The prognosis of breast cancer in males a report of 335 cases

Guinee, Vincent F.; Shallenberger, Rick; Olsson, Håkan; Möller, Torgil; Blink, J. W. van den; Péter, Zoltán; Durand, M.; Dische, Stanley; Cleton, F. J.; Zewuster, Roelof; Cui, Meiying; Lane, Warren W.; Richter, Rudolf

doi:10.1002/1097-0142(19930101)71:1<154::aid-cncr2820710125>3.0.co;2-#

Cited by 155 publications

(82 citation statements)

References 31 publications

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“…Although several studies have stated that the prognosis was worse in MBC than in females, it was determined that there were no differences in the prognosis of the two genders when paired according to age and stage (105). A large study with more than 335 male patients found that if nodal status is used to compare MBC and FBC, then the prognosis was similar (106). The less favorable results in male patients are due to the more advanced stage at presentation as well as a higher mean age at presentation leading to more co-morbidity (52,107).…”

Section: Prognosis Survival and Prognostic Factorsmentioning

confidence: 85%

Male Breast Cancer

Yalaza¹,

2016

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IntroductionOver the past two decades, major improvements have been achieved in the understanding of breast cancer, and cure can be offered if the disease is diagnosed at an early stage. However, the disease is more often diagnosed at more advanced stages (3 or 4) in men, in contrast to women. Its rarity among men as well as lack of awareness leads to its detection at later stages. Randomized studies cannot be carried on due to the low incidence of breast cancer in males, with only a few published prospective therapeutic studies in the literature. While the information on male breast cancer (MBC) was obtained from retrospective studies, the recommendations for treatment were derived from studies conducted on female breast cancer (1). This review presents the frequency, etiology, clinical-pathological characteristics and treatment approaches for the rare MBC. Epidemiology-EtiologyMale breast cancer is rare and constitutes 0.5-1% of all patients with breast cancer. The reason of the low incidence rate in men is the relatively low amount of breast tissue along with the difference in their hormonal environment. Even though breast tissue is less in men as compared to women, the factors that influence malignant changes are similar. The Surveillance, Epidemiology and End Result (SEER) Program reported that the incidence of breast cancer was highest at ages 52-71 during 1973-2000, whereas the peak incidence in males was 71 years (2). In fact, some authors state that MBC imitate the behavioral pattern of post-menopausal female breast cancer. The incidence of breast cancer in males and females has increased in the past 25 years. International Association of Cancer Registries (IACR) emphasized this increase and stated that the incidence of female breast cancer increased by 20%, while breast cancer-related deaths increased by 14%. The SEER data also showed that the rate that was 1.1 for 100.000 men in the mid-1970s and raised to 1.44 for 100.000 men by 2010 (3). In USA, 2240 men were diagnosed with breast cancer within the year 2013. The lifetime rate of diagnosis with male breast cancer is 1 in 1000. According to the IACR Turkey data, 0.37% of all cancer types among males are breast cancer (4, 5). IACR has published its new cancer estimates for the year 2012. The most recent cancer estimates for 28 cancer types in 184 countries, which record cancer data, have been made available for users on the GLOBOCAN 2012 website (6).The rate of presentation with advanced stage breast cancer has been decreasing in men. As a matter of fact, a study conducted in 1995 reported the rate of Stage 1-2 disease on diagnosis as 70%, whereas it was reported as 67% in 2010 and 82% in 2015 (7-9). MBC constitutes less than 1% of male cancers and it has a varying rate of incidence across different geographies and ethnic groups (10, 11). Its annual prevalence in Europe is 1 in 10.000 men and these cases constitute less than 1% of all patients with breast cancer (4). However, this rate is above 6% in Central African countries (12). This relatively hig...

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Section: Prognosis Survival and Prognostic Factorsmentioning

confidence: 85%

Male Breast Cancer

Yalaza¹,

2016

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“…Men with tumor size from two to five cm have for 40% greater risk of death in comparison to men who have a tumor smaller than 2cm (Mustafa et al, 1998), that is five year survival of men with breast cancer smaller than 2cm is 74%, while 37% in those with a tumor greater than 5cm (Guinee et al, 1993). In our study the rate of overall five year survival of men with breast cancer in relation to tumor size is 100% for tumors ≤2cm, and 38% for tumors greater than 5cm.…”

Section: Discussionmentioning

confidence: 99%

Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

Šipetić-Grujičić

Murtezani²,

Z³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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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.

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“…Male breast carcinoma (MBC) represents only 1% of all mammary cancers (Hecht and Winchester, 1994) and seems to behave more aggressively than female breast carcinomas (FBCs) (Ribeiro, 1985;Salvadori et al, 1994), although no difference in survival between MBC and FBC has been reported (Guinee et al, 1993;Cutuli et al, 1995;Weber-Chappuis et al, 1996). Treatment of MBC is far from standardization because of the uncommon nature of the disease, and no randomized comparisons of treatment have been carried out as in FBC.…”

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confidence: 99%

Androgen receptor expression in male breast carcinoma: lack of clinicopathological association

et al. 1999

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Summary Androgen receptor (AR) expression was retrospectively analysed in 47 primary male breast carcinomas (MBCs) using a monoclonal antibody on formalin-fixed, paraffin-embedded tissues. AR immunopositivity was detected in 16 out of 47 (34%) cases. No association was found with patient age, tumour stage, progesterone receptor (PGR) or p53 protein expression. Well-differentiated MBCs tended to be AR positive more often than poorly differentiated ones (P = 0.08). A negative association was found between ARs and cell proliferative activity: MIB-1 scores were higher (25.4%) in AR-negative than in AR-positive cases (21.11%; P = 0.04). A strong positive association (P = 0.0001) was found between ARs and oestrogen receptors (ERs). In univariate analysis, ARs (as well as ERs and PGRs) were not correlated with overall survival; tumour histological grade (P = 0.02), size (P = 0.01), p53 expression (P = 0.0008) and MIB-1 scores (P = 0.0003) had strong prognostic value. In multivariate survival analysis, only p53 expression (P = 0.002) and histological grade (P = 0.02) retained independent prognostic significance. In conclusion, the lack of association between AR and most clinicopathological features and survival, together with the absence of prognostic value for ER/PGR status, suggest that MBCs are biologically different from female breast carcinomas and make it questionable to use antihormonal therapy for patients with MBC.

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The prognosis of breast cancer in males a report of 335 cases

Cited by 155 publications

References 31 publications

Male Breast Cancer

Male Breast Cancer

Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

Androgen receptor expression in male breast carcinoma: lack of clinicopathological association

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