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Chakrabarti D, Ghosh A, Qayoom S, Manjunath S, Khalid B, Rajan S, Akhtar N, Ramakant P, Verma M, Srivastava K, Kumar V, Gupta R, Mishra AK, Bhatt MLB. Long-term clinical outcomes of male breast cancer patients treated with curative intent by trimodality therapy at an academic university hospital in India. J Med Imaging Radiat Oncol 2024. [PMID: 39034491 DOI: 10.1111/1754-9485.13733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/02/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Male breast cancer is rare and accounts for less than 1% of all breast cancer cases worldwide. METHODS This retrospective cohort study included all patients of invasive male breast cancer treated with curative intent by a trimodality approach via a multidisciplinary team at an academic university hospital in India between 2009 and 2023. Records were identified from a prospectively maintained database. Clinicopathological parameters, treatment details and survival were recorded and analysed. RESULTS Thirty-four patients were included. The median (IQR) age was 55(44-63) years. Most patients were overall stage III (74%) and node positive (79%) with Scarff-Bloom-Richardson grade II (50%). Twenty-five patients (73%) were oestrogen receptor (ER) positive. Lymphovascular space invasion (LVSI) and perineural invasion (PNI) were present in 62% and 21% of patients, respectively. The most common chemotherapy timing was adjuvant (53%) followed by neoadjuvant (41%), and the most commonly used regimen consisted of a combination of doxorubicin-cyclophosphamide followed by a taxane (53%). Most (85%) patients underwent a mastectomy, five patients underwent breast conservation. All patients received radiotherapy to a dose of 42.6 Gy in 16 fractions, followed by a tumour bed boost for those undergoing breast conservation. At a median follow-up of 70 months (range 10-159 months), the five and ten-year overall survival was 91% and 58%, and the five-year disease-free survival (DFS) was 67%. The median DFS was 72 months. On univariate analysis, the tumour sub-type (Luminal versus TNBC) significantly predicted DFS (P = 0.03 log-rank). CONCLUSION Breast cancer in males has a high incidence of node positivity, ER positivity and LVSI. Even with advanced stages at presentation, trimodality therapy in a multidisciplinary setting offers good long-term outcomes.
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Affiliation(s)
- Deep Chakrabarti
- Department of Radiotherapy, King George's Medical University, Lucknow, India
- The Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Arunima Ghosh
- Department of Radiotherapy, King George's Medical University, Lucknow, India
| | - Sumaira Qayoom
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Shreyamsa Manjunath
- Department of Endocrine Surgery, King George's Medical University, Lucknow, India
| | - Bushra Khalid
- Department of Radiotherapy, King George's Medical University, Lucknow, India
| | - Shiv Rajan
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Naseem Akhtar
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Pooja Ramakant
- Department of Endocrine Surgery, King George's Medical University, Lucknow, India
| | - Mranalini Verma
- Department of Radiotherapy, King George's Medical University, Lucknow, India
| | - Kirti Srivastava
- Department of Radiotherapy, King George's Medical University, Lucknow, India
| | - Vijay Kumar
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Rajeev Gupta
- Department of Radiotherapy, King George's Medical University, Lucknow, India
| | - Anand Kumar Mishra
- Department of Endocrine Surgery, King George's Medical University, Lucknow, India
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Soni A, Verma Y, Chauhan A, Kaur P, Kaushal V, Paul D. Male breast cancer: a 30 year retrospective analysis from a tertiary cancer care centre. Ecancermedicalscience 2023; 17:1551. [PMID: 37377689 PMCID: PMC10292857 DOI: 10.3332/ecancer.2023.1551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Indexed: 06/29/2023] Open
Abstract
Background Male breast cancer (MBC) is one of the rare malignancies that account for less than 1% of all malignancies in males. However, the clinicopathological characteristics of MBC are not entirely similar to female breast cancer; but still, it is treated in line with the female breast cancer protocols. Aims To retrospectively analyse trends in MBC as to its distribution, presentation, treatment, and outcome. Material and method A total of 106 patients with MBC from 1991 to 2020 were analysed retrospectively. Frequency distribution analysis of the demographic and clinicopathological data and treatment variables was done. Results Median age of presentation was 57 years; ranging from 30 to 86 years. Either of the sides was almost equally affected with an R: L ratio of 1.2:1. The average duration of complaint was 26.2 months (range 1-240 months). History of gynaecomastia was noted in 18 patients, significant benign prostate hypertrophy in 13, and hypertension needing medical treatment in 14 patients. The majority of the patients were smokers (72/106) and alcoholics (43/106). Five patients reported positive family history. 21 patients had metastatic disease at presentation and received palliative treatment. Stage II was seen in 36.8%, stage III in 43.4%, and stage IV in 19.8% of patients. Node positives were 63.2%. Pathology was invariably (90.5%) infiltrative ductal carcinoma. Radiation was administered in 85.8% of the patients, chemotherapy in 72.6% of patients, and hormonal treatment was given in 47.2% of patients. The median overall survival (OS) was 78 months. OS at 5 and 10 years was 78% and 58% respectively. Conclusion Despite the possibility of MBC being apparent at an early stage, patients present with locally advanced disease. Radical surgery with adjuvant/neoadjuvant chemotherapy and adjuvant radiotherapy remains the gold standard. Cancer education campaigns must be run to catch the early disease and to radically treat the disease.
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Affiliation(s)
- Abhishek Soni
- Department of Radiation Oncology, Pt. B. D. Sharma PGIMS, Rohtak 124001, Haryana, India
| | - Yashpal Verma
- Department of Radiation Oncology, Pt. B. D. Sharma PGIMS, Rohtak 124001, Haryana, India
| | - Ashok Chauhan
- Department of Radiation Oncology, Pt. B. D. Sharma PGIMS, Rohtak 124001, Haryana, India
| | - Paramjeet Kaur
- Department of Radiation Oncology, Pt. B. D. Sharma PGIMS, Rohtak 124001, Haryana, India
| | - Vivek Kaushal
- Department of Radiation Oncology, Pt. B. D. Sharma PGIMS, Rohtak 124001, Haryana, India
| | - Diptajit Paul
- Department of Radiation Oncology, Pt. B. D. Sharma PGIMS, Rohtak 124001, Haryana, India
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Das Majumdar SK, Das DDK, Barik S, Badajena A, Parida DK. Evaluation of Clinicopathological and Prognostic Factors of Male Breast Cancer: A Single-Centre Experience. Cureus 2021; 13:e20298. [PMID: 35036180 PMCID: PMC8752343 DOI: 10.7759/cureus.20298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/05/2022] Open
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Chhabra MK, Chintamani, Kadyaprath G, Srivastva A, Selvakumar V, Ranjan P, Durga CK, Thomas S, Kaur N, Singh M, Govil M, Gupta A. Male Breast Cancer—an Indian Multicenter Series of 106 Cases. Indian J Surg 2021. [DOI: 10.1007/s12262-019-01953-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Wang B, Wang H, Zhao A, Zhang M, Yang J. Poor prognosis of male triple-positive breast Cancer patients: a propensity score matched SEER analysis and molecular portraits. BMC Cancer 2021; 21:523. [PMID: 33964913 PMCID: PMC8106220 DOI: 10.1186/s12885-021-08267-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/28/2021] [Indexed: 11/26/2022] Open
Abstract
Background The purpose of this study was to explore clinicalpathology features, molecular features and outcome of male breast cancer patients who expressed ER, PR as well as HER-2, namely triple-positive male breast cancer (TP-MBC), and compared them with triple-positive female breast cancer patients (TP-FBC). Methods TP-MBC and TP-FBC from 2010 to 2017 were selected from the Surveillance, Epidemiology, and End Results database (SEER). Kaplan-Meier plotter and multivariable Cox regression model were applied to analyse the difference between TP-MBC and TP-FBC on cancer-specific survival (CSS) and overall survival (OS). Propensity score matched (PSM) analysis was used to ensure well-balanced characteristics. 7 cases TP-MBC and 174 cases TP-FBC patients with the genomic and clinical information were identified from the cohort of The Cancer Genome Atlas (TCGA) and the Memorial Sloan Kettering (MSK). Result 336 TP-MBC and 33,339 TP-FBC patients were taken into the study. The percentages of TP-MBC in MBC patients were higher than the rates of TP-FBC in FBC patients from 2010 to 2017 except 2012. Compared with TP-FBC, more TP-MBC were staged III (17.9% vs. 13.5%) or stage IV (11.0% vs. 6.9%). TP-MBC were more frequently to be older than 65-years-old (47.0% vs. 29.3%), Balck (15.2% vs. 10.8%), ductal carcinoma (91.7% vs. 84.4%) and metastases to lung (4.5% vs. 2.1%) or bone (8.6% vs. 4.7%). TP-MBC had worse OS and CSS than TP-FBC in all stages (P < 0.001). In multivariable prediction model of TPBC, male patients had a higher risk than female. Lastly, the worse OS (P < 0.001) and CSS (P = 0.013) were seen in the 1:3 PSM analysis between TP-MBC and TP-FBC. Genomic analysis revealed that TP-MBCs have some notable rare mutations, like ERBB2, ERBB3, RB1, CDK12, FGFR2, IDH1, AGO2, GATA3, and some of them are not discovered in TP-FBC. Conclusion TP-MBC had a worse survival than TP-FBC, and there were different genomic features between two groups. Current knowledge and treatment to TP-MBC maybe inadequate and remain to be explored. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08267-9.
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Affiliation(s)
- Biyuan Wang
- Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Hui Wang
- Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Andi Zhao
- Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Mi Zhang
- Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Jin Yang
- Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China.
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Presentation and Spectrum of Male Breast Cancer in a Rural Cancer Center in a Subunit of Tata Memorial Center, India. Indian J Surg Oncol 2021; 12:330-334. [PMID: 34295077 DOI: 10.1007/s13193-021-01306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/01/2021] [Indexed: 10/21/2022] Open
Abstract
This is a retrospective study of the incidence and clinical profile of male breast cancer (MBC) presenting to a rural cancer center in Punjab, India. All MBC cases registered over a period of 4.5 years from January 2015 to July 2019 were included. The study included 34 MBC patients accounting for 1.9% of all breast cancer cases with median age of 62.5 years. All patients were from Punjab except one, with majority from district Sangrur. Family history was present in 7 (20.6%) patients. Mean BMI (n = 23) was 24.8. The median duration of symptoms was 6 months (range 1-60 months). Main complaint was lump in 58.8% of patients followed by lump with ulceration (41.2%). All cases were mostly unilateral, left in 21 (61.8%) and right in 13 (38.2%), and one had bilateral breast cancer. Most tumors were centrally located (70.6%). Infiltrating ductal carcinoma and grade 3 were the commonest histology. ER positivity was high seen in 76.5% cases. In our study, 16 (47.1%) patients presented with distant metastasis at the time of diagnosis, and 10 (39.1%) were locally advance. Bone (41%) followed by lung (17%) were the most common sites of metastasis. Thirteen patients were treated radically, nine were treated with palliative intent, and twelve patients defaulted. Median follow-up period was 16.5 months. MBC constituted 1.9% of all breast cancers registered at our institute, which is higher than worldwide average. Our study population had a longer time to presentation, and majority were metastatic.
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Ram D, Rajappa SK, Selvakumar VP, Shukla H, Goel A, Kumar R, Kumar K. Male breast cancer: A retrospective review of clinical profile from a tertiary cancer care center of India. South Asian J Cancer 2020; 6:141-143. [PMID: 29404286 PMCID: PMC5763618 DOI: 10.4103/sajc.sajc_2_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aim: Present study was done with an aim to analyse the clinicopathological and survival characteristics of male breast cancer patients. Methods: We did a retrospective review of our database and analysed total 27 patients who presented to breast oncology unit of Rajiv Gandhi cancer centre and research institute from January 2010 to April 2016. Results: Most common stage at presentation in our study was in stage II. The median follow up was 32.75 months. The actuarial 5-year survival was 92.30% and DFS was 76.30%. Only hormone receptor status was found as a significant prognostic variable among the prognostic factors studied for disease free survival. Conclusions: Carcinoma breast in male is a relatively rare disease and management principles are translated from our understanding of breast cancer in women. A relatively early stage at presentation is a contrasting finding of our series which may be responsible for a significantly better actuarial 5 year survival rates.
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Affiliation(s)
- Dharma Ram
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Suhas K Rajappa
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Veda P Selvakumar
- Department of Breast Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Himanshu Shukla
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Ashish Goel
- Departments of BLK Super Speciality Hospital, New Delhi, India
| | - Rajeev Kumar
- Department of Breast Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Kapil Kumar
- Departments of BLK Super Speciality Hospital, New Delhi, India
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