Search

Purpose: 1% of all breast cancer cases occur in men. There are significant differences regarding clinical behaviour and genetic profiles between female (FBC) and male breast cancer (MBC). Parameters for decision-making on treatment and prognosis are derived from FBC. Ki67 has a high value as a prognostic and predictive factor in FBC, but accurate Ki67 cut-off points for MBC are missing. In this study, we aimed to evaluate adequate examination methods and reliable cut-off points for Ki67 to assess the highest prognostic value for patient's overall survival (OS)., Methods: In this multicentric retrospective study, histological specimens were obtained from 104 male patients who were diagnosed and treated for primary invasive breast cancer. We applied three methods of Ki67 analysis: Tumor average scoring (TA), tumor border scoring (TB) and hot-spot scoring (HS). Calculated Ki67 cut-off points for each method were assessed as a threshold for patients' overall survival (OS)., Results: Ki67 cut-off points were 13.5 for the TA group, 22.5 for the HS group and 17.5 for the TB group. Only Ki67 TA cut-off calculations demonstrated statistical significance (p = 0.04). Ki67 expression analysis of TA showed that more than 90% of patients with low Ki67 levels (< 13.5) were alive after 5-year follow-up., Conclusion: Our findings demonstrate that determination of Ki67 expression in TA is the most reliable to define a cut-off point with high prognostic value. A Ki67 cut-off point of 13.5 shows highest statistical power to define luminal A subgroup and OS., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Breast plasmacytoma (BP) is extremely rare. The published data on this manifestation include predominantly case reports and do not provide any statistical information., Purpose: To identify clinical signs and radiological features of BP., Material and Methods: Five patients with BP were retrospectively identified in the pathological and radiological databases of the years 1997-2009 at our institution. Additionally, 48 patients were collected from the literature in the period from 1988 to date. Therefore, our study involves 53 patients., Results: The prevalence of BP in our institution was 1.5% of all identified cases with plasmacytoma and 0.2% of the cases with breast cancer. In 8 of 53 patients (15%), primary BP was diagnosed, and in 45 patients (85%) involvement of the breast was a secondary event of the multiple myeloma (MM). Clinically, 83% of the patients presented with breast lumps. BP was diagnosed incidentally in 9%. In 8% of the cases clinical signs were not reported. On mammography, intramammary round or oval masses were most commonly found (89%). They were solitary in 66% of the cases and multiple in 34%. Median size was 21 mm, ranging from 8 to 90 mm. In 9% of the identified cases BP manifested as diffuse infiltration of the breast. In 2% no abnormalities were identified on mammography. On ultrasound, identified lesions were homogeneously echo-poor or hypoechoic, less frequently mixed hypo- to hyperechoic. Treatment of BP is the same as for other localizations of plasmacytoma and is based on chemotherapy and/or radiotherapy. Primary BP had a better prognosis than breast involvement as a secondary event in MM., Conclusion: In conclusion, BP does not have specific radiological or clinical features and can be misdiagnosed as primary breast carcinoma or even as a benign process. However, BP should be considered in the differential diagnosis of breast disorders, especially in patients with MM.

Gynaecomastia, the enlargement of the male breast, is considered as an andrological disease. To date, a review on male breast cancer (MBC) has not been published in an andrological journal. The papers underlying this review were published from authors of different institutions: Clinical Genetics, Dermatology, Gynaecology, Internal Medicine, Oncology, Pathology, Psychiatry, Radiology and Surgery. MBC accounts for approximately 1% of breast cancer patients. A total of 182 men died of breast cancer in 1999, in Germany. In the US, 1500 new cases per year occur. MBC accounts for <5% of surgically removed breast lumps. Diseases with increased oestrogen action increase the risk of MBC. Mutations of distinct genes are estimated to account for up to roughly 10% of MBC. BRCA1 and BRCA2 gene mutations are responsible for approximately 80% of the families with hereditary breast cancer. The diagnosis of MBC is not possible without histological examination. Different diagnostic procedures such as clinical diagnosis, sonography, mammography, fine-needle biopsy and core needle facilitate the decision whether a biopsy is necessary.

Germline mutations in the BRCA1 and BRCA2 gene account for the majority of high-risk breast/ovarian cancer families. We have screened such families from Northern Germany by using DHPLC analysis and subsequent direct sequencing techniques. In ten families we identified six novel BRCA1 and 4 novel BRCA2 mutations comprising four frame shift mutations, one nonsense and one splice site mutation in the BRCA1 gene as well as three frameshift mutations and one nonsense mutation in the BRCA2 gene. Our analysis contributes to the further characterisation of the mutational spectrum of BRCA1 and BRCA2., (Copyright 2000 Wiley-Liss, Inc.)