The Significance Of Hormone Receptors In Male Breast Cancer

Abstract

Background Male mammary glands are usually considered a rudimentary organ. However, they may be exposed to similar pathological influences as female breasts. These pathological influences may cause the development of malignant breast tumors. Breast cancer in males is a rare disease, nevertheless, it is a serious problem. According to numerous national cancer registries from around the world, this disease takes 1% on average in the structure of morbidity of malignant neoplasms of this organ in both sexes. Methods In our study (168 patients) estrogen receptors were positive in the tumors of 75% of patients. The positive rate of progesterone receptors was observed in 44% of patients. The detection rate of steroid hormone receptors in malignant tumors of the male breast ranges from 65 to 100%, depending on the criteria for identifying their positivity level. The hormone therapy in the early and late stages of cancer include antiestrogens, steroid and non-steroid aromatase inhibitors, both as monotherapy and in combination with LHRH-agonists, fulvestrant and other hormonal agents. Results There was no dependence found between the receptor status of the tumors and the age of patients with breast cancer. Breast cancer in men has a more aggressive course than the same disease in women. This means lower survival rate of male patients, greater number of locally advanced and metastatic cases, with delayed primary treatment, and resistance to treatment compared to female breast cancer patients. The incidence of receptor positive tumors in men does not increase with age, as observed in women with breast cancer. Despite numerous reports on the effectiveness of hormone therapy in men with breast cancer, many aspects of this type of therapy remain largely unexplained. Conclusions Hormone therapy appears the most effective in patients with the so-called feminization syndrome, which includes signs of hyperestrogenemia, as well as in patients with multiple unfavorable prognostic signs (stage III of cancer, low differentiation of tumor cells, status of regional lymph nodes N2-3, medium, severe and morbid obesity). Orchiectomy does not increase the survival rate, therefore, its application is impractical.

Male Breast Cancer: An Updated Review of Epidemiology, Clinicopathology, and Treatment

“…In contrast to FeBC, which contains mostly ER-alpha receptors, the majority of MaBC have ER-beta receptors, indicating possible different biological activities at the molecular level between MaBC and FeBC. This may warrant a different approach to MaBC in terms of anti-estrogen therapy compared with FeBC [ 68 ].…”