General Information
Male breast cancer is rare. Less than 1% of all breast carcinomas occur in
men.[1] The mean age at diagnosis is between 60 and 70, although men of all
ages can be affected with the disease.
Predisposing risk factors [2] appear to include radiation exposure, estrogen
administration, and diseases associated with hyperestrogenism, such as
cirrhosis or Klinefelter’s syndrome.[3] There are definite familial
tendencies, with an increased incidence seen in men who have a number of female
relatives with breast cancer. An increased risk of male breast cancer has been
reported in families in which the BRCA2 mutation on chromosome 13q has been
identified.[4,5]
The pathology is similar to that of female breast cancer, with infiltrating
ductal cancer the most common tumor type.[6] Intraductal cancer has been
described as well. Inflammatory carcinoma and Paget’s disease of the nipple
have also been seen in men, but lobular carcinoma in situ has not.[6] Lymph
node involvement and the hematogenous pattern of spread are similar to those
found in female breast cancer. The TNM staging system for male breast cancer
is identical to the staging system for female breast cancer. (Refer to the PDQ
summary on Breast Cancer Treatment for more information.)
Prognostic factors that have been evaluated include the size of lesion and the
presence or absence of lymph node involvement, both of which correlate well
with prognosis.[2,7] Whether ploidy and S phase correlate with survival is
uncertain.[8]
Overall survival is similar to that of women with breast cancer. The
impression that male breast cancer has a worse prognosis may stem from the
tendency toward diagnosis at a later stage.[2,9]
References
- Borgen PI, Wong GY, Vlamis V, et al.: Current management of male breast cancer. A review of 104 cases. Ann Surg 215 (5): 451-7; discussion 457-9, 1992.
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- Giordano SH, Buzdar AU, Hortobagyi GN: Breast cancer in men. Ann Intern Med 137 (8): 678-87, 2002.
[PUBMED Abstract]
- Hultborn R, Hanson C, Köpf I, et al.: Prevalence of Klinefelter's syndrome in male breast cancer patients. Anticancer Res 17 (6D): 4293-7, 1997 Nov-Dec.
[PUBMED Abstract]
- Wooster R, Bignell G, Lancaster J, et al.: Identification of the breast cancer susceptibility gene BRCA2. Nature 378 (6559): 789-92, 1995 Dec 21-28.
[PUBMED Abstract]
- Thorlacius S, Tryggvadottir L, Olafsdottir GH, et al.: Linkage to BRCA2 region in hereditary male breast cancer. Lancet 346 (8974): 544-5, 1995.
[PUBMED Abstract]
- Winer EP, Morrow M, Osborne CK: Malignant tumors of the breast. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001, pp 1651-1716.
- Cutuli B, Lacroze M, Dilhuydy JM, et al.: Male breast cancer: results of the treatments and prognostic factors in 397 cases. Eur J Cancer 31A (12): 1960-4, 1995.
[PUBMED Abstract]
- Gattuso P, Reddy VB, Green L, et al.: Prognostic significance of DNA ploidy in male breast carcinoma. A retrospective analysis of 32 cases. Cancer 70 (4): 777-80, 1992.
[PUBMED Abstract]
- Ravandi-Kashani F, Hayes TG: Male breast cancer: a review of the literature. Eur J Cancer 34 (9): 1341-7, 1998.
[PUBMED Abstract]
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