Prognostic significance of tumor subtypes in male breast cancer: A population-based study.

Leone, José Pablo; Leone, Julieta; Zwenger, Ariel Osvaldo; Iturbe, Julian; Vallejo, Carlos; Leone, Bernardo Amadeo

doi:10.1200/jco.2015.33.15_suppl.1072

Cited by 10 publications

(16 citation statements)

References 14 publications

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“…These findings are consistent with the literature (2,24,26). Despite the small size of our study, we were able to confirm several unique characteristics of MBC compared to FBC, such as older age at diagnosis (median age 73 years), higher rates of ER positivity, PR positivity, and AR positivity, and lower HER2 positivity (5,24,25).…”

Section: Discussionsupporting

confidence: 93%

“…In addition, we identified two patients (5%) having basal-like tumors by both PAM50 and our IHC panel. This was unexpected, since basal-like tumors are rarely found in male breast cancer (24)(25)(26). However, it must be noted that both of these tumors were found subcutaneously and without relation to recognizable glandular breast tissue.…”

Section: Discussionmentioning

confidence: 94%

“…Several studies classifying MBC into molecular subtypes based on IHC markers have been reported (20,(24)(25)(26)(27)(28). Comparison between studies is, however, complicated by the fact that the studies use different definitions for the subtypes.…”

Section: Discussionmentioning

confidence: 99%

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Subtyping of male breast cancer by PAM50 and immunohistochemistry: a pilot study of a consecutive Danish cohort

Christensen

Lautrup

Lyng

et al. 2020

APMIS

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Male breast cancer (MBC) is a rare disease that is still to be fully understood. In female breast cancer, molecular subtyping by gene expression has proven its significance. In this study, we characterize a consecutive cohort of MBC patients surgically treated from 1997 to 2017, identified at our institution (N = 37), and report the association between molecular subtypes found by a surrogate panel of immunohistochemical (IHC) markers, and the PAM50 signature, as well as risk of recurrence score and overall survival for the different subtypes. PAM50 subtypes were determined using the nCounter FLEX system instrument and software. The distribution of molecular subtypes according to the PAM50 signature was as follows: 56% luminal B, 39% luminal A, and 5% basal‐like. None of the tumors were HER2‐enriched. Using IHC surrogate markers, we found 80% luminal B‐like, 15% luminal A‐like, and 5% basal‐like. None were HER2‐positive (non‐luminal). We found a strong statistical association between subtypes found by PAM50 signature and the IHC surrogate markers (p < 0.001). Furthermore, we found luminal A tumors to be smaller in size compared to luminal B tumors (p = 0.04). Patients with luminal A subtype tumors had the lowest ROR scores with a mean of 39, whereas patients with luminal B subtype tumors had a mean ROR score of 69. Significant worse overall survival for luminal B tumors compared to luminal A tumors was seen (p = 0.02). Male breast cancer seems to be a mainly luminal disease, with luminal B being the most frequent subtype. Further studies are needed to ensure correct therapeutic strategies for this select group of patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 94%

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Subtyping of male breast cancer by PAM50 and immunohistochemistry: a pilot study of a consecutive Danish cohort

Christensen

Lautrup

Lyng

et al. 2020

APMIS

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“…When examining pathologic characteristics of male BC, Leone et al reviewed 960 male patients with BC from the SEER database and showed that 84.9% of patients had hormone receptor (HR)-positive/HER2-negative BC, which was a similar distribution seen in our study population of 87.2%. 12 They also had 12.2% of patients with HR-positive/HER-2-positive disease and 2.9% of patients with triple negative BC, which was similar to our distribution of 10.6% and 2.1%, respectively.…”

Section: Discussionsupporting

confidence: 88%

Male Breast Cancer: 13-Year Single Institution Experience

Srour

Amersi

Mirocha

et al. 2020

The American Surgeon™

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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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“…15 Several research groups have attempted to classify male breast cancer into molecular subtypes using the same immunohistochemical classification of female breast cancer and the subsequent clinical outcome. [16][17][18][19][20] These reports have in common that, the majority of the tumors were classified as luminal A (60-80%) defined as ER-positive and/or PRpositive and Her2-negative. Luminal B subtype defined as ER-positive and/or PR-positive and Her2-positive was the second more frequent subtype after luminal A.…”

Section: Discussionmentioning

confidence: 99%

Male breast cancer: correlation between immunohistochemical subtyping and PAM50 intrinsic subtypes, and the subsequent clinical outcomes

et al. 2018

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Male breast cancer is a rare disease that is still poorly understood. It is mainly classified by immunohistochemistry as a luminal disease. In this study, we assess for the first time the correlation between molecular subtypes based on a validated six-marker immunohistochemical panel and PAM50 signature in male breast cancer, and the subsequent clinical outcome of these different subtypes. We collected 67 surgical specimens of invasive male breast cancer from four different Spanish pathology laboratories. Immunohistochemical staining for the six-marker panel was performed on tissue microarrays. PAM50 subtypes were determined in a research-use-only nCounter Analysis System. We explored the association of immunohistochemical and PAM50 subtypes. Overall survival and disease-free survival were analyzed in the different subtypes of each classification. The distribution of tumor molecular subtypes according PAM50 was: 60% luminal B, 30% luminal A and 10% human epidermal growth factor receptor 2 (Her2) enriched. Only one Her2-enriched tumor was also positive by immunohistochemistry and was treated with trastuzumab. None of the tumors were basal-like. Using immunohistochemical surrogates, 51% of the tumors were luminal B, 44% luminal A, 4% triple-negative and 1% Her2-positive. The clinicopathological characteristics did not differ significantly between immunohistochemical and PAM50 subtypes. We found a significant worse overall survival in Her2-enriched compared with luminal tumors. Male breast cancer seems to be mainly a genomic luminal disease with a predominance of the luminal B subtype. In addition, we found a proportion of patients with Her2-negative by immunohistochemistry but Her2-enriched profile by PAM50 tumors with a worse outcome compared with luminal subtypes that may benefit from anti-Her2 therapies.

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Prognostic significance of tumor subtypes in male breast cancer: A population-based study.

Cited by 10 publications

References 14 publications

Subtyping of male breast cancer by PAM50 and immunohistochemistry: a pilot study of a consecutive Danish cohort

Subtyping of male breast cancer by PAM50 and immunohistochemistry: a pilot study of a consecutive Danish cohort

Male Breast Cancer: 13-Year Single Institution Experience

Male breast cancer: correlation between immunohistochemical subtyping and PAM50 intrinsic subtypes, and the subsequent clinical outcomes

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