Male breast cancer: Pathology, treatment, and outcome

Abstract

814 Background: A single-institution retrospective review of the clinical/pathologic presentation, treatment, and outcome of male breast cancer was conducted. Methods: Data pertaining to clinical/pathologic presentation, treatment, and outcome were obtained by chart review of 21 male breast cancer patients from 1976–2004. Results: Patients presented at a median age of 67 years (34–90), with 71.4% presenting with a self-detected breast mass. Left sided breast cancer was present in 61.9% of patients and there were no reported cases of bilateral disease. The pathologic subtypes were infiltrating ductal carcinoma (80.9%), DCIS (9.5%), adenocarcinoma (4.7%), and intraductal papillary carcinoma (4.7%). Additionally, ER and PR positivity were 80.9 and 76.2% respectively, with 90.5% of tumors >1 cm in greatest diameter. Modified radical mastectomy was performed in 90.4% of patients revealing positive lymph nodes in 52.3% of patients. Adjuvant chemotherapy and/or hormonal therapy were prescribed in 23.8 and 47.6% of cases, respectively. Adjuvant radiation therapy was administered in 14.3% of patients. Documented local and distant recurrences were 9.5 and 19.0% respectively, while 9/15 (60%) of patients were alive at 5 years. Two patients died secondary to metastatic disease, one died from unrelated ventricular fibrillation/AMI, and an additional three patients were lost to follow-up. Of the two patients that died from breast cancer, one patient had lymph node positive disease and did not receive adjuvant chemotherapy, the other patient recurred in the chest wall and had not received adjuvant radiation therapy for a 5 cm, 11/12 lymph node positive primary tumor. Conclusions: Despite many similarities in male and female breast cancer, because of lack of screening in men, a majority of tumors were larger in size (>1 cm) and more often had regional lymph node involvement at the time of diagnosis. Furthermore, historically adjuvant chemotherapy and hormonal therapy were prescribed in relatively few patients as compared with females. With only 60% of patients surviving 5 years, physicians should be encouraged to prescribe adjuvant therapy in an attempt to improve outcome. No significant financial relationships to disclose.