Breast cancer in males.

Unidad de Patología Mamaria, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, España.
Cirugia y cirujanos (Impact Factor: 0.32). 07/2011; 79(4):296-8.
Source: PubMed

ABSTRACT Male breast cancer has a very low incidence (<1%). It has traditionally been considered to have a poorer prognosis than breast cancer in females due to delayed diagnosis as a cause of decreased survival. Our goal is to analyze our series and to identify factors influencing survival.
We conducted a retrospective study from 1997-2008 (n = 32). Inclusion criteria were male gender and histological confirmation of breast cancer. We analyzed epidemiological data (age and personal and family history), tumors (size, grade of differentiation, histological type, location, TNM stage, receptors), therapeutic regimen (surgical technique, adjuvant therapy) and survival (relapse, followup, death).
Male breast cancer represents 0.9% of all breast cancers treated in our center. The average age of our patients was 66.84 years. Only 9.3% demonstrated gynecomastia as a presenting complaint. Histologically, 90% were infiltrating ductal type; 59.25% were diagnosed in early stages (I-II) compared to 40.74% in stages III-IV. Aggressive surgical techniques are still performed, compared to conservative techniques (74.19% vs. 19.36%). With a median follow-up of 52.82 months, the mortality rate was 16%. Existence of distant metastasis has been the only statistically significant factor in survival.
The percentage of cases of male breast cancer is very low compared to breast cancer in females. Limited studies in the literature make gender-specific findings difficult. A low percentage of conservative surgical procedures are performed, even though this has increased considerably in recent years. The existence of distant metastasis was the main determinant of survival.

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    ABSTRACT: To investigate clinicopathological characteristics and outcomes of male breast cancer (MBC). We retrospectively analyzed the data of 20 MBC patients in comparison with female ductal carcinoma treated at Yonsei University Severance Hospital from July 1985 to May 2007. Clinicopathological features, treatment patterns, and survival were investigated. MBC consists of 0.38% of all breast cancers. The median age was 56 years. The median symptom duration was 10 months. The median tumor size was 1.7 cm, 27.8% showed node metastasis, and 71.4% were estrogen receptor positive. All 20 cancers were arisen from ductal cells. No lobular carcinoma was found. The incidence of stages 0, I, II, and III in patients were 2, 10, 4, and 3, respectively. All patients underwent mastectomy. One with invasive cancer did not receive axillary node dissection and stage was not exactly evaluated. Adjuvant treatments were determined by pathologic parameters and stage. Clinicopathological parameters and survival rates of MBC were comparable to those of female ductal carcinoma. The onset age of MBC was 10 years older and symptom duration was longer than in female patients. No difference in outcomes between MBC and female ductal carcinoma suggests that the biology of MBC is not different from that of females. Therefore, education, an appropriate system for early detection, and adequate treatment are necessary for improving outcomes.
    Yonsei Medical Journal 01/2009; 49(6):978-86. · 1.31 Impact Factor
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    ABSTRACT: To review the epidemiology, presentation, diagnosis, molecular genetics, treatment and prognosis of male breast cancer. Articles, written in English or French, selected from the Medline database (1966 to January 2001), corresponding to the key words "male breast cancer," according to the following criteria: covering institutional experience or comparing diagnostic and treatment modalities, and epidemiologic or general reviews. Of 198 articles found 50 fulfilled the review criteria. Risk factors included advanced age, a positive family history, Jewish origin, black race, excess exposure to female hormones (Klinefelter's syndrome), environmental exposure (irradiation), alcohol, obesity, higher socioeconomic or higher educational status and childlessness. Gynecomastia remains a controversial factor, this term being used for both a histologic reality and a physical finding. Advanced disease is characterized by pain, bloody discharge and skin ulceration. There is no definitive diagnostic algorithm. Experience with male breast mammography is limited, and imaging is less informative for patients under 50 years of age. Fine-needle aspiration tends to overestimate the rate of malignancy. The commonest histologic finding is infiltrating ductal adenocarcinoma. Treatment includes modified radical mastectomy, followed by cyclophosphamide-methotrexate-5-fluorouracil or 5-fluorouracil-Adriamycin-cyclophosphamide chemotherapy for disease of stage II or greater. Radiotherapy does not seem to add any benefit. The disease is highly receptor-positive; however, many patients discontinue tamoxifen due to side effects. The most important prognostic factors are tumour size, lymphatic invasion and axillary node status. Because of the low incidence of male breast cancer, advances will be obtained mainly with the rapid transfer of newly gained knowledge in female mammary neoplasia. The increased use of adjuvant chemotherapy combined with tamoxifen postoperatively may have a positive impact on survival. Public education should be oriented toward men at higher risk to reduce the interval between appearance of symptoms and consultation. Rigorous data collection will allow for thorough reporting of risk factors and thus the possibility of characterizing the etiology of this disease.
    Canadian journal of surgery. Journal canadien de chirurgie 09/2002; 45(4):296-302. · 1.63 Impact Factor


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Dec 14, 2014