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Khare VS, Huda F, Misra S, Amulya KR, Raj N, Karn S, Basu S. Male Breast Cancer: An Updated Review of Patient Characteristics, Genetics, and Outcome. Int J Breast Cancer 2024; 2024:9003572. [PMID: 38559438 PMCID: PMC10981544 DOI: 10.1155/2024/9003572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
Male breast cancer (MBC) is a rare entity, underrepresented in population studies and clinical trials, resulting in management of MBC to be informed by current research on female breast cancer (FBC). A literature review was conducted by accessing relevant articles on 2 databases, by searching keywords "male breast cancer". A total of 29 articles from year 2011 to 2022 were selected for this review. The authors found that male breast cancer generally occurs later in life with higher stage, higher grade, and more estrogen receptor (ER) positive tumours. Most of the studies noted the mean age for MBCs at the time of presentation as >60 years. Risk factors for male breast cancer include family history, obesity, lower physical activity, and syndromes like the Klinefelter syndrome. Positive family history is much higher in MBC compared to FBC (30.9 vs. 18.4%). BRCA 2 cancers constitute a higher proportion compared to FBCs. A lot of genetic mutations have been observed. Some show promise to assess disease-specific survival and proliferative rate like TWIST1 and RUNX3, among others. MBCs usually present with a palpable lump in central region, with a bigger size and chance of nodal involvement and metastasis compared to FBCs. They are mostly infiltrating ductal type and hormone receptor positive, with worse histological grade. Treatment usually follows the same principles as FBCs (systemic therapy, surgical excision, and radiotherapy), with poorer prognosis to same treatment approach, possibly owing to its advanced stage at presentation. This is a rare entity which requires further research to ascertain need for different management approach than FBCs.
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Affiliation(s)
- Vidhu Shekhar Khare
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Farhanul Huda
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Subhasis Misra
- Department of Surgical Oncology, BayCare Health System, Department of Medical Education, University of South Florida, Tampa, USA
| | - Kanmatha Reddy Amulya
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Nirmal Raj
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Summi Karn
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
| | - Somprakas Basu
- Department of General Surgery, All India Institute of Medical Sciences, 249203, Rishikesh, India
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Zheng G, Wang H, Liu FY, Leone JP. Male breast cancer: a 20-year multicenter experience. BREAST CANCER MANAGEMENT 2022. [DOI: 10.2217/bmt-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Male breast cancer (MBC) is a rare disease and accounts for approximately 1% of breast cancer. Treatment is largely extrapolated from female breast cancer due to lack of data in MBC. However, there are distinct features of MBC that warrant different treatment approach. We aim to better characterize the risk factors, clinicopathologic features, treatment and outcome of MBC patients from six hospitals across Steward Healthcare Network. Materials & methods: A total of 107 men with breast cancer were identified from the respective cancer registry at Steward and 64 patients were included with complete medical records. Their clinical, histopathological and treatment records were retrospectively reviewed. Kaplan–Meier method was used to determine the 5, 10 year overall survival (OS) rate and relapse free survival rate and Cox Regression test was used to assess the association between patient outcome and age at diagnosis, metastasis status at time of diagnosis, tumor size, nodal involvement and use of chemotherapy. Results: Of these 64 patients, median age at diagnosis was 68 years, majority of patients were white, 13 patients had family history of breast or ovarian cancer (20.3%), four patients tested positive for BRCA2 (6.25). Majority of patients presented painless breast lump. A total of 59 patients (92.2%) had invasive ductal carcinoma, and 31 patients (48.4%) had lymph node involvement at time of diagnosis. A total of 62 patients (96.8%) had M0 disease at time of diagnosis. About 97% of patients had estrogen receptor (ER) positive cancer. Most patients underwent mastectomy (87.5%), 35 patients (54.6%) received adjuvant radiation therapy, 19 patients (30%) received adjuvant chemotherapy and 96.7% of patients received adjuvant hormonal therapy. The median follow-up was 71.5 months (range 6–250 months), 5-year survival rate was 86.9% (95% CI: 74.5–93.6%), 5-year relapse free survival rate was 89.9% (95% CI: 77.4–95.7%) and 10-year survival rate was 58.1% (95% CI: 41.0–71.8%). The presence of distant metastasis at the time of initial diagnosis was the only factor associated with shorter OS (hazard ratio: 22.54, p < 0.0001). Conclusion: Majority of MBC patients present with palpable breast mass and the tumors are almost exclusively hormone receptor positive. Majority of patients present without distant metastasis and received surgical therapy; however, only a small subset of patients received breast conserving surgery for T1 tumor. Almost all patients received adjuvant hormonal therapy. OS and relapse free survival in our cohort is similar to historic reports in female breast cancer.
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Affiliation(s)
- Guoliang Zheng
- Department of Medicine, St Elizabeth Medical Center, Teaching Hospital of Boston University School of Medicine, 736 Cambridge Street, Boston, MA 02135, USA
| | - Haoyang Wang
- Department of Medicine, St Elizabeth Medical Center, Teaching Hospital of Boston University School of Medicine, 736 Cambridge Street, Boston, MA 02135, USA
| | - Fang-Yu Liu
- Department of Medicine, St Elizabeth Medical Center, Teaching Hospital of Boston University School of Medicine, 736 Cambridge Street, Boston, MA 02135, USA
| | - Jose Pablo Leone
- Dana Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA
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Davey MG, Davey CM, Bouz L, Kerin E, McFeetors C, Lowery AJ, Kerin MJ. Relevance of the 21-gene expression assay in male breast cancer: A systematic review and meta-analysis. Breast 2022; 64:41-46. [PMID: 35512428 PMCID: PMC9079225 DOI: 10.1016/j.breast.2022.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/22/2022] [Accepted: 04/26/2022] [Indexed: 12/19/2022] Open
Affiliation(s)
- Matthew G Davey
- Department of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, H91YR71, Ireland.
| | - Ciara M Davey
- Department of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, H91YR71, Ireland
| | - Luis Bouz
- Department of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, H91YR71, Ireland
| | - Eoin Kerin
- Department of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, H91YR71, Ireland
| | - Carson McFeetors
- Department of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, H91YR71, Ireland
| | - Aoife J Lowery
- Department of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, H91YR71, Ireland
| | - Michael J Kerin
- Department of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, H91YR71, Ireland
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