Male breast cancer: 22 case reports at the National Hospital of Niamey- Niger (West Africa)

Abstract

Background: Male breast cancer (MBC) is rare. The objective of the study is to report clinicopathological characteristics, treatment patterns, and outcomes of MBC. Method: This study, which includes two parts (retrospective and prospective), focused on all hospitalized male patients with breast cancer during 17 years (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) with histological confirmation. Results: The series included 22 patients. The mean age was 52.8 years (range: 28-80 years). MBC represented 5.7% of all breast cancers. Most patients had an advanced disease with skin ulceration and inflammation T3 (31.9%) and T4 (59.1%). The majority of patients came from rural areas (63.6%). The duration of signs ranged from 1 to 7 years. Histology found infiltrating ductal carcinoma in 14 cases (63.6%), sarcoma in 3 cases (13.6%), papillary carcinoma in 2 cases (9%), and lobular carcinoma, medullar carcinoma, and mucinous carcinoma in 4.6% each of the others cases. The treatment had consisted of a radical mastectomy (Halsted or Patey) in 19 cases (86.4%) with axillary clearance and incomplete resection in 3 cases (13.6%). In the retrospective study follow-up of 14 patients, we lost sight of 13 patients 6 months after surgery. In the prospective study of 8 patients 10 to 36 months after mastectomy, 4 patients were deceased (50%), 4 were alive with 1 case having a local recurrence and pulmonary metastasis. Conclusion: The advanced clinical forms of MBC are most frequent with skin ulceration and nodal enlargement. The absence of radiotherapy and the low access of chemotherapy limited the treatment to radical mastectomy (Halsted) in the majority of cases.

Male Breast Cancer : A Retrospective Study

“…These may be a reflection of the proper adjuvant treatment received in most of their patients and we believe that this may be because of the large number of LN negative patients (46.2 %) which had significant impact on survival (p = 0.001) (22,24) . Median TTP was 40 months similar to results obtained by Foerster et al, Whereas 5years DFS was 21.4%, which is in consistent with literature that range from (21%-89%) (20,23,30) . These lower survival rates as mentioned before considered sequel of high relapse rate which in turn may be as a result of delayed presentation with high tumor stage.…”

“…The most striking finding in this study is the age at presentation which was revealed to be 59 years old (median) and range (22-85 years) which is much lower than that reported in studies from USA, France, Canada that were (65years, 66.5years, 69.5years) respectively (19,20,21) . Similar to that reported from other studies in Egypt & Sudan, while it is more in that reported from study in West Africa with median age 52.8 years (17,18,22,23) . Presentation of MBC almost by lump in 61 -95% of patients with similar results our study revealed that presentation of patients were lump (57.1%), nipple retraction (21.5%), ulcer (14.3%) and bleeding per nipple (7.1%) & with respect to OS bleeding per nipple was significantly better than other presentations (p=0.029), while it was highly significant regarding TTP (p= <0.001).…”

“…Surgery is the cornerstone of treatment of MBC, the preservative methods applied for FBC should not be used for MBC because of small breast, central tumors, invasion of the skin, and the pectoral muscle (23) .…”

Young male breast cancer, a small crowd, the survival, and prognosis?

“…In fact, male breast cancer may be presented with more aggressive behavior and the lymph node metastasis rate ranges from 35% to 84%. [ 29 – 31 ] Pitifully, some molecular characteristics affecting the prognosis of male patients with breast cancer were not analyzed in our study. Several studies have pointed that a significant number of patients (mostly BRCA2 mutation positive) developed multiple cancers including male breast cancer; most male cancers are ER positive but without a corresponding increase in PR positivity and only a weaker association with estrogen-controlled markers such as PS2, HSP27, and Cathepsin D; increased methylation defines a subset of familial male breast cancer and with average methylation index may be a useful prognostic marker.…”

Epidemiologic and Clinical Profiles of Breast Diseases in Niger

“…A previous study from Niger reported a 5.7% breast cancer rate among males [10] . Higher rates of approximately 9% male breast cancer were reported from Nigeria [23–24] .…”