF SURGERY
CONSULTANT OF SURGERY
التعديل الأخير تم بواسطة سمر فنّان ; 08-09-08 الساعة 01:18 PM
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08-09-08, 01:11 PM
جديد مواضيع قسم المنتدى الطبي - Medical Forum
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