Male breast cancer: correlation between immunohistochemical subtyping and PAM50 intrinsic subtypes, and the subsequent clinical outcomes

Sánchez-Muñoz, Alfonso; Vicioso, Luís; Santonja, Ángela; Álvarez, Martina; Plata-Fernández, Yessica; Miramón, José; Zarcos, Irene; Ramírez-Tortosa, César L.; Montes-Torres, Julio; Jerez, José M.; Luque, Vanessa de; Llácer, Casilda; Sousa, Cristina Elisabeth Fernández-De; Pérez-Villa, Lidia; Alba, Emilio

doi:10.1038/modpathol.2017.129

Cited by 19 publications

(23 citation statements)

References 41 publications

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“…A smaller study of 67 MBC from Sanches-Muñjos, doing PAM50 subtyping based on a 50-gene signature also showed an overweight of Luminal B subtype [15]. This means that we will have to be aware that more men are Luminal B, compared to females with luminal type breast cancer [28].…”

Section: Discussionmentioning

confidence: 98%

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Male breast cancer: clinicopathological characterization of a National Danish cohort 1980–2009

et al. 2020

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Background To describe relevant pathological parameters of Danish male breast cancer patients (MBCP) diagnosed from 1980 to 2009, and to relate these data to treatment, overall survival (OS) and standardized mortality rate (SMR). Materials and methods The MBCP cohort was defined from national Danish registers. A total of 643 MBCP were identified with tissue available in 457. Among these, 384 were primary operable. Where tissue blocks were available, tumor type, grade, estrogen receptor (ER), progesteron receptor (PgR) and androgen-receptor (AR) status as well as HER 2 and Ki67 were performed. OS was quantified by Kaplan-Meier estimates and SMR was calculated based on mortality rate among patients relative to the mortality rate in the general population. Results Male breast cancer was more often of ductal type, grade II and a very high proportion were ER and AR positive and HER2 negative. Intrinsic subtypes based on immunohistochemical evaluation showed luminal subtype. Ki67 ratio increased over period of study. OS declined by increased age, bigger tumor size, positive lymph node status, higher grade and Luminal B subtype. Hazard ratio and relative risk of SMR were highest for patients aged < 60 years. Conclusion Male breast cancer is of luminal subtype, but more often Luminal B. Ki67 is crucial in evaluation of subtypes by immunohistochemistry, but have limitations. Subtyping seems to be of major importance. AR also can have a role in future treatment.

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Section: Discussionmentioning

confidence: 98%

“…Studies made on intrinsic subtypes based on histopathological criteria show that almost all are of luminal subtype and most often Luminal A compared to Luminal B, although results are conflicting [11,13,14]. Only very few and small studies doing molecular subtype, based on PAM50, showed Luminal B to be more common [15].…”

Section: Introductionmentioning

confidence: 99%

Male breast cancer: clinicopathological characterization of a National Danish cohort 1980–2009

et al. 2020

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“…Sanchez-Munoz et al confirmed the correlation between IHC and PAM50 intrinsic subtypes in patients with male BC; however, they defined a proportion of patients with HER-2 negative by IHC but HER-2 enriched by PAM50 analyses. [4] Although in female patients with BC, luminal A had a favorable prognosis than luminal B; in our male BC dataset, patients with luminal A and B had similar recurrence pattern and metastatic involvement. EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program also did not reveal any recurrence-free survival and OS in their dataset among BC subtypes.…”

Section: Discussionmentioning

confidence: 69%

“…[3] Basal-like tumors were rare. [4] The data on HER-2 overexpression by IHC are inconsistent in studies. Two series reported 1.7% and 15% HER-2 positivity, respectively.…”

Section: Resultsmentioning

confidence: 99%

Long Term Follow-Up of Male Breast Cancer Patients, Single Center Experience

Çakar¹,

Sert²,

Gürsoy³

et al. 2019

TJ Oncol

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Male breast cancer (BC) represents <1% of all BC cases. Our study aimed to define immunohistochemistry (IHC) based surrogate subtype distribution of male BCs, and to define the recurrence pattern and survival among subgroups. METHODS We retrospectively reviewed the medical records of patients with male BC admitted to Ege University School of Medicine, Medical Oncology and Radiation Oncology Clinics between 1998 and 2017. Patient demographics, pathological feature of the primary tumor, adjuvant treatment options, and survival data were analyzed. We defined intrinsic BC subtypes according to estrogen receptor (ER), progesterone receptor (PR), HER-2, and ki-67 status. RESULTS We identified 58 patients with male BC. The median age at diagnosis was 59 years (IQR: 30-78), and median follow-up was 83.7 months. Invasive ductal carcinoma was the most common histology (79.3%). Of the patients, 8.6% presented with stage-4 disease. A total of 24 (41.4%) patients had luminal Alike , 28 (48.3%) had luminal B-like, 2 (3.4%) had HER-2 positive, and 4 (6.9%) had triple negative breast cancer (TNBC). Eighteen deaths were observed during follow-up. The overall survival (OS) and disease-free survival (DFS) rates among BC subgroups were not statistically significant. Median OS was 161 months (95% CI 94.7-228.4) in the patient group. DFS was statistically related to initial tumor stage. CONCLUSION The disease onset was found at younger age with more locally advanced setting compared to literature. Luminal predominance was demonstrated. Initial stage but not BC subtypes predict the risk of relapse in patients with male BC.

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“…Since the rarity of the disease hinders large prospective randomized clinical trials, MBC is significantly less well understood compared to female breast cancer (FBC) (3). Traditionally, MBC has been thought to be similar to post-menopausal FBC, and treatment of MBC has been based upon knowledge from studies with a smaller number of patients and studies of FBC (4,5). Differences between MBC and FBC do, however, exist; for example, MBC more often arises with an underlying germline cancer predisposition and displays a different penetrance compared to FBC (6).…”

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confidence: 99%

Subtyping of male breast cancer by PAM50 and immunohistochemistry: a pilot study of a consecutive Danish cohort

Christensen

Lautrup

Lyng

et al. 2020

APMIS

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Male breast cancer (MBC) is a rare disease that is still to be fully understood. In female breast cancer, molecular subtyping by gene expression has proven its significance. In this study, we characterize a consecutive cohort of MBC patients surgically treated from 1997 to 2017, identified at our institution (N = 37), and report the association between molecular subtypes found by a surrogate panel of immunohistochemical (IHC) markers, and the PAM50 signature, as well as risk of recurrence score and overall survival for the different subtypes. PAM50 subtypes were determined using the nCounter FLEX system instrument and software. The distribution of molecular subtypes according to the PAM50 signature was as follows: 56% luminal B, 39% luminal A, and 5% basal‐like. None of the tumors were HER2‐enriched. Using IHC surrogate markers, we found 80% luminal B‐like, 15% luminal A‐like, and 5% basal‐like. None were HER2‐positive (non‐luminal). We found a strong statistical association between subtypes found by PAM50 signature and the IHC surrogate markers (p < 0.001). Furthermore, we found luminal A tumors to be smaller in size compared to luminal B tumors (p = 0.04). Patients with luminal A subtype tumors had the lowest ROR scores with a mean of 39, whereas patients with luminal B subtype tumors had a mean ROR score of 69. Significant worse overall survival for luminal B tumors compared to luminal A tumors was seen (p = 0.02). Male breast cancer seems to be a mainly luminal disease, with luminal B being the most frequent subtype. Further studies are needed to ensure correct therapeutic strategies for this select group of patients.

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Male breast cancer: correlation between immunohistochemical subtyping and PAM50 intrinsic subtypes, and the subsequent clinical outcomes

Cited by 19 publications

References 41 publications

Male breast cancer: clinicopathological characterization of a National Danish cohort 1980–2009

Male breast cancer: clinicopathological characterization of a National Danish cohort 1980–2009

Long Term Follow-Up of Male Breast Cancer Patients, Single Center Experience

Subtyping of male breast cancer by PAM50 and immunohistochemistry: a pilot study of a consecutive Danish cohort

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