SUMMARY: One in eight females in the United
states will develop
cancer in her life time (1) but the incidence of male breast cancer is
much
lower and has been estimated as 1.06 per 100,000 men (2). Because of
the
relatively rarity of male breast cancer the potential complications
such as
post-surgical lymphedema have not been well studied. Further, there is
essentially no reference data describing the normal amounts and
variations of
arm tissue water in males. This absence of reference data makes it
difficult to
determine what levels of tissue water differences between at-risk and
contralateral
arms constitutes a complication of breast cancer related treatment
including
surgery and radiation.
The worldwide variation of male breast cancer
resembles that of breast cancer in women, with higher rates in North
America
and Europe and lower rates in
Male and female
breast cancers share many common risk factors such as advancing age,
family
history, BRCA2 gene mutation, and obesity. However others are male
specific
that include the following conditions. Klinefelter Syndrome which is a
condition occurring in men with a XXY genotype, Androgen receptor
mutation in
which the androgen receptor suffers a change
in structure and proper function, CYP17 mutations leading
to
pseudohermaphroditism, Cowden syndrome which is characterized by
multiple tumor
growths and predisposition to certain cancers, mutations in CHEK2, a
gene which
is activated in response to DNA damage, increased endogenous estrogen
levels, and other testicular disorders.
Other factors linked to cancer in general include increased alcohol
intake and
exposure to oestrogens via diet and household products.
Owing to the rarity
of male breast cancer, few epidemiological or clinical trial data are
available. Therefore, our understanding of the disease comes from
studies of
female breast cancer that might be painting an inaccurate picture when
it comes
to contributing factors, age at presentation, evaluation and treatment
strategies. Recent studies show that gender -related differences do
exist,
therefore, epidemiological and clinical trials are needed to clearly delineate the specifics of breast
cancer in males. (4,5)
Men and women may respond differently to
therapeutic
interventions, drug regimens and their undesirable side effects
probably exist.
One such effect is the development of lymphedema after a patient
undergoes
breast surgery. In the
Lymphedema
once present tends to get progressively worse
without treatment and can result in physical deformity, discomfort,
pain, loss
of mobility, skin breakdown and infection with an overall significant
negative
impact on the patient’s health and well being. As such,
interventional therapy
is best when initiated as early as possible. This underscores the need
for
research efforts to detect its presence as early as possible. Prior
work has
utilized biophysical measurements to establish normal ranges of
reference
values that could serve to help detect changes in tissue water in
females
(7-10).
References
1. Desantis C., Ma J., Bryan L., Jemal A.,: Breast Cancer Statistics 2013. Cancer Journal for Clinicians, 2014, 64:1, (52-62)
2. Joli R. et al. Epidemiology of Male Breast Cancer. Cancer Epidemiology, Biomarkers and Prevention, 2005, pp14-20
3. Gomez-Raposo
C., Zambrana Tevar F., Sereno Moyano M., Lopez Gomez M.,
Casado E.,: Male breast cancer. Cancer Treatment Reviews, 2010,
451-457, Volume
36, Issue 6
6.
VanHoose L.D.,
Paskett E. D., Twasami-Ankrah P., Smith K.M., Wanchai A., Green J.M.,
Stewart
B.R., Armer J.M.,: Systematic review of cancer-associated lymhedema
risk
factors. Journal of Women’s Health 2013, 22:10 (900)