Male Breast Cancer: 37-Year Data Study at a Single Experience Center in Turkey

Male breast cancer (MBC) is rare, accounting for less than 1% of all breast cancer and less than 1% of all cancer cases, with less than 0.5% of all cancer deaths in men, annually.MBC usually presents as a firm, painless mass along with palpable axillary nodes, nipple retraction, and ulceration of the skin at presentation. MBC is usually located in the subareolar region, but can also be seen in the upper outer quadrant. As is the case with women, the left breast is involved more predominantly than the right breast, and approximately 1% all of cases are bilateral. Approximately 90% of MBC are invasive ductal carcinomas. Lobular histology is rare, accounting for only 1.5% of MBC. MBC has high rates of hormone-receptor expression; approximately 90% express oestrogen receptor (ER), and 81% express progesterone receptor (PR). Tumor size and lymph node involvement are important prognostic factors in MBC, as is for female breast cancer. There are no prospective randomized trials comparing the efficacy of different treatment options for MBC. The standard surgical approach for localized MBC is a modified radical mastectomy (MRM), but as with women, retrospective studies suggest that equal effectiveness can be achieved with a radical mastectomy, MRM, or simple mastectomy in terms of local recurrence and survival. There is limited data regarding the indications for post mastectomy radiation therapy (RT) in men treated for breast cancer; the recommendation is to follow the same guidelines as for women. Post mastectomy RT appears to reduce loco regional recurrence in MBC; however, the influence on survival is unknown. Many retrospective studies have evaluated the role of adjuvant hormonal therapy, and these studies have revealed that most male patients can benefit from adjuvant tamoxifen in terms of recurrence and death.

Author(s): Edwina N Scott

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