Male Breast Cancer: A Clinicopathologic Study of 42 Patients in Eastern India

Abstract

Retrospective review of presentation, treatment and outcome of male breast cancer in a tertiary cancer centre in eastern India. Data of 42 male breast cancer (MBC) patients, who presented between April, 2001 and March, 2008 were collected from institute records with respect to epidemiological characteristics, clinical and pathological parameters, treatment pattern and outcome. This series includes 42 patients with mean age of 56 years (range 31-78 years). MBC represented 1.1 % of all breast cancer. History of lump in the breast with duration ranging from 1 month to 4 years was the most common clinical presentation (80.95 %). Histopathology found infiltrating ductal carcinoma in 35 (83.33 %), followed by papillary carcinoma in 3 (7.14 %), undifferentiated carcinoma in 2 (4.76 %), mucinous carcinoma in 1 (2.38 %) and myxofibrosarcoma in 1 (2.38 %) patient. Hormone receptor (HR) study was performed on 29 patients. Twenty six (89.7 %) patients were hormone receptor positive in that 8 (27.6 %) were ER positive and 18 (62.1 %) were ER and PR positive. 3 (10.3 %) were hormone receptor negative.Axillary lymph node dissection was performed on 30 patients. Of those, 60 % were found to be positive (pN+) and 40 % were negative (pN-). Of the patients with invasive carcinoma 2.86 % were pathologic stage I, 37.14 % stage II, 42.86 % stage III and 17.14 % stage IV. Of the 35 treated patients, total 30 (85.71 %) patients underwent surgery. The surgery consisted of a modified radical mastectomy (MRM) 24 (80 %), radical mastectomy according to Halsted (RM) 6 (20 %). Adjuvant therapy i.e. Chemotherapy and Radiotherapy was administered to the patient based upon their stage. The standard treatment for all HR positive patients was administration of tamoxifen. Based upon the follow-up information (ranging from 17 month to 136 months), 4 (14.28 %) patients developed local recurrence over 4 to 26 months (mean17.5 months) and 5 patients developed distant metastasis over 24 to132 months (mean 78 months). Disease specific survival varied from 4 months to 132 months, with a mean of 56.75 months. Thirteen out of 28 evaluable patients (46.43 %) were disease free at 5 years. Male Breast cancer is a rare disease often ignored in the community, because of which it is seeks medical attention at advanced stage. Majority of MBC are found to be HR positive, hence hormonal therapy should to be strongly considered and multicentric prospective studies are needed to improve outcome.

Male Breast Cancer: a 24 Year Experience of a Tertiary Care Hospital in Pakistan

“…(Kaushik et al, 2014) Most Western studies have reported a 5 year OS of greater than 60% whereas results of Asian and African countries have shown a 5 year OS ranging from 40-60%. (Giordano et al, 2004;Miao et al, 2011;Shah et al, 2012;Sedighi et al, 2013) Our 5 year OS was 61.1% which was consistent with most of the South Asian studies as well as Western studies.…”

“…This can be attributed to factors such as lack of screening mammography and public awareness. (Giordano et al, 2004;Miao et al, 2011;Shah et al, 2012;Kaushik et al, 2014) The average age at diagnosis in our population was 52 years with 7 of our patients falling in the age group 50 to 55. This was 5 years younger than the age of diagnosis of women with FBC in Pakistan.…”

“…Our average age at diagnosis was slightly younger than that mentioned in Western literature but was similar to reports from India, Egypt and Iran. (Shah et al, 2012;Sedighi et al, 2013;Soliman et al, 2014) Hyperestrogenism caused by liver failure secondary to infectious etiologies has been considered as a cause of relatively higher rates of MBC in developing regions of the world. (Kaushik et al, 2014) This can be one possible cause of a younger age at diagnosis in these studies.…”

“…MD Anderson reported Adriamycin based chemotherapy to have a reduced risk of death as compared to CMF. (Shah et al, 2012;Zygogianni et al, 2012) Definite data on the treatment of MBC needs to be proven with prospective trials. Adjuvant hormonal therapy with Tamoxifen is given to ER and PR positive patients.…”

“…However, it has little effect on the overall survival rate. (Shah et al, 2012;Zygogianni et al, 2012) MRM was the popular choice amongst our patients as well. One of the limitations of our study was the lack of chemotherapy detail available.…”