In a series comprising 265 male patients with breast cancer, histologic typing and grading were carried out in 187 cases using the WHO Classification. Among the 187 patients, a total of 30 cases of special cancer types were found (22 carcinomas and 8 sarcomas). There were no carcinomas of lobular type. The sarcomas in our series had a relatively high frequency and a favorable prognosis. Histologic grading was carried out in 150 carcinomas. The 30 cases of special types and 7 cases with insufficient tumor tissue were excluded. The distribution of the 150 cases was: 29% with Grade I, 54% with Grade II, and 17% with Grade III. The histologic grading was correlated with prognosis, and a significant fall in the 5‐year survival rate was found from Grade I to II and from Grade II to III.
In order to elucidate the question of whether or not gynecomastia is a premalignant state, a Danish series comprising 265 cases of male breast cancer was reviewed with regard to a previous history of gynecomastia and the finding of clinical gynecomastia on admission. Furthermore, preparations from 187 cases of the same series were assessed with a view to the presence of histologically verified gynecomastia. In 10 patients there was a history of gynecomastia; only one patient presented clinical gynecomastia on admission. In 79 cases there was sufficient breast tissue for a histological study; this revealed gynecomastia in 21 cases, 6 of which were of florid type (type I) and 15 of quiescent fibrous type (type II). In 2 cases ducts with severe atypia of the epithelium were found, but in spite of investigations of serial sections no transition into invasive growth was revealed. It is concluded that the following features seem to support the theory that gynecomastia, may be a premalignant state: A, the finding of severe atypia of the epithelium in the ducts in concurrent gynecomastia and breast cancer; B. lower mean age in cases of breast cancer with concurrent gynecomastia; C. the higher ratio of male to female breast cancer and the low mean age of the male patients in an area with a high frequency of gynecomastia; D. heavily increased frequency of breast cancer in patients with the Klinefelter syndrome.
Summary.-A series of 257 cases of carcinoma of the male breast in Denmark during the period from 1 January 1943 to 1 July 1972 has been reviewed, and a number of clinical symptoms have been recorded and assessed.Male breast carcinoma comprised 0-80' of all breast carcinomata in Denmark.The average age was 65-2 years, which is considerably higher than in women. The median duration of symptoms was 6 months. In only 130o was a palpable tumour the single symptom present on referral. In 27 o ulceration was found on admission. However, ulceration was not, as commonly supposed, a particularly early manifestation of male breast cancer. It has been proved that ulceration is significantly related to duration of symptoms and size of tumour. According to the TNM clas-
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