Oana Cristina VOINEA, Monica Mihaela CIRSTOIU, Daniel ION, Maria SAJIN, Adrian Vasile DUMITRU, Oana Mari PATRASCU, Dan-Corneliu JINGA and Adriana Elena NICA

ABSTRACT

Background: Breast carcinoma is the most important cause of death in women’s oncologic pathology worldwide. Due to its high frequency, important advances in diagnostic and management of this entity were made. Because of its rarity (only 0.5-1% in all breast cancers), little is known about male breast cancer, and no specific male standardised protocol was made, treatment and follow-up being adopted from women breast cancer guidelines. We consider that this entity, with its hormone specific profile, is worth being considered for further studies, taking into account that male breast cancer has a far worse prognostic than female breast cancer.
Methods: We present our four-year experience with male breast lesions in a retrospective review study, including gynecomastia and breast carcinoma cases.
Results: We identified 17 male breast lesions, 11 of them with a diagnosis of gynaecomastia, the rest being breast carcinomas. Four malignant lesions were encountered in the 5th, 6th and 7th decade, with two of them in young adults (35 and 40 years old). In a single case, two different histotypes of breast carcinoma were found. All of them were G2, with tumoral stages varying between IB to IV. Androgen receptors were expressed in each case, in different percentages.
Conclusions: Male breast carcinoma is a rare entity with a poor prognosis, a diffuse and profound invasion of adjacent structures, and a high expression of hormone receptors, and with no histologic relation to gynaecomastia, considering that no associated benign lesions were found.
Keywords: gynaecomastia, male breast carcinoma, androgen receptors, hormonal profile.

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Oana Maria PATRASCU, Mariana COSTACHE, Adrian Vasile DUMITRU, Corina Nicoleta MEHOTIN, Maria SAJIN and Anca Mihaela LAZAROIU

ABSTRACT

Background: From the first recognition of dysplastic nevi as a pathology per se, many debates have been raised and many histological and immunohistological studies have been conducted in order to establish the true significance of these lesions. Therefore, the aim of this study was to establish if there is a correlation between HMB-45, Melan A and Bcl-2 expression and the grade of dysplasia, as well as between the marker’s staining patterns.

Material and Methods: Ten dysplastic nevi from six female patients were selected and their histological features (size, dysplasia), as well as the immunohistological staining patterns, were studied (HMB-45, Melan A, Bcl-2). The Pearson correlation coefficient and regression was calculated with Windows Excel Data Analysis.

Results: We demonstrated that there was a notable correlation between the dysplasia and the size of the lesions (r(8)= 0.62 with p-value= 0.052), and also between Melan A and Bcl-2 (a r(6)= 0.73, p<0.05), but we did not obtain a statistically significant correlation between other features (p>0.05).

Conclusions: We can affirm, at least in our cases, there is a correlation between the grade of dysplasia and the size of the lesion, and also, that there is a correlation between Melan A and Bcl-2 staining, explained by MITF gene. These results were only partial concordant with those in other studies, therefore a larger number of cases is recommended to be further analyzed in order to clearly draw a conclusion.

Keywords: dysplastic nevi, Bcl-2, Melan A, HMB-45, imunohistological stains

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