Male breast cancer - a single center experience

Abstract

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...

Male Breast Cancer: The Philippine General Hospital Experience

“…Male breast cancer in the Philippines still remains to be a rare disease and is consistent with other studies accounting for less than one percent of all breast cancer cases. Despite reports of increasing trend for both sexes 2,5 , the figures are still low as compared to female breast cancer, and differs primarily on the later onset of presentation for males. Unlike in other territories where male breast cancer was seen to be more prevalent-Northern America, Europe, Africa, as well as in Jewish men regardless of their residence, present findings remain consistent with a lower incidence for Asians, for example, Japan with 5 per 1,000,000 cases of breast cancers.…”

“…Male breast cancer is a relatively uncommon disease that accounts for less than one percent of all breast cancers. 1 There is only a certain population among Jewish men 2 as 35 well as some Africans in Tanzania where the incidence is relatively higher at about 6 percent. 3,4,6 In sub-Saharan Africa, the similarity in the occurrence of endemic hepatic disease and male breast cancer has led to the suggestion of hyperestrogenism as a possible cause.…”

“…However, despite the similarities, differences exist such that male breast cancer usually has a lower incidence and appears at a later onset. 1,2 The most commonly identified factors attributed to poor outcomes are the relatively small size of the male breast, lack of awareness that males can also have breast cancer, poor health seeking behavior, lack of diagnostic and treatment algorithms, absence of screening programs, and associated comorbidities due to advanced age upon diagnosis. 2,3,4,5 A strong family predisposition has been linked to the disease 5,6 , with recommendation for testing for breast cancer mutations (BRCA2) for the high risk population.…”

“…2,3,4,5 A strong family predisposition has been linked to the disease 5,6 , with recommendation for testing for breast cancer mutations (BRCA2) for the high risk population. 2 Men who tested positive for BRCA2 are said to carry six percent of absolute lifetime risk. 6 In the absence of terminal lobules for the male breast, the identified pathology is said to be of the ductal type, with hormone-receptor positivity and rarely with Human Epidermal Growth Factor (HER-2) neu positivity.…”

“…6 In the absence of terminal lobules for the male breast, the identified pathology is said to be of the ductal type, with hormone-receptor positivity and rarely with Human Epidermal Growth Factor (HER-2) neu positivity. 2 Males with a first-degree relative affected with breast cancer were found to have two-to-three times increased risk for the disease, and have also been associated with Cowden disease as well as Hereditary non-polyposis colorectal cancer (HNPCC) syndrome. There is also a susceptibility to develop a second primary cancer (16% risk) and a thirty-fold increased risk to develop contralateral breast cancer compared to two to four times in females.…”