Document Type : Research articles
Authors
1 Department of Pathology, Department of Medical Pathology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey
2 Professor, Department of Pathology, Department of Medical Pathology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey
Abstract
Background: Although it is generally accepted that gynecomastia poses no risk of male breast cancer (MBC), the incidence of atypical changes observed in gynecomastia and their effects on the risk of MBC has been investigated recently.
Objectives: Therefore, with follow-ups in our series, the present research was conducted to determine the incidence of atypia and its effect on breast cancer in gynecomastia cases.
Methods: A total of 151 breast tissues were surgically removed from 108 patients between the ages of 12-90. Atypia was investigated based on gynecomastia in the preparations sampled from these tissues.
Results: Around 22 simple hyperplasia, eight atypical ductal hyperplasia (ADH), and one ductal carcinoma in situ were found in 151 breast tissues. Breast cancer was not observed in any patients during the follow-up period. Atypical ductal hyperplasia was seen in younger patients compared to simple hyperplasia (P=0.021). No relationship was observed between lesion size and the incidence of atypia (P=0.538).
Conclusion: According to the findings of this study, ADH determined in cases with gynecomastia pose no risk of breast cancer in parallel with the current data in the literature. However, it is accepted that the presence of atypia based on gynecomastia needs to be investigated in series with a large number of cases.
Keywords
- Shaaban AM. Pathology of the male breast. Diagn Histopathol. 2019;25(4):138-42. doi: 10.1016/j.mpdhp.2019.01.004.
- Hamady ZZ, Carder PJ, Brennan TG. Atypical ductal hyperplasia in male breast tissue with gynaecomastia. Histopathology. 2005;47(1):111-2. doi: 10.1111/j.1365-2559.2005.02042.x. [PubMed: 15982330].
- Rahmani S, Turton P, Shaaban A, Dall B. Overview of gynecomastia in the modern era and the leeds gynaecomastia investigation algorithm. Breast J. 2011;17(3):246-55. doi: 10.1111/j.1524-4741.2011.01080.x. [PubMed: 21477170]
- Al-Allak A, Govindarajulu S, Shere M, Ibrahim N, Sahu AK, Cawthorn SJ. Gynaecomastia: a decade of experience. Surgeon. 2011;9(5):255-8. doi: 10.1016/j.surge.2010.10.004. [PubMed: 21843819].
- Alali L, Honarpisheh H, Shaaban A, Speirs V. Conditions of the male breast: Gynaecomastia and male breast cancer (Review). Mol Med Rep. 2010;3(1):21-6. doi: 10.3892/mmr_00000213. [PubMed: 21472195].
- Narula HS, Carlson HE. Gynaecomastia—pathophysiology, diagnosis and treatment. Nat. Rev Endocrinol. 2014;10(11):684-98. doi: 10.1038/nrendo.2014.139. [PubMed: 25112235].
- Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G. Gynecomastia: A systematic review. J Plast Surg Hand Surg. 2015;49(6):311-8. doi: 10.3109/2000656X.2015.1053398. [PubMed: 26051284].
- Reisenbichler E, Hanley KZ. Developmental disorders and malformations of the breast. Semin Diagn Pathol. 2019;36(1):11-5. doi: 10.1053/j.semdp.2018.11.007. [PubMed: 30503250].
- Tavassoli FA, Norris HJ. A comparison of the results of long-term follow-up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast. Cancer. 1990;65(3):518-29. doi: 10.1002/1097-0142(19900201)65:3<518::aid-cncr2820650324>3.0.co;2-o. [PubMed: 2297643].
- Page DL, Dupont WD, Rogers LW, Rados MS. Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer. 1985;55(11):2698-708. doi: 10.1002/1097-0142(19850601)55:11<2698:: aid-cncr2820551127>3.0.co;2-a. [PubMed: 2986821].
- Ferzoco RM, Ruddy KJ. The Epidemiology of Male Breast Cancer. Curr Oncol Rep. 2016;18(1):1-6. doi: 10.1007/s11912-015-0487-4. [PubMed: 26694922].
- Coopey SB, Kartal K, Li C, Yala A, Barzilay R, Faulkner HR, et al. Atypical ductal hyperplasia in men with gynecomastia: what is their breast cancer risk? Breast Cancer Res Treat. 2019;175(1):1-4. doi: 10.1007/s10549-018-05117-4. [PubMed: 30666539].
- Weiss JR, Moysich KB, Swede H. Epidemiology of male breast cancer. Cancer Epidemiol Biomarkers Prev. 2005;14(1):20-6. [PubMed: 15668471].
- Wells JM, Liu Y, Ginter PS, Nguyen MT, Shin SJ. Elucidating encounters of atypical ductal hyperplasia arising in gynaecomastia. Histopathology. 2015;66(3):398-408. doi: 10.1111/his.12545. [PubMed: 25215584]
- Bannayan GA, Hajdu SI. Gynecomastia: clinicopathologic study of 351 cases. Am J Clin Pathol. 1972;57(4):431-37. doi: 10.1093/ajcp/57.4.431. [PubMed: 5012934].
- Senger JL, Chandran G, Kanthan R. Is routine pathological evaluation of tissue from gynecomastia necessary? A 15-year retrospective pathological and literature review. Plast Surg. 2014;22(2):112-6. [PubMed: 25114624]
- Andersen JA, Gram JB. Male breast at autopsy. Acta Pathol Microbiol Immunol Scand A. 1982;90(3):191-7. doi: 10.1111/j.1699-0463.1982.tb00081_90a.x. [PubMed: 6285667].
- Cole FM, Qizilbash AH. Carcinoma in situ of the male breast. J Clin Pathol. 1979;32(11):1128-34. doi: 10.1136/jcp.32.11.1128. [PubMed: 229125].
- Lapid O, Jolink F, Meijer SL. Pathological findings in gynecomastia: analysis of 5113 breasts. Ann Plast Surg. 2015;74(2):163-6. doi: 10.1097/SAP.0b013e3182920aed. [PubMed: 23788148].
- Coyne JD. Gynecomastia with atypical ductal hyperplasia and ductal carcinoma ın situ associated with ınvasive breast carcinoma in a male patient on antiretroviral therapy: a case report. Int J Surg Pathol. 2016;24(2):139-41. doi: 10.1177/1066896915608437. [PubMed: 26612847].
- Shirah BH, Shirah HA. Incidental unilateral and bilateral ductal carcinoma in situ encountered in the surgical management of young male gynecomastia. Breast Dis. 2016;36(2-3):103-10. doi: 10.3233/BD-160223. [PubMed: 27612041].
- Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet. 2006;367(9510):595-604. doi: 10.1016/S0140-6736(06)68226-3. [PubMed: 16488803].
- Niewoehner CB, Schorer AE. Gynaecomastia and breast cancer in men. Bmj. 2008;336(7646):709-13. doi: 10.1136/bmj.39511.493391.BE. [PubMed: 18369226].
- Isley LM, Cluver AR, Leddy RJ, Baker MK. Primary sarcoid of the breast with incidental malignancy. J Clin Imaging Sci. 2012;2:1-4. doi: 10.4103/2156-7514.99180. [PubMed: 22919560].
- Olsson H, Bladstrom A, Alm P. Male gynecomastia and risk for malignant tumours–a cohort study. BMC cancer. 2002;2(1):1-6. doi: 10.1186/1471-2407-2-26. [PubMed: 12383352].
- Kasielska A, Antoszewski B. Surgical management of gynecomastia: an outcome analysis. Ann Plast Surg. 2013;71(5):471-5. doi: 10.1097/SAP.0b013e31824e296a. [PubMed: 23187709].
- Koshy JC, Goldberg JS, Wolfswinkel EM, Ge Y, Heller L. Breast cancer incidence in adolescent males undergoing subcutaneous mastectomy for gynecomastia: is pathologic examination justified? A retrospective and literature review. Plast Reconstr Surg. 2011;127(1):1-7. doi: 10.1097/PRS.0b013e3181f9581c. [PubMed: 20871489].
- Tavassoli FA, Eusebi V. Tumours of the mammary gland.(Atlas of Tumor Pathology. Series 4). United States: American Registry of Pathology;2009.
- Cakan N, Kamat D. Gynecomastia: evaluation and treatment recommendations for primary care providers. Clin Pediatr. 2007;46(6):487-90. doi: 10.1177/0009922806294800. [PubMed: 17579100].
- Daniels IR, Layer GT. Gynaecomastia. Eur J Surg. 2001;167(12):885–92. doi: 10.1080/110241501753361550.
', './data/ircmj/coversheet/cover_en.jpg'))