XXXX : a special therapeutic problem. Anything new? (Review).

@entity1 @entity0 @entity2675 @entity5 @entity1442 @entity13525
@entity2675 (MBC) is an uncommon phenomenon, accounting for <1% of all @entity5 in @entity1 . It represents a biologically heterogeneous disorder, and its clinical course may vary from indolent and slowly progressive to rapidly metastatic disease. Most of our current knowledge regarding its biology, natural history, and treatment strategies has been extrapolated from its female counterpart. Information regarding prognostic relevance of new molecular markers is limited. At the European Institute of Oncology we performed a study showing data in which p21Waf1 and @entity13525 proteins were evaluated in a series of @entity2675 @entity1 . Our data suggest that the immunohistochemical evaluation of p21Waf1 and @entity13525 expression in male @entity0 may be a further useful marker for selecting @entity1 who express functional proteins that can be predictive for the most efficient endocrine response. Moreover, searching for more conservative treatment, we introduced in our clinical practice sentinel node biopsy, and if present, sentinel node biopsy of the internal mammary chain. The potential clinical implications of complete nodal staging are far-reaching, and give us a major new opportunity to stratify male @entity1 with @entity0 for appropriate surgery as well as giving valuable prognostic information. @entity2675 has biological differences compared with female @entity0 . It responds to hormonal manipulation and chemotherapy, but optimal treatment regimens in males are unknown. By analogy to the female @entity0 , post-mastectomy radiotherapy should be proposed in case of @entity1442 stage and/or lymph node positivity (considering the small volume of the male mammary gland, we suggest post-mastectomy irradiation in case of T >1 cm and/or presence of >1 metastatic axillary lymph node). Breast conserving surgery, performed in selected cases of @entity2675 , should be always followed by radiotherapy. Despite a wealth of small retrospective studies on MBC, its rarity means there is a lack of prospective randomized controlled treatment trials, which needs to be addressed if significant advances are to be made in the treatment of this unusual challenging disease.
