MULTIFOCAL BILATERAL METACHRONOUS BREAST CANCER IN MAN. CLINICAL CASE

Multifocal malignant tumors (MMT) represent a comprehensive and multifaceted problem of clinical oncology.

Today, as far as observations are accumulated, there are attempts to determine a real incidence rate of multifocal tumors. Research of MMT problem becomes more and more actual and significant in oncology. Several dozen thousands of MMT observations have been described all over the world for the recent 30 years. There is a stable trend towards the increase of the number of patients with such pathology. This is primarily concerned with the improvement of diagnostics, medical treatment and increased expectation of life.

The increase in incidence of MMT is due to such factors as increased average expectation of life, increased intensity of carcinogenic effects, urbanization, accumulation of hereditary loading and improved diagnostics of oncologic diseases. Detection and record of such pathology are based first on detection of simultaneous tumors, second – on diagnostics of tumor and retrospective determination according to life record data of the first neoplasm, third – on determination of further tumor at regular follow-up, which requires prolonged and high quality examination of the patients.

MMT most commonly develop in patients elder than 50 y. o., even in elder age in men than in women. The article describes a case of bilateral breast cancer in man. Clinicopathologic and immunohistochemical characteristics of the tumor were studied, the genetic polymorphisms were investigated by the method of polymerase chain reaction, associated with the risk of breast cancer development, genetic analysis of BRCA1 and BRCA2, blood cancer markers was done. Full equivalence of clinicopathologic and biological properties of tumor of the right and left mammae, witnessing the common etiology and pathogenesis of neoplastic process, was established. Each case of bilateral breast cancer in men shall be studied with particular care and referred in international medical literature for analysis of pathogenesis of such disease.

1. Tischkowitz M.D., Hodgson S.V., Fentiman I.S. Male breast cancer: аetiology, genetics and clinical management. Int J Clin Pract 2002;56(10):750–4.

2. Levi F., Lucchini F., Vecchia C.L. Epidemiology of male breast cancer. Eur J Cancer Prev 2002;11(4):315–8.

3. Weiss J.R., Moysich K.B., Swede H. Epidemiology of male breast cancer. Cancer Epidemiol Biomarkers Prev 2005;14(1):20–6.

4. Cutuli B. Strategies in treating male breast cancer. Expert Opin Pharmacother 2007;8(2):193–202.

5. Lambley J., Maguire E., Yin Lam K. Synchronous bilateral breast cancer in an elderly man. Breast J 2005;11(2):153.

6. Forloni F., Giovilli M., Pecis C. еt аl. Pituitary prolactin-secreting macroadenoma combined with bilateral breast cancer in a 45-year-old male. J Endocrinol Invеst 2001;24(6):454–9.

7. Volm M.D., Talamonti M.S., Thangavelu M., Gradisher W.K. Pituitary adenoma and bilateral male breast cancer: an unusual association. J Surg Oncol 1997;64(1):74–8.

8. Olsson H., Alm P., Kristoffersson U., Landin-Olsson M. Hypophyseal tumor and gynecomastia preceding bilateral breast cancer development in a man. Cancer 1984;53(9): 1974–7.

9. Напалков Н.П., Бохман Я.В., Семиглазов В.Ф. Первично-множествен- ные злокачественные опухоли. Л., 1987. 168 с. [Napalkov N.P., Bokhman Yа.V., Semiglazov V.F. Multifocal malignant tumors. Leningrad, 1987. 168 р. (In Russ.)].

10. Giordano S.H. A review of the diagnosis and management of male breast cancer. Oncologist 2005;10(7):471–9.

11. DeVita V.T., Lawrence T.S., Rosenberg S.A. Cancer: principles and practice of oncology. 8th ed. Philadelphia: Lippincott Williams and Wilkins, 2008. Pp. 1643–4.

12. Giordano S.H., Hortobagyi G.N. Leuprolide acetate plus aromatase inhibition for male breast cancer. J Clin Oncol 2006;24(21):42–3.

13. Nahleh Z.A. Hormonal therapy for male breast cancer: A different approach for a different disease. Cancer Treat Rev 2006;32(2):101–5.

14. Olsson H. Estrogen receptor content in malignant breast tumors in men – a review. J Mammary Gland Biol Neoplasia 2000;5(3):283–7.

15. Zabolotny B.P., Zalai C.V., Meterissian S.H. Successful use of letrozole in male breast cancer: a case report and review of hormonal therapy for male breast cancer. J Surg Oncol 2005;90(1):26–30.

16. Шкурников М.Ю., Нечаев И.Н., Хаустова Н.А. и др. Экспрессионный про- филь воспалительной формы рака молочной железы. Бюллетень эксперименталь- ной биологии и медицины 2013;155(5): 619–24. [Shkurnikov М.Yu., Nechaev I.N., Khaustova N.A. et al. Expression profile of inflammatory breast cancer. Bulleten’ eksperimental’noy biologii i meditsiny = Bulletin of Experimental Biology and Medicine 2013;155(5):619–24. (In Russ.)].

17. Narod S.A., Offit K. Prevention and management of hereditary breast cancer. J Clin Oncol 2005;23(8):1656–63.

18. Swerdlow A.J., Schoemaker M.J., Higgins C.D. еt аl. Cancer incidence and mortality in men with Klinefelter syndrome: а сohort study. J Natl Cancer Inst 2005;97(16):1204–10.

19. Maltseva D.V., Khaustova N.A., Fedotov N.N. et al. High-throughput identification of reference genes for research and clinical Rt-qPCR analysis of breast cancer samples. J Clin Bioinforma 2013;3(1):13.

20. Злокачественные заболевания в России в 2011 году (заболеваемость и смертность). Под ред. В.И. Чиссова, В.В. Старинского, Г.В. Петровой. М., 2013. С. 32–40. [Malignant diseases in Russia in 2011 (incidence and morbidity). Ed. by V.I. Chissov, V.V. Starinsky, G.V. Petrova. M., 2013. Pp. 32–40. (In Russ.)].