The biological markers and results of treatment in male breast cancer patients. The Cracow experience.

Abstract

Male breast cancer is a rare form of carcinoma with an incidence rate of approximately 0.5-1% compared with cases of breast carcinoma as a whole. Male breast cancer reacts effectively to endocrine therapy because of a high frequency of hormone receptor expression.The aim of the present study was the assessment of correlations between stage, grade, expression of steroid receptors, basal/mesenchymal markers and proliferation index, as well as analysis of the impact of the above-mentioned parameters on overall (OS) and disease-free survival (DFS) in the group of 32 male breast cancer patients, treated at the Centre of Oncology in Cracow.We showed the significant positive correlation between MIB-1 LI and tumor stage, and hormone receptors (ER or PgR) immunonegativity, and expression of EGFR, vimentin (p<0.05) and P-cadherin (the last at statistical border). The presence of any of basal or masenchymal markers correlated with a more advanced tumor stage. Moreover tumors without vimentin expression were characterised by lower MIB-1 LI and were more frequently EGFR immunonegative.We found that hormone receptor negativity, vimentin immunopositivity and high MIB-1 LI are significant independent indicators of poor OS and DFS for male breast cancer patients (p<0.05). Key words: male breast cancer, basal markers, mesenchymal markers, nodal status, hormonal receptorsMale breast cancer is a rare form of carcinoma with an incidence rate of approximately 0.5-1% compared with cases of breast carcinoma as a whole [1,2,3,4]. Its peak incidence is noted in the seventh decade of life [5,6,7]. The most significant risk factors are an increased concentration of estrogen and obesity, that are a result of estrogen overproduction, impaired metabolism, and disturbances in the concentration of estrogen and androgen (i.e. in Klinefelter's syndrome) as well as the use of estrogenes in prostate cancer treatment [6,8,9,10,11]. Other factors include alcoholism, liver cirrhosis, the presence of hereditary BRCA1 and BRCA2 gene mutations and exposure to ionizing radiation, the electromagnetic field and increased temperature [6,8,9,12,13,14,15,16,17].According to Anderson et al., male breast cancer is characterised by similar biological factors to those present in the female variant of the cancer [18]. However, these tumors are diagnosed in more advanced stages of the disease, are characterised by higher degree of differentiation (more frequently G1, G2 grade) and a lower mitotic index in comparison to female breast cancer [5,19]. There are also differences in the frequency of the expression of hormone receptors and growth factor receptors [19,20]. Besides, the prognosis for male breast cancer is worse [5,18,20,21]. A study by Baojiang et al. of 5-year survival rates of patients suffering from male breast carcinoma and female breast carcinoma produced the following results: 61.2% and 68.7% (DFS), and 75.% and 82.9% (OS), respectively [20].Male breast cancer has a higher (over 90%) hormone receptor expression and, as a consequence, reacts more effect...

The role of adjuvant chemotherapy in stage I–III male breast cancer: a SEER-based analysis

“… 17 In the present study, tumour stage, grade and ER status were independent prognostic factors for OS. 18 Therefore, to further understand the association between adjuvant chemotherapy and the survival of stage I–III male breast cancer patients, we stratified the patients by tumour grade, stage, receptors status, tumour size and LN status. The data of HER2 status were available only after 2010 due to limitations in the SEER database.…”

“…10 Several large clinical trials have shown that some women with breast tumour >1 cm may avoid adjuvant chemotherapy without reducing the overall survival rate. 11 For example, the TAILORx trial 12,13 was a prospective and randomized trial for women with hormone receptor-positive, human epidermal growth factor receptor 2-negative, stage T1-2, lymph node-negative and recurrence score (RS) of 11-25 breast cancers (HR+, HER2-, T1-2, N0, M0, RS [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], in which the patients received adjuvant endocrine therapy alone or adjuvant chemotherapy followed by endocrine therapy. The two groups had similar treatment efficacy and no significant differences in disease-free survival (DFS) or overall survival (OS).…”

Deep learning models predicting hormone receptor status in breast cancer trained on females do not generalize to males: further evidence of sex-based disparity in breast cancer

“…For both sexes, prognostication and treatment decision making is dependent upon the expression pro les of the nuclear hormone receptors ERα and PR, currently determined by immunohistochemistry. High expression of ERα and PR are both predictors of improved outcome in MBC, associated with improved overall and disease-free survival, older age of diagnosis, low mitotic index, and lower pathological stage [6][7][8][9][10][11][12][13] The expression of these receptors is notably different between MBC and FBC. Contrary to females, BC in males is almost universally ERα positive (95% in MBC vs. 75% in FBC).…”