Clinicopathological and Immunohistochemical Characteristics in Male Breast Cancer: A Retrospective Case Series

Masci, Giovanna; Caruso, Michele; Caruso, Francesco; Salvini, P.; Carnaghi, Carlo; Giordano, Laura; Miserocchi, Vittoria; Losurdo, Agnese; Zuradelli, Monica; Torrisi, Rosalba; Tommaso, Luca Di; Tinterri, Corrado; Testori, Alberto; Garcia–Etienne, Carlos A.; Gatzemeier, Wolfgang; Santoro, Armando

doi:10.1634/theoncologist.2014-0243

Cited by 62 publications

(63 citation statements)

References 27 publications

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“…In the present study, out of 14 patients with stage II or III disease, 5 patients did not receive adjuvant chemotherapy due to advanced age, patient or physician choice, and comorbidities. The 5-(87%) and 10-year (74%) OS rates and the 5-year DFS rate estimated in the current study are consistent with previously published studies (13,(24)(25)(26).…”

Section: Discussionsupporting

confidence: 92%

Male breast cancer - a single center experience

2016

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Abstract. Due to its rarity, male breast cancer remains a poorly characterized disease. The present study obtained retrospective clinicopathological data, treatment patterns and outcomes for all male patients diagnosed with breast cancer in the Oncology Department, Faculty Hospital Trenčín (Trenčín, Slovakia) over the last 21 years from January 1995 to December 2015. A total of 21 patients with male breast cancer were analyzed, with a median patient age of 65.6 years. Two patients were diagnosed with lobular invasive cancer; all others were diagnosed with cancer of a ductal origin. One patient presented with metastatic disease in the pleural cavity. The primary tumors in 8 patients were staged as pT1, whilst 6 patients were staged as pT2 and 7 as pT4. Axillary lymph node involvement was present in 11 patients (52%) and 15 patients were hormone receptor-positive (83%). All but 1 patient underwent mastectomy and surgical staging of the axilla. Adjuvant chemotherapy, radiotherapy and hormone treatment was administered in the same manner as breast cancer treatment in female patients. The median follow-up time was 4.5 years. The 5-and 10-year overall survival rates were 87 and 74%, respectively, and the estimated median disease-free survival for the same population was 9.5 years (95% confidence interval, 6.2-14.6). The survival rates reported in the present retrospective study are comparable with previously published studies. In addition, the current study reported predominant hormone-positive characteristics and rare expression of human epidermal growth factor receptor 2. However, further multi-institutional trials are required to allow for informed treatment decisions in this uncommon disease. IntroductionMale breast cancer is a rare disease accounting for <1% of all diagnosed breast cases (1). The only ethnic group with a higher than average incidence of male breast cancer is Jewish men, regardless of their residence (2). A previous study determined a strong family predisposition for the disease, with an odds ratio of 3.3 (3). It is recognized that breast cancer (BRCA) mutations may be detected in a significant portion of male breast cancer cases (primarily BRCA2) and the National Comprehensive Cancer Network guidelines recommend genetic testing for such patients (4). It has been suggested that male breast cancer is associated with a poorer prognosis compared with females, largely due to delays in diagnosis, lack of clinical care pathways and associated comorbidities due to the advanced age of patients (5). A recent comparative analysis of menopausal status in female patients with breast cancer concluded poorer outcomes for male patients with breast cancer compared with postmenopausal females and similar outcomes to premenopausal female patients with breast cancer (6). Recommendations for treatment in males are extrapolated from extensive evidence in women. Due to lack of breast tissue, simple mastectomy is commonly the preferred surgical procedure. Sentinel lymph node biopsy is feasible and is being performed mor...

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Section: Discussionsupporting

confidence: 92%

Male breast cancer - a single center experience

2016

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“…Information derived from these small numbers are at best anecdotal. In the last decade interest in MBC has grown, resulting in accumulation of more substantial numbers of cases allowing study of common biomarkers including estrogen receptor (ER) α, progesterone receptor (PR)910111213) and human epidermal growth factor receptor 2 (HER2)910111213 as well as less frequently evaluated biomarkers such as ERβ9 androgen receptor (AR)910121314), Bcl-21013, p53101213, Ki6710111315, FOXP114, GCDFP14, NAT116, HLA16, MGB14, COX-217, CD3418 and survivin17. BRCA mutations have also been studied19.…”

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confidence: 99%

Characterisation of male breast cancer: a descriptive biomarker study from a large patient series

Humphries

Rajan

Honarpisheh

et al. 2017

Sci Rep

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Male breast cancer (MBC) is rare. We assembled 446 MBCs on tissue microarrays and assessed clinicopathological information, together with data from 15 published studies, totalling 1984 cases. By immunohistochemistry we investigated 14 biomarkers (ERα, ERβ1, ERβ2, ERβ5, PR, AR, Bcl-2, HER2, p53, E-cadherin, Ki67, survivin, prolactin, FOXA1) for survival impact. The main histological subtype in our cohort and combined analyses was ductal (81%, 83%), grade 2; (40%, 44%), respectively. Cases were predominantly ERα (84%, 82%) and PR positive (74%, 71%), respectively, with HER2 expression being infrequent (2%, 10%), respectively. In our cohort, advanced age (>67) was the strongest predictor of overall (OS) and disease free survival (DFS) (p = 0.00001; p = 0.01, respectively). Node positivity negatively impacted DFS (p = 0.04). FOXA1 p = 0.005) and AR p = 0.009) were both positively prognostic for DFS, remaining upon multivariate analysis. Network analysis showed ERα, AR and FOXA1 significantly correlated. In summary, the principle phenotype of MBC was luminal A, ductal, grade 2. In ERα+ MBC, only AR had prognostic significance, suggesting AR blockade could be employed therapeutically.

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“…MBC tumors express ER and PR more often,7 and lower HER2 overexpression than FBC 23. Studies show that about 81% of MBCs express ER and about 74% of them express PR 2.…”

Section: Discussionmentioning

confidence: 95%

Clinical features of patients with male breast cancer in Shanxi province of China from 2007 to 2016

Wang

Tian

et al. 2019

Journal of Investigative Medicine

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This study aims to understand the clinical features, treatment, and prognosis of patients with male breast cancer (MBC) in Shanxi province of China from 2007 to 2016. Data for 77 patients with MBC were collected for analysis. Immunohistochemistry, pathological results, and other data such as demographic characteristics (age, marital status, smoking history, drinking history, and family history of cancer) as well as clinical data were investigated by retrieving information from the patients’ medical records. A total of 12,404 patients were diagnosed with breast cancer between 2007 and 2016, and 77 were patients with MBC among them. The median diagnosis age of patients with MBC was 62 years (range, 24–84 years). The most common complaint was a painless lump in the breast, accounting for 68.8% of the patients, and the main pathological type in MBC was infiltrating ductal carcinoma (66.2%). In terms of hormone receptors, 80.5% (62/77) of patients with MBC were estrogen receptor positive, 75.3% (58/77) of patients were progesterone receptor positive, and only 6.5% (5/77) of patients were HER2 overexpressing. The multivariant Cox proportional hazards regression analysis showed that M stage is an independent prognostic factor (p=0.018, HR=18.791, 95% CI 1.663 to 212.6). The epidemiological and clinical features of Chinese MBC are similar to that of other countries. As the Chinese public have limited knowledge of MBC, it is necessary to increase awareness among them about it. Further research with a large sample size is required for better understanding of the risks associated with MBC.

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Clinicopathological and Immunohistochemical Characteristics in Male Breast Cancer: A Retrospective Case Series

Cited by 62 publications

References 27 publications

Male breast cancer - a single center experience

Male breast cancer - a single center experience

Characterisation of male breast cancer: a descriptive biomarker study from a large patient series

Clinical features of patients with male breast cancer in Shanxi province of China from 2007 to 2016

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