Background:Male breast cancer(MBC)is a rare but significant health concern,accounting for less than 1%of all breast cancer cases.Despite its low incidence,it presents unique clinical,genetic,and psychosocial challenge...Background:Male breast cancer(MBC)is a rare but significant health concern,accounting for less than 1%of all breast cancer cases.Despite its low incidence,it presents unique clinical,genetic,and psychosocial challenges.Genetic predispositions,including BRCA2 mutations and hormonal imbalances,are key factors influencing the development of MBC.However,the rarity of the condition has led to limited research and fewer treatment guidelines specifically for male patients.Methods:A comprehensive literature review was conducted using PubMed,MEDLINE,and Embase databases to identify studies focusing on the epidemiology,risk factors,clinical presentation,diagnosis,treatment,and psychosocial impacts of male breast cancer.Articles were selected based on relevance,peer-review status,and focus on MBC in male patients.Data were synthesized narratively,and findings were contextualized based on the methodology and design of included studies.Results:The review identified several significant risk factors for MBC,including BRCA2 mutations,hormonal imbalances(particularly estrogen and testosterone levels),and family history of breast cancer.MBC is often diagnosed at later stages due to the absence of routine screening in men,resulting in poorer survival outcomes compared to female breast cancer.Treatment strategies for MBC largely mirror those for women,including surgery,radiation,chemotherapy,and hormonal therapies.However,the psychosocial impacts of MBC are unique to men,with issues such as stigma,body image concerns,and societal perceptions of masculinity.Conclusions:Male breast cancer remains an understudied area of oncology,with significant gaps in research related to early detection,targeted therapies,and long-term care.Collaborative international research efforts,such as the MERGE consortium and the International Male Breast Cancer Program,are essential for improving understanding and treatment outcomes.Genetic counseling,early screening,and personalized treatment approaches are crucial in managing the disease.Further research focusing on the molecular basis of MBC,along with the psychosocial needs of affected men,is necessary to enhance both survival rates and quality of life for male breast cancer patients.展开更多
BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1 RA)are effective in diabetes and obesity,reducing hyperglycemia by increasing insulin release and delaying gastric emptying.However,they can cause gastropares...BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1 RA)are effective in diabetes and obesity,reducing hyperglycemia by increasing insulin release and delaying gastric emptying.However,they can cause gastroparesis,raising concerns about aspiration during procedures.Recent guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary aspiration.AIM To evaluate the effect of GLP-1 RAs on gastric residual contents during endosco-pic procedures.METHODS A retrospective chart review at BronxCare Health System,New York,from January 2019 to October 2023,assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic procedures.Two groups were compared based on dietary status before the procedure.Data included demographics,symptoms of gastroparesis,opiate use,hemoglobin A1c,GLP-1 agonist indication,endo-scopic details,and aspiration occurrence.IBM SPSS was used for analysis,cal-culating means,standard deviations,and applying Pearson’s chi-square and t-tests for associations,with P<0.05 as being significant.RESULTS During the study,306 patients were included,with 41.2%on a clear liquid/low residue diet and 58.8%on a regular diet before endoscopy.Most patients(63.1%)were male,with a mean age of 60±12 years.The majority(85.6%)were on GLP-1 RAs for diabetes,and 10.1%reported digestive symptoms before endoscopy.Among those on a clear liquid diet,1.5%had residual food at endoscopy compared to 10%on a regular diet,which was statistically significant(P=0.03).Out of 31 patients with digestive symptoms,13%had residual food,all from the regular diet group(P=0.130).No complications were reported during or after the procedures.CONCLUSION The study reflects a significant rise in GLP-1 RA use for diabetes and obesity.A 24-hour liquid diet seems safe for endoscopic procedures without aspiration.Patients with upper gastrointestinal symptoms might have a higher residual food risk,though not statistically significant.Further research is needed to assess risks based on diabetes duration,gastroparesis,and GLP-1 RA dosing,aiming to minimize interruptions in therapy during procedures.展开更多
文摘Background:Male breast cancer(MBC)is a rare but significant health concern,accounting for less than 1%of all breast cancer cases.Despite its low incidence,it presents unique clinical,genetic,and psychosocial challenges.Genetic predispositions,including BRCA2 mutations and hormonal imbalances,are key factors influencing the development of MBC.However,the rarity of the condition has led to limited research and fewer treatment guidelines specifically for male patients.Methods:A comprehensive literature review was conducted using PubMed,MEDLINE,and Embase databases to identify studies focusing on the epidemiology,risk factors,clinical presentation,diagnosis,treatment,and psychosocial impacts of male breast cancer.Articles were selected based on relevance,peer-review status,and focus on MBC in male patients.Data were synthesized narratively,and findings were contextualized based on the methodology and design of included studies.Results:The review identified several significant risk factors for MBC,including BRCA2 mutations,hormonal imbalances(particularly estrogen and testosterone levels),and family history of breast cancer.MBC is often diagnosed at later stages due to the absence of routine screening in men,resulting in poorer survival outcomes compared to female breast cancer.Treatment strategies for MBC largely mirror those for women,including surgery,radiation,chemotherapy,and hormonal therapies.However,the psychosocial impacts of MBC are unique to men,with issues such as stigma,body image concerns,and societal perceptions of masculinity.Conclusions:Male breast cancer remains an understudied area of oncology,with significant gaps in research related to early detection,targeted therapies,and long-term care.Collaborative international research efforts,such as the MERGE consortium and the International Male Breast Cancer Program,are essential for improving understanding and treatment outcomes.Genetic counseling,early screening,and personalized treatment approaches are crucial in managing the disease.Further research focusing on the molecular basis of MBC,along with the psychosocial needs of affected men,is necessary to enhance both survival rates and quality of life for male breast cancer patients.
文摘BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1 RA)are effective in diabetes and obesity,reducing hyperglycemia by increasing insulin release and delaying gastric emptying.However,they can cause gastroparesis,raising concerns about aspiration during procedures.Recent guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary aspiration.AIM To evaluate the effect of GLP-1 RAs on gastric residual contents during endosco-pic procedures.METHODS A retrospective chart review at BronxCare Health System,New York,from January 2019 to October 2023,assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic procedures.Two groups were compared based on dietary status before the procedure.Data included demographics,symptoms of gastroparesis,opiate use,hemoglobin A1c,GLP-1 agonist indication,endo-scopic details,and aspiration occurrence.IBM SPSS was used for analysis,cal-culating means,standard deviations,and applying Pearson’s chi-square and t-tests for associations,with P<0.05 as being significant.RESULTS During the study,306 patients were included,with 41.2%on a clear liquid/low residue diet and 58.8%on a regular diet before endoscopy.Most patients(63.1%)were male,with a mean age of 60±12 years.The majority(85.6%)were on GLP-1 RAs for diabetes,and 10.1%reported digestive symptoms before endoscopy.Among those on a clear liquid diet,1.5%had residual food at endoscopy compared to 10%on a regular diet,which was statistically significant(P=0.03).Out of 31 patients with digestive symptoms,13%had residual food,all from the regular diet group(P=0.130).No complications were reported during or after the procedures.CONCLUSION The study reflects a significant rise in GLP-1 RA use for diabetes and obesity.A 24-hour liquid diet seems safe for endoscopic procedures without aspiration.Patients with upper gastrointestinal symptoms might have a higher residual food risk,though not statistically significant.Further research is needed to assess risks based on diabetes duration,gastroparesis,and GLP-1 RA dosing,aiming to minimize interruptions in therapy during procedures.
