Breast cancer in men: a series of 45 cases and literature review

Abstract

Immunohistochemical profiling studies carried out on female breast cancer has been extrapolated to breast cancer in males. Although, we do not know if it really reflects the reality of this pathology in males patients since the studies are often retrospective and studying a limited number of patients. The objectives was to describe particualrities of breast cancer in males and analyze the evolutionary characteristics and study the molecular profile of this rare disease in Tunisian men. It is a retrospective, descriptive and analytic study carried out over a period of 15 years in the departments of gynecology-obstetrics, general surgery, medical carcinology and anatomopathology of the Farhat Hached Teaching Hospital in Sousse, Tunisia. Fourty five patients were included.The most common histological type was invasive ductal carcinoma (95% of our patients). Our series was divided into 3 immunohistochemical groups with a majority group: luminal A (68.2%), followed by luminal B (27.3%) and only one patient had a triple negative type tumor (4.5%).The Overall survival rate (OSR) at 5 and 10 years was 83.2% and 76.8% respectively. Recurrence-free survival (RFS) at 5 and 10 years was 64.5% and 58.6%, respectively. The OSR was influenced significantly by age, clinical and histological size of the tumor, the presence of distant metastases and the occurrence of recurrence. Recurrence-free survival (RFS) was influenced by age, clinical and histological size of the tumor, and infiltration of the dermis. Breast cancer in males has similarities with women's breast cancer. However, it remains diagnosed at a later stage.

Male Breast Cancer Review. A Rare Case of Pure DCIS: Imaging Protocol, Radiomics and Management

“…In our case, the patient is 43 years old. He was younger than the average age of onset (67 years) as described in literature [ 1 , 4 , 19 ]. MBC seems to present from 5 to 10 years later than in women, probably due to several aspects such as a delay between onset of symptoms and timing of diagnosis (from 6 to 35 months) [ 19 ] and a general diagnosis at an advanced stage, several years after the real onset of the pathology.…”

“…Nipple abnormalities are early and more frequent than in women (40–50%) because of the low volume of breast tissue in men and the central location of some tumours. Paget’s disease complicates 1.45% of male breast cancers versus 0.68% in women [ 19 ].…”

“…MBC seems to present from 5 to 10 years later than in women, probably due to several aspects such as a delay between onset of symptoms and timing of diagnosis (from 6 to 35 months) [ 19 ] and a general diagnosis at an advanced stage, several years after the real onset of the pathology. The late diagnosis itself could be the result of the absence of a screening programme, the lack of symptoms in the early stages and the ignorance or denial of the disease, considered as strictly feminine by men and extremely rare by the practitioners [ 19 ].…”

“…Data from the National Institute of Surveillance, Epidemiology and End Results (SEER) show that, in United States, early forms of MBC increased from 1973 to 2012 for both men and women, but if this increase is more significant for women, men were more likely than women at stage III and IV (24.9% vs. 17.2%) [ 19 ].…”

“…However, others have found that, once separated by lymph node stage or involvement, the prognosis is the same. The reported 5-year overall survival rate for male breast carcinoma varies considerably from 40% to 80% with a specific survival rate of 89% and 72% at 5 years and 10 years respectively [ 19 ]. As most breast cancers in men are estrogen-receptor positive, tamoxifen is generally the standard adjuvant therapy [ 10 , 65 , 66 , 67 , 68 , 69 ].…”