Male breast cancer: a retrospective study of 15 years
M.A. Eryilmaz
1
, A. Igci
2
, M. Muslumanoglu
2
, V. Ozmen
2
, M. Koc
3
1
Konya Education and Research Hospital, General Surgery Clinic, Konya;
2
Medical School of Istanbul University, Department of General
Surgery, Istanbul;
3
Meram Medical School of Selcuk University, Department of Radiation Oncology, Konya, Turkey
Summary
Purpose: To retrospectively evaluate the 15-year ex-
perience with breast cancer in males at a single institution.
Methods: The data from 25 male patients who had un-
dergone surgery for breast cancer at a single center were ret-
rospectively analysed. Their medical records were studied for
clinical characteristics, therapeutic modalities used and fac-
tors associated with disease free (DFS) and overall survival
(OS), like local recurrence/distant metastasis.
Results: The median patient age was 67 years (range
38-83). The most frequent presenting symptom was a palpa-
ble lump. Eighteen (72%) patients underwent modiied radi-
cal mastectomy (MRM), while sentinel lymph node biopsy
(SLNB) was performed in 14 (56%) cases. Of 25 patients, 21
(84%) underwent axillary lymph node dissection (ALND) and
15 (71.4%) of them had pathological axillary lymph node in-
volvement. Two of 25 (8%) patients with bone and liver me-
tastases underwent toilet mastectomy due to breast ulceration.
Estrogen receptor (ER) was positive in 15 (60%) patients,
while progesterone receptor (PR) and C-erbB2 (HER-2)
were positive in 10 (40%) and 2 (8%) patients, respectively.
Ten patients (40%) had both ER(+) and PR(+). The median
follow-up period was 19 months (range 3-102). Local recur-
rence developed in one (4%) patient and distant metastasis in
4 (16%). Five-year OS and DFS were 53 and 49%, respective-
ly. In univariate and multivariate analysis, pathological tumor
size (<2 vs. >2 cm), pathological lymph node involvement and
preoperative skin involvement over the breast were not associ-
ated with breast recurrence. Only in univariate analysis local
recurrence/distant metastasis were associated with poor OS.
Conclusion: Large cooperative studies are needed us-
ing strict clinical and laboratory criteria to advance the un-
derstanding of this disease and to identify the most effective
treatment approaches.
Key words: male breast cancer, sentinel lymph node biopsy,
tissue-sparing surgery
Introduction
Male breast cancer (MBC) accounts for less than
1% of all diagnosed breast cancers and less than 1% of
all cancers in men [1]. Breast cancer in men and wom-
en contrasts in the age at diagnosis, the histological
types and the expression of hormone receptors. The
median age at diagnosis in men is 68 years, compared
with 63 years in women [2-4]. Men with breast cancer
have a higher occurrence of ductal histology. More than
85% of all cases are invasive ductal carcinomas (IDC),
whereas its rate in women is 70-75% [5]. Male patients
have also higher rate of hormone receptor positive dis-
ease [5,6].
Despite the biological differences, clinical out-
comes for breast cancer in men are similar to those for
women when they are matched for age, treatment, and
stage of cancer [5-7]. Currently, there is no standardized
treatment guideline for MBC. However, management
of MBC is mostly based on evidence derived from data
analysis of female breast cancer (FBC) patients [3,8].
The usual treatment for male patients is to undergo
MRM. Relatively recently, breast-conserving surgery
(BCS) became more of an issue in women with breast
cancer. With this trend, BCS has been demonstrated to
be feasible in MBC cases, though there is little experi-
ence with BCS, the indication is limited and irm evi-
dence about safety is lacking [8-14].
In this retrospective study we report a single cen-
ter experience with MBC during the last 15 years, in-
cluding clinicopathological features, recurrence and
survival of patients treated with surgery (radical mas-
Correspondence to: Mehmet Koc, MD, PhD. Meram Medical School of Selcuk University, Department of Radiation Oncology, 420 90 Konya, Turkey.
Tel.: +90 332 2236942, Fax: +90 332 2236182, E-mail: mhkoc@hotmail.com
Received 19-07-2011; Accepted 14-08-2011
Journal of BUON 17: 51-56, 2012
© 2012 Zerbinis Medical Publications. Printed in Greece
ORIGINAL ARTICLE