Surgery especially modified radical mastectomy

Surgery, especially modified radical mastectomy, is the “gold standard” for the treatment of male breast cancer. Postoperative adjuvant radiotherapy is recommended for male patients with large breast cancer and axillary lymph node and chest muscle involvement; it can reduce the risk of local cancer recurrence and improves survival for men with breast cancer stage III, but not for lower stages. Tamoxifen is the treatment of choice for men with hormone receptor (ER and PR) positive breast cancer owing to a high sensitivity to SCH772984 in male breast cancer. Other endocrine treatments, such as using aromatase inhibitors, are not as effective as tamoxifen. Systemic chemotherapy with cytostatics is recommended for male patients with cancer stage II or greater, and with metastatic axillary lymphadenopathy. Because the male patient in the present case refused to receive axillary lymph node dissection, the pathological AJCC staging of the tumor could not be performed. Therefore, it was difficult to know if the treatment was sufficient. If the patient had agreed to a left modified radical mastectomy, an appropriate therapeutic strategy could be selected according to the complete pathological results. For HCC with early stage disease (stage A, preserved liver function with Child-Pugh score A and B, and with solitary nodule or up to three nodules ≤3 cm in size), the treatment of choice is tumor resection, liver transplantation, or percutaneous ablation with a long 5-year survival rate ranging from 50% to 75%. Patients with intermediate stage HCC (stage B, Child-Pugh score A and B, and with large and multifocal tumor) are candidates for transarterial chemoembolization, as shown in the present case. The 3-year survival rate may reach 50% even without any treatment. Patients with advanced stage (stage C, vascular invasion) may be refractory to the aforementioned therapies, and have shorter life spans, with 50% survival at one year. They may benefit from sorafenib, a multikinase inhibitor used to suppress tumor growth; however, the drug may cause adverse effects such as diarrhea, weight loss, fatigue, and skin reaction. Patients with end stage disease (with extensive tumor invasion and performance status >2) may die in less than three months.
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