Abstract
BackgroundMale breast cancer (MBC) is a rare disease accounting for approximately 1% of all breast carcinomas. Presently treatment recommendations are derived from the standards for female breast cancer. However, those approaches might be inadequate because of distinct gender specific differences in tumor biology of breast cancer. This study was planned in order to contrast potential differences between female and male breast cancer in both tumor biological behavior and clinical management.MethodsMBC diagnosed between 1995-2007 (region Chemnitz/Zwickau, Saxony, Germany) was retrospectively analyzed. Tumor characteristics, treatment and follow-up of the patients were documented. In order to highlight potential differences each MBC was matched with a female counterpart (FBC) that showed accordance in at least eight tumor characteristics (year of diagnosis, age, tumor stage, nodal status, grade, estrogen- and progesterone receptors, HER2 status).Results108 male/female matched-pairs were available for survival analyses. In our study men and women with breast cancer had similar disease-free (DFS) and overall (OS) survival. The 5-years DFS was 53.4% (95% CI, range 54.1-66.3) in men respectively 62.6% (95% CI, 63.5-75.3) in women (p > 0.05). The 5-years OS was 71.4% (95% CI, 62.1-72.7%) and 70.3% (95% CI, 32.6-49.6) in women (p > 0.05). In males DFS analyses revealed progesterone receptor expression as the only prognostic relevant factor (p = 0.006). In multivariate analyses for OS both advanced tumor size (p = 0.01) and a lack of progesterone receptor expression were correlated (p = 0.01) with poor patients outcome in MBC.ConclusionOur comparative study revealed no survival differences between male and female breast cancer patients and gives evidence that gender is no predictor for survival in breast cancer. This was shown despite of significant gender specific differences in terms of frequency and intensity of systemic therapy in favor to female breast cancer.
Highlights
Male breast cancer (MBC) is a rare disease accounting for approximately 1% of all breast carcinomas
The relatively unfavorable outcome in male breast cancer has been attributed to more advanced local tumor stage and high incidence of lymph node invasion at the time of diagnosis [9,10,11]
For 108 male breast cancer patients one matching woman could be chosen from a total of 13.333 female breast cancer patients
Summary
Male breast cancer (MBC) is a rare disease accounting for approximately 1% of all breast carcinomas. Treatment recommendations are derived from the standards for female breast cancer. Those approaches might be inadequate because of distinct gender specific differences in tumor biology of breast cancer. In contrast to the breast cancer in women, male breast carcinoma (MBC) is rare, accounting for less than 1% of all cases of breast carcinoma with an incidence of 1 in 100.000 men [1,2]. The relatively unfavorable outcome in male breast cancer has been attributed to more advanced local tumor stage and high incidence of lymph node invasion at the time of diagnosis [9,10,11]. It has been postulated that close proximity to skin and nipple facilitates early invasion of lymph vessels leading to earlier regional and distant metastasis
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