Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

Abstract

Background: The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. Materials and Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. Results: The mean age at diagnosis with breast cancer was 64.3±10.5 years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ≤2 cm, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. Conclusions: Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.

Histopathological Review of Male Breast Cancer Cases

“…Six cases had distant metastasis. Nipple involvement was noted in 9 cases, of which 7 located in central quadrant, 8 were IDC, 1 was pure DCIS and 1 had in situ component in addition to invasive component. Tumor necrosis was seen in 9 cases (27.3%), perineural invasion in 15 cases (45,5%), tumor emboli in dermal lymphatics in 10 cases (30.3%).…”

“…Grujicic et al and Bruce et al reported IDC as most common subtype because male breast normally consist of only ducts [8,9]. Lobular tissue is present only in case of increased estrogen exposure [4].…”

“…The overall 5-year survival in case of lymph node metastasis is 57%, whereas it is 85% in non-metastatic cases [18]. Age, size, grade, lymph node metastasis and steroid receptor status are defined as independent prognostic factors for MBC survival [8]. Bergmann et al found that metastasis at diagnosis, older age, higher tumor stage and smoking status are independent factors associated with risk of death [8].…”

“…Age, size, grade, lymph node metastasis and steroid receptor status are defined as independent prognostic factors for MBC survival [8]. Bergmann et al found that metastasis at diagnosis, older age, higher tumor stage and smoking status are independent factors associated with risk of death [8]. Grujicic et al showed 100% overall survival for tumors ≤2cm, 38% for tumors >5cm [8].…”

A Systemic Analysis on Pemetrexed in Treating Patients with Breast Cancer

“…Breast cancer remains a significant problem for global health as it is one of the most common cause of tumorrelated death world-wide (Fouz et al, 2013;Engin et al, 2013;Sedighi et al, 2013;Zhu et al, 2013;Wu et al , 2014;Cabuk et al, 2014;Chin et al, 2014;Fouladi et al, 2014;Majeed et al, 2014;Gogia et al, 2014;Liu et al, 2014;Louisa et al, 2014;Moazzezy et al, 2014;Niu et al, 2014;Rizalar et al, 2014;Sipetic-Grujicic et al, 2014;Prajoko et al, 2014;Inanc et al, 2014;Varol et al, 2014;Yadav et al, 2014). Pemetrexed is a novel multitargeted antifolate that inhibits several enzymes in the de novo pathways of pyrimidine and purine biosynthesis, including thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide ormyltransferase.…”