Male breast cancer: An institution’s 25-year experience.

247 Background: There are no prospective and few large retrospective studies of male breast cancer (MBC). This study’s aim was to describe our institutional experience with MBC and evaluate the ability of the AJCC staging system to stratify survival. Methods: All MBC cases were identified from our institution’s cancer registry from 1984-2008. Data collected included tumor characteristics, lymph node status, treatment, age, and survival. Results: During the study period 166 MBC cases were identified. Median age at diagnosis was 62 years (range 27-87). Most common presentation was a palpable breast mass (77%). Stage at diagnosis was stage 0 (6%), stage 1 (27%), stage 2 (36%), stage 3 (17%), stage 4 (5%), and unknown (9%). Procedure performed was mastectomy in 148 patients (89%), lumpectomy in 10 patients (6%) and unknown in 8 patients (5%). Median tumor size was 2.0 cm (range 0.2-11.0 cm). Most common histology was invasive ductal carcinoma (91%). Estrogen and progesterone receptor status assessed at diagnosis was positive in 93% and 86% of cases tested respectively. HER2/neu status was positive in 6 of 47 cases tested (13%). Nodal staging was performed by axillary dissection (AD) (70%), sentinel node biopsy (SN) alone (11%), SN and AD (11%) and no axillary staging (8%); 43% were node positive, 47% node negative and 10% unknown. Adjuvant chemotherapy was given to 40 patients (24%), adjuvant hormonal therapy to 42 patients (25%) and adjuvant radiation therapy was used in 33 cases (20%). With a median follow-up of 5.5 years, 86 patients (52%) have died: 44 due to breast cancer, 23 due to causes unrelated to breast cancer, and in 19 the cause of death is unknown. Median overall survival was 9.3 years. Median cancer-specific survival was 16.0 years. For patients initially diagnosed at stage 2, 3, and 4 median cancer-specific survival was 12.9, 7.2, and 0.8 years respectively. Median cancer-specific survival was significantly different for stages 2 vs. 3 (p = 0.03) and 3 vs. 4 (p = 0.0006). Conclusions: MBC most commonly presents as a palpable mass, is hormone responsive, and is most commonly treated with mastectomy. The TNM system appropriately stratifies men with MBC by duration of survival.

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Unilateral nipple discharge in a man without a palpable mass diagnosed as breast cancer

BMJ Case Reports ◽

10.1136/bcr-2020-236223 ◽

2020 ◽

Vol 13 (11) ◽

pp. e236223

Author(s):

Karan N Ramakrishna ◽

Justin Durland ◽

Christopher Ramos ◽

Amit Singh Dhamoon

Keyword(s):

Breast Cancer ◽

Male Breast Cancer ◽

Ductal Carcinoma ◽

Early Recognition ◽

Nipple Discharge ◽

Care Physician ◽

Male Breast ◽

Laboratory Findings ◽

Palpable Mass ◽

History Of

A 69-year-old man without a family history of breast cancer presented to his primary care physician with a 1-year history of clear, unilateral nipple discharge (ND) without an associated palpable breast mass. His laboratory findings were significant for hyperprolactinaemia at 28 ng/mL. Diagnostic work up including mammography, ultrasound and core needle biopsy ultimately revealed a ductal carcinoma in situ and a rare papillary variant of invasive ductal carcinoma. The patient was referred to a multidisciplinary oncology team and underwent a right total mastectomy followed by adjuvant hormonal therapy. The patient made a good postoperative recovery and remains without evidence of recurrence 6 months from surgery. Male breast cancer is rare, but its incidence is increasing. Male breast cancer presenting as ND without a palpable mass is uncommon. Early recognition of breast symptoms in men can lead to earlier diagnoses and improved outcomes.

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The Unknown microRNA Expression of Male Breast Cancer. Similarities and Differences with Female Ductal Carcinoma. Their Role as Tumor Biomarker

Journal of Cancer ◽

10.7150/jca.23151 ◽

2018 ◽

Vol 9 (3) ◽

pp. 450-459 ◽

Cited By ~ 7

Author(s):

Maria J Merino ◽

Sara Gil ◽

Carmen Garcia Macias ◽

Karlena Lara

Keyword(s):

Breast Cancer ◽

Male Breast Cancer ◽

Ductal Carcinoma ◽

Microrna Expression ◽

Male Breast ◽

Tumor Biomarker ◽

Similarities And Differences

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Male Breast Cancer: 13-Year Single Institution Experience

The American Surgeon ◽

10.1177/0003134820964444 ◽

2020 ◽

Vol 86 (10) ◽

pp. 1345-1350

Author(s):

Marissa K. Srour ◽

Farin Amersi ◽

James Mirocha ◽

Armando E. Giuliano ◽

Alice Chung

Keyword(s):

Breast Cancer ◽

Male Breast Cancer ◽

Ductal Carcinoma ◽

Disease Free Survival ◽

Recurrence Score ◽

Breast Conserving Surgery ◽

Male Breast ◽

Brca Mutations ◽

Estrogen Receptor Positive ◽

Stage 1

Due to the low incidence of male breast cancer (BC), there are few studies evaluating outcomes. We evaluated the clinicopathologic features and outcomes of male BC. Male patients with BC from January 2006 to December 2018 were identified. Of 49 patients, mean age was 64 (range 33-94) years. Of the 27 (55.1%) patients who had genetic testing, 9 (33.3%) had a Breast Cancer gene (BRCA) 1 or 2 mutation. The majority of patients had a mastectomy (n = 43/49, 87.8%) and had invasive ductal carcinoma (n = 47/49, 95.9%). 20 patients (n = 20/43, 46.5%) had positive lymph nodes. 41 (n = 41/47, 87.2%) patients had estrogen receptor positive disease. The majority of patients were pathologic stage 2 (n = 21/46, 45.7%), followed by stage 1 (n = 15/46, 32.6%), stage 3 (n = 6/46, 13.0%), and stage 4 (n = 4/46, 8.7%). Eight patients had the 21-gene recurrence score performed. Of patients with stage 1-3 BC, 10 (n = 10/43, 23.3%) patients had recurrence. With median follow-up of 4.1 (range .6-10.6) years, 5-year overall survival was 82.9% and 5-year disease-free survival was 65.9%. In conclusion, our cohort of patients with male BC had a high incidence of BRCA mutations and most commonly had high-grade estrogen positive stage 2 tumors. Breast conserving surgery was utilized in 4% of patients and genomic testing utilized in 55% of patients.

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Early-stage male breast cancer: A 10-year experience

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e11630 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e11630-e11630

Author(s):

N. Gercovich ◽

E. Gil Deza ◽

M. Russo ◽

C. Garcia Gerardi ◽

C. Diaz ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Male Breast Cancer ◽

Ductal Carcinoma ◽

Early Stage ◽

Male Breast ◽

Stage I ◽

Stage Ii ◽

Breast Cancers ◽

Breast Cancer Patients

e11630 Introduction: Male breast cancer is very rare, representing only between 0.7% and 1% of all breast cancers, and only half of them are early stage cases. Objective: The present study has been designed with the aim of studying retrospectively the clinical onset and evolution of male invasive breast cancer patients (stages I and II) treated at IOHM between 1997 and 2008. Methods: The records of 3,000 breast cancer cases followed between 1997 and 2008 were searched, looking for male stage I and II breast cancer patients. A database was designed following the recommendations of the Directors of Surgical Pathology of the USA. The information registered encompassed: adjuvant treatments, recurrence date and date of final consultation or death. Results: Twelve pts were identified. Mean age (range)= 66 yo (50–89 yo). Tumoral type= Invasive Ductal Carcinoma 12 pt. Tumoral subtype= NOS 9 pt (75%) Apocrine 2 pt (17%) Micropapillar 1 pt (8%). Nottingham´s grade= Grade 2: 8 pt, Grade 3: 3 pt, N/A=1 pt. Stage= I= 6 pt, II=6 pt. ER (Positve= 9 pt, Negative=1 pt, N/A= 2 pt). PR (Positve= 8 pt, Negative= 2 pt, N/A=2 pt). Her2neu (0+= 3 pt, 1+= 3 pt, 2+= 2 pt, N/A= 4 pt). Surgery= Mastectomy= 11 pt, Lumpectomy 1= pt. Radiotherapy=5 pt. Adjuvance= No=2 pt, Hormonotherapy (HT)= 3 pt, Chemotherapy (CHT) = 3 pt, CHT+HT= 4 pt. Recurrence= Yes= 2 pt, No= 10 pt. Survival: Dead= 1 pt, Alive =11 pt. Mean Time To Progression= Stage I =66 months, Stage II =42 months. Global survival: Stage I =66 months, Stage II =52 months. Conclusions: 1. Twelve stage I and II male breast cancer patients were identified out of 3000 (0.4%) breast cancer cases diagnosed and followed in the past 10 years at the IOHM. 2. Mastectomy was the surgical procedure in 11 of the 12 cases 3. Ten pt underwent adjuvant treatment. 4. With a mean follow up time of 60 months, all stage I patients are alive and there were no recurrences. Two of the 6 stage II pts progressed and one died. No significant financial relationships to disclose.

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Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer

American Journal of Men s Health ◽

10.1177/1557988316669044 ◽

2016 ◽

Vol 11 (4) ◽

pp. 1190-1199 ◽

Cited By ~ 8

Author(s):

Orimisan Samuel Adekolujo ◽

Shourya Tadisina ◽

Ujwala Koduru ◽

Jill Gernand ◽

Susan Jane Smith ◽

...

Keyword(s):

Breast Cancer ◽

Marital Status ◽

Male Breast Cancer ◽

Stage Iv ◽

Tumor Stage ◽

Male Breast ◽

Cancer Type ◽

Stage At Diagnosis ◽

Cancer Specific Survival ◽

Stage Iv Disease

The effect of marital status (MS) on survival varies according to cancer type and gender. There has been no report on the impact of MS on survival in male breast cancer (MBC). This study aims to determine the influence of MS on tumor stage at diagnosis and survival in MBC. Men with MBC ≥18 years of age in the SEER database from 1990 to 2011 were included in the study. MS was classified as married and unmarried (including single, divorced, separated, widowed). Kaplan–Meier method was used to estimate the 5-year cancer-specific survival. Multivariate regression analyses were done to determine the effect of MS on presence of Stage IV disease at diagnosis and on cancer-specific mortality. The study included 3,761 men; 2,647 (70.4%) were married. Unmarried men were more often diagnosed with Stage IV MBC compared with married (10.7% vs. 5.5%, p < .001). Unmarried men (compared with married) were significantly less likely to undergo surgery (92.4% vs. 96.7%, p < .001). Overall unmarried males with Stages II, III, and IV MBC have significantly worse 5-year cancer-specific survival compared with married. On multivariate analysis, being unmarried was associated with increased hazard of death (HR = 1.43, p < .001) and increased likelihood of Stage IV disease at diagnosis ( OR = 1.96, p < .001). Unmarried males with breast cancer are at greater risk for Stage IV disease at diagnosis and poorer outcomes compared with married males.

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Male Breast Cancer Has Limited Effect on Survivor’s Perceptions of Their Own Masculinity

American Journal of Men s Health ◽

10.1177/1557988316631512 ◽

2016 ◽

Vol 11 (2) ◽

pp. 246-252 ◽

Cited By ~ 3

Author(s):

Sarah Rayne ◽

Kathryn Schnippel ◽

John Thomson ◽

Joanna Reid ◽

Carol Benn

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Male Breast Cancer ◽

Ductal Carcinoma ◽

Breast Cancer Diagnosis ◽

Male Breast ◽

Delayed Presentation ◽

Breast Cancer Patients ◽

Hospital Patients ◽

Stage 1

The purpose of the current study was to describe male breast cancer in Johannesburg, South Africa, and assess whether male breast cancer patients’ perception of their own masculinity was affected by having a cancer commonly seen in women. A retrospective file review was carried out at two hospitals, one private and one government, of male breast cancer patients from 2007 to 2012 followed by a telephone survey of patients identified during review. Of approximately 3,000 breast cancer patients seen in the 5 years reviewed, 23 cases of male breast cancer were identified. Most were diagnosed with invasive ductal carcinoma ( n = 19, 83%). Stage at presentation was from stages 0 to 3 (Stage 0 [ n = 2, 9%], Stage 1 [ n = 3, 13%], Stage 2 [ n = 12, 52%], Stage 3 [ n = 6, 26%]) and no patients were metastatic at presentation. The telephonic survey was completed by 18 patients (78%). Nearly all ( n = 17/18) shared their diagnosis with family and close friends. Two thirds of patients delayed presentation and government hospital patients were more likely to present later than private sector hospital patients. Although most male breast cancer patients sampled did not perceive the breast cancer diagnosis as affecting their masculinity, Black men and those treated in government hospitals were less likely to be aware of male breast cancer, and were more likely to have their perception of their own masculinity affected.

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Clinical features of patients with male breast cancer in Shanxi province of China from 2007 to 2016

Journal of Investigative Medicine ◽

10.1136/jim-2018-000823 ◽

2018 ◽

Vol 67 (3) ◽

pp. 699-705

Author(s):

Weigang Wang ◽

Xiaoqin Xu ◽

Baoguo Tian ◽

Yan Wang ◽

Lili Du ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Features ◽

Male Breast Cancer ◽

Hormone Receptors ◽

Ductal Carcinoma ◽

Cox Proportional Hazards ◽

Male Breast ◽

Shanxi Province ◽

Smoking History ◽

Large Sample Size

This study aims to understand the clinical features, treatment, and prognosis of patients with male breast cancer (MBC) in Shanxi province of China from 2007 to 2016. Data for 77 patients with MBC were collected for analysis. Immunohistochemistry, pathological results, and other data such as demographic characteristics (age, marital status, smoking history, drinking history, and family history of cancer) as well as clinical data were investigated by retrieving information from the patients’ medical records. A total of 12,404 patients were diagnosed with breast cancer between 2007 and 2016, and 77 were patients with MBC among them. The median diagnosis age of patients with MBC was 62 years (range, 24–84 years). The most common complaint was a painless lump in the breast, accounting for 68.8% of the patients, and the main pathological type in MBC was infiltrating ductal carcinoma (66.2%). In terms of hormone receptors, 80.5% (62/77) of patients with MBC were estrogen receptor positive, 75.3% (58/77) of patients were progesterone receptor positive, and only 6.5% (5/77) of patients were HER2 overexpressing. The multivariant Cox proportional hazards regression analysis showed that M stage is an independent prognostic factor (p=0.018, HR=18.791, 95% CI 1.663 to 212.6). The epidemiological and clinical features of Chinese MBC are similar to that of other countries. As the Chinese public have limited knowledge of MBC, it is necessary to increase awareness among them about it. Further research with a large sample size is required for better understanding of the risks associated with MBC.

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Predictors of adjuvant radiation therapy in the treatment of male breast cancer and its impact on outcomes: A propensity matched analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e12516 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e12516-e12516

Author(s):

Veli Bakalov ◽

Thejus Thayyil Jayakrishnan ◽

Stephen Abel ◽

Christie Hilton ◽

Bindu Rusia ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Male Breast Cancer ◽

Cox Regression ◽

Breast Conservation ◽

Male Breast ◽

Breast Conservation Surgery ◽

P Value ◽

Adjuvant Radiation ◽

Adjuvant Radiation Therapy

e12516 Background: Male breast cancer (MBC) accounts for 1% of all breast cancers and there is a paucity of data on factors impacting the treatment strategies and outcomes. We hypothesized that adjuvant radiation therapy (Adj-RT) may improve survival outcomes and sought to examine predictive factors for Adj-RT receipt. Methods: We queried the National Cancer Database (NCDB) for patients with stages I-III MBC treated with surgery (breast conservation surgery- BCS or mastectomy-MS) within 180 days of diagnosis (years 2004-2015). Multivariable logistic regression identified predictors of adjuvant radiation therapy receipt. Multivariable Cox regression evaluated predictors of survival. Propensity matching for adj-RT accounted for indication biases. Results: We identified 6,217 patients meeting the eligibility criteria (1457 BCS vs. 4760 MS). The majority of patients were white (85%) and within the age range of 50-80 years (74%). Although Adj-RT was omitted for 30% of BCS patients, the utilization was higher compared to MS (OR=26, p-value=0.001). The predictors of Adj-RT use were – African American race, higher stage, higher grade, presence of lymphovascular invasion and ER/Her-2 positivity for the entire cohort and higher age, urban location and higher income for BCS. Adj-RT was associated with lower mortality in the propensity matched model (overall HR for BCS=0.28, p-value<0.001; overall HR for MS=0.62,p-value=0.001) and is shown in the table. Conclusions: This study demonstrates there may be an association between decreased mortality and Adj-RT in MBC undergoing BCS. Although this implies that Adj-RT should be routinely delivered, it appears to be omitted frequently and its use requires further investigation. The study also suggests a benefit to Adj-Rt after MS for stage-III MBC. [Table: see text]

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Rare Case of Male Breast Cancer and Axillary Lymphoma in the Same Patient: An Unique Case Report

Case Reports in Medicine ◽

10.1155/2011/940803 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Emiliano Sordi ◽

Katia Cagossi ◽

Maria Grazia Lazzaretti ◽

Daniel Gusolfino ◽

Fabrizio Artioli ◽

...

Keyword(s):

Breast Cancer ◽

Male Breast Cancer ◽

Ductal Carcinoma ◽

Malignant Lesion ◽

Gene Mutations ◽

Radical Mastectomy ◽

Simultaneous Presentation ◽

Needle Aspiration ◽

Male Breast ◽

First Case

Breast cancer in men is uncommon, and even more rare is the simultaneous presentation of two different malignancies. A 39-year-old man was diagnosed with both breast cancer and axillary lymphoma. Familiar history revealed that his mother died because of breast cancer. The patient underwent fine needle aspiration leading to the diagnosis of malignant lesion. Modified radical mastectomy was performed. Histology revealed an infiltrating ductal carcinoma 2.8 cm wide, grade 2, with vascular and lymphatic invasion. Surprisingly, one of the second level nodes was confirmed as a high-grade large B cell non-Hodgkin's lymphoma. No family inheritance or gene mutations (BRCA 1 and 2) were found. The patient underwent local radiotherapy, followed by 6 chemotherapy courses (RCHOP) and treatment with tamoxifen 20 mg/daily. To our knowledge, this is the first case reported in literature of male breast cancer and axillary lymphoma simultaneously confirmed in the same patient.

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