ERKEK MEME KANSERİ CERRAHİ DENEYİMİMİZ

Amaç Erkek Meme Kanseri nadir görülen bir hastalıktır. İnsidansı son yıllarda artmakta, ancak sağkalım sonuçları iyileşmektedir. Prospektif randomize çalışmaların eksikliği nedeniyle, kadın meme kanseri kılavuzlarına göre tedavisi ve takibi yapılmaktadır. Ancak kendine özgü anatomi ve fizyolojisi nedeniyle hastalığın seyrinde farklılıklar olabileceği düşünülmektedir. Gereç ve Yöntem Süleyman Demirel Üniversitesi Tıp Fakültesi Cerrahi Onkoloji Kliniği’ nde Ocak 2011 – Ocak 2020 tarihleri arasında meme kanseri nedeniyle opere edilen erkek hastaların verileri retrospektif olarak değerlendirildi. Adenokarsinom dışındaki meme patolojileri çalışmaya dahil edilmedi. Bulgular Çalışmaya 7 hasta dahil edildi. Aynı süre içerisinde 847 kadın hasta görülürken, erkek hasta oranı % 0,8 idi. Tüm hastalara total mastektomi ile birlikte level 1, 2, 3 aksiller diseksiyon yapıldı. Patoloji sonuçları değerlendirildiğinde; 1 (% 14,2) hastada evre 1, 2 (% 28,5) hastada evre 2, 3 (% 42,8) hastada evre 3, 1 (% 14,2) hastada evre 4 hastalık olduğu görüldü. Genel sağkalım ortanca değeri 48 ay (min: 35 - max: 53 ) olarak saptandı. Sonuç Erkek meme kanserinin aynı evredeki hastalarda prognozunun kadın meme kanserinden daha kötü olmadığı gösterilmiştir. Ancak geç tanı, tedaviye uyumsuzluk ve standardizasyon problemleri nedeniyle pratikte daha kötü prognoz söz konusudur. Erkek meme kanseri konusunda farkındalığın artırılması ve yapılacak geniş çaplı prospektif randomize çalışmalar neticesinde tedavinin erkek meme kanserine özgü, standardize edilmesi ile daha iyi sonuçlara ulaşılabileceğini düşünüyoruz.

Anahtar Kelimeler:

erkek meme kanseri, , mastektomi, meme kanseri

OUR MALE BREAST CANCER SURGERY EXPERIENCE

Objective Male breast cancer is a rare disease. Its incidence has increased in recent years, but survival outcomes are improving. Due to the lack of prospective randomized trials, it is treated and followed up according to female breast cancer guidelines. However, it is thought that there may be differences in the course of the disease due to its unique anatomy and physiology. Materials and Methods The data of male patients who were operated for breast cancer in Süleyman Demirel University Medical Faculty Surgical Oncology Clinic between January 2011 and January 2020 were evaluated retrospectively. Breast pathologies other than adenocarcinoma were not included in the study. Results Seven patients were included in the study. During the same period, 847 female patients were seen, while the rate of male patients was % 0,8. Level 1, 2, 3 axillary dissection was performed in all patients along with total mastectomy. When the pathology results were evaluated, it was seen that 1 (14,2 %) patient had stage 1, 2 (28,5 %) patient stage 2, 3 (42,8 %) patient stage 3, 1 (14,2 %) patient stage 4 disease. The median overall survival was 48 months (min: 35 - max: 53). Conclusion It has been shown that the prognosis of male breast cancer in patients at the same stage is not worse than female breast cancer. However, in practice, the prognosis is worse due to late diagnosis, noncompliance with treatment and standardization problems. We believe that better results can be achieved by raising awareness about male breast cancer and standardizing treatment specific to male breast cancer as a result of large - scale prospective randomized trials.

Keywords:

breast cancer, , male breast cancer, mastectomy,

PDF

___

[1] Romics L., O'Brien M. E., Relihan N., O'Connell F., Redmond H. P. (2009). Intracystic papillary carcinoma in a male as a rare presentation of breast cancer: a case report and literature review. Journal of Medical Case Reports, 3(1), 13.
[2] Korde L. A., Zujewski J. A., Kamin L., Giordano S., Domchek S., Anderson W. F., et all (2010). Multidisciplinary meeting on male breast cancer: summary and research recommendations. Journal of Clinical Oncology, 28(12), 2114.
[3] Anderson W. F., Jatoi I., Tse J., Rosenberg P. S. (2010). Male breast cancer: a population-based comparison with female breast cancer. Journal of Clinical Oncology, 28(2), 232.
[4] Leon - Ferre R. A., Giridhar K. V., Hieken T. J., Mutter R. W., Couch F. J., Jimenez R. E. et all (2018). A contemporary review of male breast cancer: current evidence and unanswered questions. Cancer and Metastasis Reviews, 37(4), 599-614.
[5] Salehi A., Zeraati H., Mohammad K., Mahmoudi M., Talei A. R., Ghaderi A., et all (2011). Survival of male breast cancer in Fars, South of Iran. Iranian Red Crescent Medical Journal, 13(2), 99.
[6] Auvinen A., Curtis R. E., Ron E. (2002). Risk of subsequent cancer following breast cancer in men. Journal of the National Cancer Institute, 94(17), 1330-1332.
[7] Dong C., Hemminki K. (2001). Second primary breast cancer in men. Breast cancer research and treatment, 66(2), 171.
[8] Baojiang L., Tingting L., Gang L., Li Z. (2012). Male breast cancer: A retrospective study comparing survival with female breast cancer. Oncology letters, 4(4), 642-646.
[9] Metin Y., Aydın İ., Mikdat B. (2016). Male Breast Cancer. J Breast Health, 12, 1-8.
[10] Nahleh Z. A., Srikantiah R., Safa M., Jazieh A. R., Muhleman A., Komrokji R. (2007). Male breast cancer in the veterans affairs population: a comparative analysis. Cancer: Interdisciplinary International Journal of the American Cancer Society, 109(8), 1471-1477.
[11] Gnerlich J. L., Deshpande A. D., Jeffe D. B., Seelam S., Kimbuend, E., Margenthaler J. A. (2011). Poorer survival outcomes for male breast cancer compared with female breast cancer may be attributable to in - stage migration. Annals of surgical oncology, 18(7), 1837-1844.
[12] Foerster R., Foerster F. G., Wulff V., Schubotz B., Baaske D., Wolfgarten M., Rudlowski C. (2011). Matched-pair analysis of patients with female and male breast cancer: a comparative analysis. BMC cancer, 11(1), 335.
[13] Borgen P. I., Senie R. T., McKinnon W. M., & Rosen P. P. (1997). Carcinoma of the male breast: analysis of prognosis compared with matched female patients. Annals of surgical oncology, 4(5), 385-388.
[14] Oger A. S., Boukerrou M., Cutuli B., Campion L., Rousseau E., Bussières E., et all. (2015). Male breast cancer: prognostic factors, diagnosis and treatment: a multi-institutional survey of 95 cases. Gynecologie, obstetrique & fertilite, 43(4), 290-296.
[15] Zongo N., Ouédraogo S., Korsaga - Somé N., Somé O. R., Naïma G. O., Ouangré E., et all. (2018). Male breast cancer: diagnosis stages, treatment and survival in a country with limited resources (Burkina Faso). World journal of surgical oncology, 16(1), 4.
[16] Bourhafour M., Belbaraka R., Souadka A., M'rabti H., Tijami F., Errihani H. (2011). Male breast cancer: a report of 127 cases at a Moroccan institution. BMC research notes, 4(1), 219.
[17] Al Awayshih M. M., Nofal M. N., Yousef A. J. (2019). Modified Radical Mastectomy for Male Breast Cancer. The American journal of case reports, 20, 1336.
[18] Nguyen T., Cowher M. (2012, May). Demand for breast-conserving surgery among male breast cancer patients. In Annals of surgical oncology (Vol. 19, pp. 91-92). 233 Spring St, New York, NY 10013 USA: Springer.
[19] Parker P. A., Youssef A., Walker S., Basen - Engquist K., Cohen L., Gritz E. R., et all. (2007). Short-term and long-term psychosocial adjustment and quality of life in women undergoing different surgical procedures for breast cancer. Annals of surgical oncology, 14(11), 3078-3089.
[20] Nordman I. C., Dalley D. N. (2008). Breast Cancer in Men—Should Aromatase Inhibitors Become First‐Line Hormonal Treatment?. The breast journal, 14(6), 562-569.
[21] Mauras N., Hayes V. Y., Klein K. O. (1999). Estrogen suppression in males: metabolic effects. Pediatric Research, 45(7), 94-94.
[22] Pemmaraju N., Munsell M. F., Hortobagyi G. N., Giordano S. H. (2012). Retrospective review of male breast cancer patients: analysis of tamoxifen-related side-effects. Annals of oncology, 23(6), 1471-1474.
[23] Moredo Anelli T. F., Anelli A., Tran K. N., Lebwohl D. E., Borgen P. I. (1994). Tamoxifen adminstration is associated with a high rate of treatment‐limiting symptoms in male breast cancer patients. Cancer, 74(1), 74-77.
[24] Fentiman I. S. (2018). Surgical options for male breast cancer. Breast cancer research and treatment, 172(3), 539-544.
[25] Xu S., Yang Y., Tao W., Song Y., Chen Y., Ren Y., et all. (2012). Tamoxifen adherence and its relationship to mortality in 116 men with breast cancer. Breast cancer research and treatment, 136(2), 495-502.
[26] Cloyd J. M., Hernandez - Boussard T., Wapnir I. L. (2013). Outcomes of partial mastectomy in male breast cancer patients: analysis of SEER, 1983–2009. Annals of surgical oncology, 20(5), 1545-1550.
[27] Jardel P., Vignot S., Cutuli B., Creisson A., Vass S., Barranger E., et all. (2018). Should adjuvant radiation therapy be systematically proposed for male breast cancer? A systematic review. Anticancer research, 38(1), 23-31.
[28] Cardoso F., Bartlett J. M. S., Slaets L., Van Deurzen C. H. M., van Leeuwen - Stok E., Porter P., et all. (2018). Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Annals of oncology, 29(2), 405-417.
[29] Ruddy K. J., Winer E. P. (2013). Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship. Annals of oncology, 24(6), 1434-1443.