Male Breast Cancer: A Comparative Analysis from the National Cancer Database

Abstract

Purpose Breast cancer (BC) in males accounts for <0.5% of all male cancer diagnoses and ~1% of all BCs in the United States. We sought to describe clinicopathologic characteristics among male and female BC patients and differences in overall survival (OS) through the National Cancer Database over 13 years (2004–2016). Materials and Methods Secondary to the 1:99 ratio of male to female BC cases, we randomly selected female cases for equal comparison to males cases by diagnosis year. Chi-square and t-tests compared demographic and tumor characteristics. OS was examined using Kaplan–Meier survival analysis. Results Among the ~2.7 million BC patients, 9 per 1,000 BCs were in males, the rate remained similar over time. The mean (SD) age was 64.9±13.0 years for males and 60.7±13.6 years for females. Most of the male BC cases were white (non-Hispanic) (n=19,015 [80.2%]), clinical stage I (n=7,353 [32.1%]) or stage II disease (n=7,923 [34.6%]), and tumors were moderate or poorly differentiated (84.5%). Males exhibited more comorbidities, presented with a larger proportion of disease, and decreased OS (p<0.005) than females. Male OS was >10% lower at 5-years and nearly 20% lower at 10-years for males. More males had primary BC tumors under the nipple; the 10-year OS rate for this site was 48.8%. Conclusions This study reports clinicopathologic characteristics of a large cohort of male BC. Males present at older age, with a greater comorbidity index, at later stages of disease. Increased education regarding the continued risks of male breast cancer may be warranted.

A case report of male breast cancer in a 14-year-old patient

“…An analysis of a large population showed that men with breast cancer were older at diagnosis with an age range from 47-77 years with the mean age is 60 years. 3,4 The cause of breast cancer in men is remind unknown. There are some predisposing factors that can cause breast cancer in men such as family history of breast cancer, radiation exposure, estrogen administration, and disease associated with hyperestrogenism, such as cirrhosis or Klinefelter's syndrome.…”

“…6 Although several risk factors of breast cancer in men have been identified, most cases occur with increasing age with mean age of onset at 60 years. 3,7 BRCA2 is the most related gene mutation and it has been reported that there is an increased risk of 5-10% in men who carry mutations in the tumor suppressor gene BRCA2. 1,6 In 75% cases of breast cancer in men, patient generally complaints with painless mass in the sub-areolar area.…”

“…1 An analysis of a large population showed that men with breast cancer were older at diagnosis with an age range from 47-77 years with the mean age is 60 years. 3,4 Breast cancer can also be found in pediatric patient. The incidence of breast cancer in pediatric less than 0.1% of all breast cancer and it is estimated to be 0.2-0.8/100.000 for females with less than 20 years old.…”

“…6 Although several risk factors of breast cancer in men have been identified, most cases occur with increasing age with mean age of onset at 60 years. 3,7 It is estimated that 10% of men with breast cancer have a genetic predisposition such as BRCA1, BRCA2, PTEN, P53, and CHEK21 gene mutations. However, BRCA2 is the most related gene mutation and it has been reported that there is an increased risk of 5-10% in men who carry mutations in the tumor suppressor gene BRCA2.…”

Prognostic difficulties of men with breast cancer

“…Accordingly, studies have been selected based on having >100 MBC cases, female controls, and 10‐year overall survival available. The 10‐year gender‐based overall survival rates from these reports are summarized in Table 1 1–10 …”