Male Breast Cancer: The Three Decades' Experience of a Tertiary Care Hospital in a Lower-Middle Income Country

Zeeshan, Sana; Siddiqiui, Tayyab; Shaukat, Fatima; Tariq, Muhammad; Khan, Naseer Abbas; Vohra, Lubna Mushtaque

doi:10.7759/cureus.22670

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…In total, adjuvant ET was indicated in 90% of hormone receptor-positive patients (N=201). This number is very high, contrary to some researchers who report that only 57.9% [4,20], 67.3% [21], and 76.8% [6] of men with hormone receptor-positive MBC were treated with ET. We assumed that, in addition to the region, this also depends on organization and/or quality of care.…”

Section: Overall Outcomescontrasting

confidence: 63%

Retrospective Male Breast Cancer study in the Czech Republic: Treatment and Prognosis Experience Over 11 Years in 256 Cases

Bielčiková

Holánek

Selingerová

et al. 2023

Preprint

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Purpose To analyze clinicopathologic characteristics, treatment procedures, and prognosis of men with breast cancer (MBC) in the Czech Republic and compare them with international data. Methods Men diagnosed with breast cancer in 2007–2017 were retrospectively identified from the databases of Complex Oncological Centers in the Czech Republic, and subsequently clinical, histopathological, and molecular-genetic characteristics, treatment procedures, and long-term treatment outcomes were evaluated. Prognostic factors of survival outcomes (overall survival, relapse-free survival, and breast cancer-specific mortality) were analyzed using Cox and the competing risks model. Results In this study, data from 256 patients with MBC at a median age of 66 years were analyzed. Of 201 patients with primary non-metastatic (M0) radically treated MBC, 6% were younger than 40 years, 29% had stage I, 55% were node-negative (cN0), and 54% were indicated to genetic testing. Estrogen receptor (ER) expression over 10% had 97% of tumors, 61% had high mitotic activity (Ki67), 40% high grade (G3), and 68% Luminal B-like (HER2- negative) subtype. Regarding the therapy, 97% of men underwent mastectomy (ME), 34% sentinel lymph node biopsy (SLNB), 48% adjuvant radiotherapy (RT), 13% neoadjuvant therapy, 44% adjuvant chemotherapy (CT), 90% adjuvant endocrine therapy (ET), of which 74% adjuvant tamoxifen (TMX). Patients treated with aromatase inhibitor (AI) alone had significantly shortened RFS (p < 0.001). There were also associations between OS/RFS/BCSM and disease stage, T, N, progesterone receptor (PR) expression, G and Ki67. Median OS reached 122 months in curatively treated M0 patients, 42 months in the de novo metastatic (M1) group (N = 30), and 39 months in the group of M0/X patients treated with palliative intention (N = 25). Conclusion Although the number of MBC cases with unfavorable features (young age, M1 cases, predominant Luminal B-like tumors) was higher in the Czech dataset compared to international studies, the prognosis of men remains consistent with the real-world published data.

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Section: Overall Outcomescontrasting

confidence: 63%

Retrospective Male Breast Cancer study in the Czech Republic: Treatment and Prognosis Experience Over 11 Years in 256 Cases

Bielčiková

Holánek

Selingerová

et al. 2023

Preprint

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“…Adjuvant ET was indicated for 92% of hormone receptor-positive M0 patients. This number is very high compared with prior studies, in which ET was indicated for 57.9%, 4 , 24 67.3%, 25 and 76.8% 6 of men with hormone receptor-positive MBC. Only 5% of patients discontinued ET due to their performance status, treatment intolerance, or treatment refusal.…”

Section: Discussionmentioning

confidence: 53%

Treatment and Prognosis of Male Breast Cancer: A Multicentric, Retrospective Study Over 11 Years in the Czech Republic

Bielcikova,

Holanek,

Selingerova

et al. 2024

The Oncologist

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Purpose Male breast cancer (MBC) is a rare, but increasingly common disease, and lacks prospective studies. Collaborative efforts are needed to understand and address MBC, including its prognosis, in different countries. Methods We retrospectively reviewed the clinical, histopathological, and molecular-genetic characteristics, treatments, and survival outcomes of MBC diagnosed between 2007 and 2017 in the Czech Republic. Prognostic factors of overall survival (OS), recurrence-free interval (RFi), and breast cancer-specific mortality (BCSM) were analyzed and indirectly compared to international data. Results We analyzed 256 patients with MBC (median age 66 years), including 12% with de novo metastatic (M1). Of 201 non-metastatic (M0) patients, 6% were <40 years old, 29% had stage I, 55% were cN0, and 54% underwent genetic testing. Overall, 97% of tumors had estrogen receptor expression ≥10%, 61% had high Ki67 index, 40% were high-grade (G3), and 68% were luminal B-like (HER2-negative). Systemic therapies included endocrine therapy (90%) and chemotherapy (53%). Few (5%) patients discontinued adjuvant endocrine therapy for reasons other than disease relapse or death. Patients treated with aromatase inhibitors alone had significantly shorter RFi (P < .001). OS, RFi, and BCSM were associated with disease stage, T stage, N stage, progesterone receptor expression, grade, and Ki67 index. Median OS reached 122 and 42 months in M0 and de novo M1 patients, respectively. Conclusion Due to the rarity of MBC, this study highlights important findings from real clinical practice. Although the number of patients with MBC with unfavorable features was higher in this Czech dataset than in international studies, the prognosis remains consistent with real-world evidence.

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“…Invasive carcinoma of no special type (NST) is the most common MBC [11]. Histologic types of ductal origin occur relatively more frequently in men than in women, reflecting the absence of lobular structures in the normal male breast; those of lobular origin are very uncommon in men [10,12].…”

Section: Introductionmentioning

confidence: 99%

Aggressive Male Breast Cancer—Clinical and Therapeutic Aspects Correlated with the Histopathological Examination: A Case Report and Literature Review

Petrescu,

Pirici,

Ruxanda

et al. 2023

Medicina

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Breast cancer is often seen as a disease that occurs in women, but it can also appear in men in a very small percentage, below 1%. Men have a minimal amount of breast tissue compared to women, which has the potential to become malignant in a similar way to women, although much less frequently. A patient presented with advanced local invasion due to the low amount of breast tissue, with the tumor quickly invading the adjacent structures. Histopathological and immunohistochemical examinations have an extremely important role in the pathology of breast cancer. Given that male breast cancer is rare and there are not enough surgeons specializing in breast surgery in our country, there is a lack of experience in the management and early diagnosis of this type of cancer, which will be highlighted in this article.

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Male Breast Cancer: The Three Decades' Experience of a Tertiary Care Hospital in a Lower-Middle Income Country

Cited by 4 publications

References 22 publications

Retrospective Male Breast Cancer study in the Czech Republic: Treatment and Prognosis Experience Over 11 Years in 256 Cases

Retrospective Male Breast Cancer study in the Czech Republic: Treatment and Prognosis Experience Over 11 Years in 256 Cases

Treatment and Prognosis of Male Breast Cancer: A Multicentric, Retrospective Study Over 11 Years in the Czech Republic

Aggressive Male Breast Cancer—Clinical and Therapeutic Aspects Correlated with the Histopathological Examination: A Case Report and Literature Review

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