Prognostic factors for male breast cancer: A breast center’s 10-year experience

Abstract

Male breast cancer (MBC) is rare and accounts for 1% all breast cancers. 1 Approximately, 350 men are diagnosed with the condition each year within the UK and its incidence is increasing. 2 However, due to the rare nature of the disease, MBC has been poorly studied in relation to female breast cancer (FBC). 3 We aimed to investigate the prognosis of MBC in our center's past 10-year experience, and to compare the patient, tumor, and treatment differences between men who were treated successfully and those who suffered breast cancer recurrence or all-cause mortality.We undertook a prospective cohort study of all patients diagnosed with MBC over a 10-year period from 1 January 2005 until 31 December 2014. The identifiers of all men were prospectively recorded over the study period and at the end of this study, the clinical notes were retrieved and reviewed. Outcome and treatment-related information was extracted from the clinical notes. The primary outcome measure of interest was adverse outcome, defined as ipsilateral disease recurrence, contralateral breast cancer occurrence, metastatic disease, or all-cause mortality.A total of 30 primary cases of MBC were identified; 27 unilateral and 3 bilateral cases. All patients were treated with mastectomy and either sentinel lymph node biopsy or axillary clearance, followed by adjuvant endocrine therapy. Radiotherapy and chemotherapy were reserved for cases of metastatic disease or high risk of recurrence.Of these, 24 patients adhered to adjuvant endocrine therapy, six had adjuvant chemotherapy, and 16 patients had adjuvant radiotherapy.No patients were lost to follow-up.The mean age was 68.3 years (SD 11.8) and patient characteristics are shown in Table 1. All patients were followed up annually with surveillance contralateral imaging and clinical examination. Five patients had an adverse outcome, of which three patients had a subsequent recurrence (10%) and two died from their disease (7%). Of the five patients with adverse outcome, three patients had invasive ductal carcinoma and two had invasive cribiform carcinoma. Tumor size and nodal status did not reach statistical significance (P = 0.13 and 0.14, respectively) for adverse outcome (Table 2).There is limited evidence on the prognosis of MBC; however, it is generally worse than for FBC. 4 MBC is predominantly ER-positive, 5 suggesting that underlying endocrine factors may play an important role in pathogenesis. In more recent years, a number of other receptors have also been identified with MBC such as glucocorticoid, androgen, HER2, and EGF receptors although the prognostic value of these receptors is still poorly understood. 6While not identified in our cohort, axillary nodal involvement and tumor size have previously been identified as key prognostic determinants for MBC. Although there is heterogeneous evidence on the prognosis of men with breast cancer, their prognosis is generally worse than their female counterparts. The reason for this is unclear, but since this difference in prognosis appears to be independe...

Men with breast cancer experience stigma in the waiting room

“…These women might in turn play a role in earlier detection for a male relation, especially in families where genetic screening indicates risk factors such as BRCA mutations . This could be particularly important, given that men with breast cancer are often diagnosed at more advanced stages of disease, and therefore face poorer prognoses than women …”

“…be particularly important, given that men with breast cancer are often diagnosed at more advanced stages of disease, and therefore face poorer prognoses than women. 3,9,10 Although not covered here, we acknowledge other institutional…”