male breast cancer
Introduction
Introduction to male breast cancer Male breast cancer (malemammarycancer) is a rare malignant tumor, accounting for 0.2% to 1.5% of all male cancer, accounting for about 1% of breast cancer. It is precisely because of the misunderstanding that men do not have breast cancer often leads to people losing their vigilance until they find breast cancer in the late stage of male breast cancer, thus missing the best treatment opportunity. In theory, breast cancer occurs due to the appearance of malignant tumor tissue in the breast cells. Men also have breast tissue, so they can also cause breast cancer. It is only because of differences in physiological structure that women are much more likely to develop breast cancer than men. basic knowledge The proportion of illness: 0.002% Susceptible people: seen in men Mode of infection: non-infectious Complications: breast lumps nipple discharge
Cause
Male breast cancer cause
Causes
The cause of breast cancer in men is not well understood and is currently considered to be related to the following factors.
Increased endogenous estrogen (35%):
Compared with female breast cancer, male breasts have no physiological activity and lack excessive stimulation of ovarian hormones, but the incidence of male breast development, endocrine abnormalities and liver damage, etc., Lacassegne confirmed (1932), repeated injection of estrogen into male mice It can induce breast cancer. When the liver is damaged, the liver's inactivation of estrogen is reduced, resulting in relatively excessive estrogen in the body. Male mammary gland development is increased. Some people think that male mammary gland development is a precancerous disease, which may lead to breast cancer. .
Sex chromosome abnormalities (27%):
In addition, studies have shown that some of the diseased patients have small testicles, fibrosis and vitreous changes, urinary pituitary gonadotropin increase and sex chromosome abnormalities called Klinefelter syndrome. In this case, the incidence of breast cancer The rate is 20 times higher than normal men.
Other (25%):
In domestic and international reports on male breast cancer, a considerable proportion of the family, or a family history of female breast cancer, or other cases of family cancer, suggest that male breast cancer has a certain familial. Contact with radioactive materials, local damage to the breast, and estrogen in clinical treatment can also induce breast cancer.
Pathogenesis
1. The location of the disease:
Male breast cancer occurs mostly in the central region of the breast below the nipple areola, mainly unilateral, the left side is slightly more common than the right side, and both sides of the disease at the same time or successively onset are rare.
2. Pathological morphology:
(1) Gross shape: The naked eye sees a deep lumps, the border is unclear, hard and painless, and the average diameter is 3.1 cm. It can adhere to the skin as the mass progresses, often with nodular bulges, forming ulcers, but also deep Diffusion and adhesion to the chest muscles.
(2) Histomorphology: The pathological histological type of male breast cancer under light microscope is basically the same as that of female breast cancer, which is more common in non-specific invasive cancer, accounting for 82%-86.5%; invasive cancer can be divided into adenocarcinoma, hard cancer Simple cancer, medullary carcinoma, papillary carcinoma, mucinous carcinoma, apocrine adenocarcinoma, etc. Many people believe that normal male breast cancer lacks lobular tissue, so lobular carcinoma does not occur, but lobular carcinoma has also been reported in recent years.
The source of cells in male breast cancer is still in dispute. It is worth mentioning that the detection of estrogen receptor (ER) and carcinoembryonic antigen (CEA) in cancer tissues by immunoenzyme technology is of great significance for guiding treatment and monitoring the recurrence of breast cancer. Male breast cancer can be divided into hormone-dependent and non-hormone-dependent as well as female breast cancer. It has been found that when males use estrogen to treat certain diseases, the breast can form true leaflets, and their structure and sex. Mature women have the same breasts.
Prevention
Male breast cancer prevention
1, usually pay attention to keep the breasts clean and hygienic, develop a good habit of breast self-examination.
2. Keep an eye out for changes in your breasts. If local pain and tenderness occur, and a painless mass with unclear borders is found, the nipple is inwardly recessed, or there is secretion, you should go to the hospital for consultation and examination immediately.
3, compared with women, men prefer to take nourishing nutrients, and most tonics contain hormones, should be carefully selected.
Complication
Male breast cancer complications Complications breast nipple discharge
1. Breast lumps: is the most common manifestation of breast cancer.
2. Nipple discharge: mostly benign changes, but for those over 50 years old, unilateral nipple discharge should be alert to the possibility of breast cancer; nipple depression; nipple itching, scaling, erosion, ulcers, scarring and other eczema-like Change the clinical manifestations of often Paget's disease.
3. Changes in the skin and contour of the breast: Cooper ligaments invading the skin can form a dimple sign; tumor cells block the edema of the subcutaneous hair, while the follicles are depressed to form the orange peel; when the skin is widely invaded, The epidermis forms most hard nodules or small strips, and even fuses into pieces. If the lesion extends to the back and the contralateral chest wall, it can restrict breathing and form thyroid carcinoma. Inflammatory breast cancer will have obvious enlargement of the breast, and the skin will be red and swollen. Local skin temperature increases; in addition, advanced breast cancer can cause skin ulceration to form cancerous ulcers.
4. Lymph node enlargement: ipsilateral axillary lymph nodes can be swollen, advanced breast cancer can cause swelling to the contralateral axillary lymph node; in other cases, the ipsilateral and or contralateral supraclavicular lymph nodes can be reached.
Symptom
Male breast cancer symptoms Common symptoms Male breast pruritus nipple eczema skin sticky joint
1. Visiting late: Due to the physiological and anatomical features of the male breast, and more often it is a painless breast, it is late at the time of the visit. It is reported that the pre-diagnosis course is 31.2 months, and the female breast cancer grows for more than 1 year.
2. Breast lumps are spontaneous symptoms: the common complaints at the time of the patient's visit are painless masses under the areola, easy to invade the skin and nipples, and ulcers may occur, usually unilateral, equal on both sides, few bilateral, and vice milk It can happen that initially, there are small and unclear painless masses under the nipple and nipple. About half of the patients may have redness, itching, nipple retraction and papillary eczema. As the lesion progresses, the tumor It can adhere to the skin, be fixed, and appear "satellite" nodules.
3. Regional lymph node metastasis: Due to the small size of male breast and the short anatomical features of lymphatic vessels, 54%-80% of patients have lymph node metastasis at an early stage, especially in the male areola area, which is closer to the inner lymph node. It involves the lymph nodes in the inner breast area, which is one of the reasons why the prognosis of male adenocarcinoma is worse than that of female breast cancer.
4. ER positive rate is high: male breast cancer ER positive rate is 64% ~ 76%, and has a good response to endocrine therapy, tamoxifen can be used, advanced orbital resection.
Examine
Male breast cancer examination
1. Needle aspiration cytology examination: Puncture the cells at the breast mass for pathological examination, showing severe hyperplasia and suspicious cancer cells.
2. ER measurement: Most male ER receptors were positive in male breast cancer.
3. X-ray examination of molybdenum target: It can be seen that the nipple is in a funnel shape, and there is a burr-like mass shadow in the areola area. The dense area may have radial blood vessels or sediment-like calcification points.
Diagnosis
Diagnosis of male breast cancer
Diagnostic criteria
Men with breast cancer can be considered in the following cases.
1. Older men with a painless mass in the breast.
2. Check the body mass invade the skin and nipple, and ulcers may appear.
3. Needle aspiration cytology to find severe hyperplasia, suspected cancer cells, and even cancer cells.
4. Preoperative frozen diagnosis.
Differential diagnosis
Male breast cancer should be differentiated from male mammary gland development. Male breast cancer patients are mostly elderly, unilateral mass, eccentricity of the tumor, hard and painless; needle acupuncture to find cancer cells, and male mammary gland development is more common in adolescence and Patients with liver disease are mostly bilateral discs with tenderness; needle aspiration cytology is one of the important identification methods.
