Male breast cancer is an uncommon disease accounting for only 1% of all breast cancers. We present the evaluation, treatment and outcome of male patients seen with breast cancer in our institution. Male patients that had histological diagnosis of breast cancer from 2001 to 2010 were retrospectively evaluated. After evaluation patients were treated with modified radical mastectomy. Combination chemotherapy was given to patients with positive axillary lymph nodes. Radiotherapy and hormonal therapy were also employed. There were 57 male patients with breast cancer which accounted for 9% of all breast cancers seen during the study period. Their mean age was 59 ± 2.3 years. The mean tumor diameter was 13 ± 2.5？cm. Fifty three (93%) patients presented with advanced disease including 15 with distant metastasis. Four patients with stage II disease were treated with modified radical mastectomy, chemotherapy and tamoxifen. Of the 30 patients with sage III disease that had modified radical mastectomy, complete axillary clearance and tumor free margins were achieved in 25. Overall 21 (36.8%) patients were tumor free at one year. Overall 5-year survival was 22.8%. In conclusion, male patients with breast cancer present with advanced disease which is associated with poor outcome of treatment. 1. Introduction Male breast cancer (MBC) is an uncommon disease accounting for approximately 1% of all breast cancers diagnosed in the United States each year [1, 2].Of the 209,060 total cases of breast cancer expected in the United State in 2010, 1,970 (0.94%) will occur in men and 390 men are expected to die from the disease [3]. In contrast to the recent decline in incidence of female breast cancer (FBC), the incidence of MBC has been steadily increasing over the past three decades. The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program noted increased incidence of MBC of 26% from 1973 to 1998 [4]. In the UK, current estimates indicate around 300 cases annually [5]. In contrast to western countries, the incidence of MBC in sub-Saharan Africa ranges from 1.3–15% [6–10]. In the past, incidence rates in Egypt were 12-times that of the United States but the current incidence rate (1.42%) is only slightly higher than the U.S. rate [11]. This has been attributed to the recent decline in Schistosoma parasitic infection and its associated liver fibrosis [11, 12]. In addition, it is estimated that approximately 10% of men with breast cancer have a genetic predisposition of which BRCA2 is the most clearly associated gene mutation [12, 13].
References
[1]
Z. A. Nahleh, R. Srikantiah, M. Safa, A. R. Jazieh, A. Muhleman, and R. Komrokji, “Male breast cancer in the Veterans Affairs population: a comparative analysis,” Cancer, vol. 109, no. 8, pp. 1471–1477, 2007.
[2]
K. B. Contractor, K. Kaur, G. S. Rodrigues, D. M. Kulkarni, and H. Singhal, “Male breast cancer: is the scenario changing,” World Journal of Surgical Oncology, vol. 6, article 58, 2008.
[3]
A. Jemal, R. Siegel, J. Xu, and E. Ward, “Cancer statistics, 2010,” CA Cancer Journal for Clinicians, vol. 60, no. 5, pp. 277–300, 2010.
[4]
S. H. Giordano, D. S. Cohen, A. U. Buzdar, G. Perkins, and G. N. Hortobagyi, “Breast carcinoma in men: a population-based study,” Cancer, vol. 101, no. 1, pp. 51–57, 2004.
[5]
V. Speirs and A. M. Shaaban, “The rising incidence of male breast cancer,” Breast Cancer Research and Treatment, vol. 115, no. 2, pp. 429–430, 2009.
[6]
H. Amir and K. F. Hirji, “Carcinoma of the male breast in Tanzania,” Journal of the National Medical Association, vol. 84, no. 4, pp. 337–340, 1992.
[7]
S. Bhagwandin, “Carcinoma of the male breast in Zambia,” East African Medical Journal, vol. 49, pp. l76–199, 1972.
[8]
A. T. Kidmas, B. T. Ugwu, A. N. Manasseh, D. Iya, and A. S. Opaluwa, “Male breast malignancy in Jos University Teaching Hospital,” West African Journal of Medicine, vol. 24, no. 1, pp. 36–40, 2005.
[9]
I. Hassan and O. Mabogunje, “Cancer of the male breast in Zaria, Nigeria,” East African Medical Journal, vol. 72, no. 7, pp. 457–458, 1995.
[10]
E. R. Ezeome, C. D. Emegoakor, G. U. Chianakwana, and S. N. C. Anyanwu, “The pattern of male breast cancer in Eastern Nigeria: a 12 year review,” Nigerian Medical Journal, vol. 51, pp. 26–29, 2010.
[11]
G. Rennert, “Breast cancer,” in Cancer Incidence in Four Member Countries (Cyprus, Egypt, Israel, and Jordan) of the Middle East Cancer Consortium (MECC) Compared With US SEER, L. S. Freedman, B. K. Edwards, L. A. G. Ries, and J. L. Young, Eds., 06-5873, pp. 73–79, NIH Publication, 2006.
[12]
L. A. Brinton, J. D. Carreon, G. L. Gierach, K. A. McGlynn, and G. Gridley, “Etiologic factors for male breast cancer in the U.S. Veterans Affairs medical care system database,” Breast Cancer Research and Treatment, vol. 119, no. 1, pp. 185–192, 2010.
[13]
M. Bevier, K. Sundquist, and K. Hemminki, “Risk of breast cancers in families of multiple affected women and men,” Breast Cancer Research and Treatment, vol. 132, pp. 723–728, 2012.
[14]
L. A. Korde, J. A. Zujewski, L. Kamin et al., “Multidisciplinary meeting on male breast cancer: summary and research recommendations,” Journal of Clinical Oncology, vol. 28, no. 12, pp. 2114–2122, 2010.
[15]
C. Atalay, M. Kanlioz, and M. Altinok, “Prognostic factors affecting survival in male breast cancer,” Journal of Experimental and Clinical Cancer Research, vol. 22, no. 1, pp. 29–33, 2003.
[16]
R. Foerster, F. G. Foerster, V. Wulff et al., “Matched-pair analysis of patients with female and male breast cancer: a comparative analysis,” BMC Cancer, vol. 11, article 335, 2011.
[17]
S. E. Singletary, C. Allred, P. Ashley et al., “Revision of the American Joint Committee on cancer staging system for breast cancer,” Journal of Clinical Oncology, vol. 20, no. 17, pp. 3628–3636, 2002.
[18]
C. Smigal, A. Jemal, E. Ward et al., “Trends in breast cancer by race and ethnicity: update 2006,” CA Cancer Journal for Clinicians, vol. 56, no. 3, pp. 168–183, 2006.
[19]
A. N. Olu-Eddo and M. I. Momoh, “Clinicopathological study of male breast cancer in Nigerians and a review of the literature,” Nigerian Quarterly Journal of Hospital Medicine, vol. 20, no. 3, pp. 121–124, 2010.
[20]
O. A. Mabogunje, D. J. Grundy, and J. H. Lawrie, “Orchidectomy in a rural African population,” Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 74, no. 6, pp. 749–751, 1980.
[21]
M. Bourhafour, R. Belbaraka, A. Souadka, H. M'rabti, F. Tijami, and H. Errihani, “Male breast cancer: a report of 127 cases at a Moroccan institution,” BMC Research Notes, vol. 4, article 219, 2011.
[22]
I. Sosnovskikh, P. Naninato, G. Gatti et al., “Synchronous bilateral breast cancer in men: a case report and review of the literature,” Tumori, vol. 93, no. 2, pp. 225–227, 2007.
[23]
S. Rachid, H. Yacouba, and N. Hassane, “Male breast cancer: 22 case reports at the National Hospital of Niamey, Niger,” The Pan African Medical Journal, vol. 3, pp. 15–18, 2009.
[24]
Y. Park, T. Kitahara, R. Takagi, and R. Kato, “Current status of therapy for breast cancer worldwide and in Japan,” World Journal of Clinical Oncology, vol. 10, pp. 125–134, 2011.
[25]
C. E. H. Scott-Conner, P. R. Jochimsen, H. R. Menck, and D. J. Winchester, “An analysis of male and female breast cancer treatment and survival among demographically identical pairs of patients,” Surgery, vol. 126, no. 4, pp. 775–781, 1999.
[26]
F. N. Ihekwaba, “The management of male breast cancer in Nigerians,” Postgraduate Medical Journal, vol. 69, no. 813, pp. 562–565, 1993.
[27]
A. S. Oguntola, A. O. Aderonmu, M. L. Adeoti, S. A. Olatoke, O. Akanbi, and S. O. Agodirin, “Male breast cancer in LAUTECH teaching hospital Osogbo, South Western Nigeria,” The Nigerian Postgraduate Medical Journal, vol. 16, no. 2, pp. 166–170, 2009.
[28]
A. Y. Ukwenya, L. M. D. Yusufu, P. T. Nmadu, E. S. Garba, and A. Ahmed, “Delayed treatment of symptomatic breast cancer: the experience from Kaduna, Nigeria,” South African Journal of Surgery, vol. 46, no. 4, pp. 106–110, 2008.
[29]
F. M. Saleh and N. P. Ansari, “Invasive ductal carcinoma in a young male breast,” Mymensingh Medical Journal, vol. 21, pp. 162–164, 2012.
[30]
R. Gennari, G. Curigliano, B. A. Jereczek-Fossa et al., “Male breast cancer: a special therapeutic problem. Anything new?” International Journal of Oncology, vol. 24, no. 3, pp. 663–670, 2004.
[31]
L. Mauriac, E. Luporsi, B. Cutuli, et al., “Summary version of standard options and recommendations for non metastatic breast cancer,” British Journal of Cancer, vol. 89, supplement 1, pp. 517–531, 2003.
[32]
E. Yu, H. Suzuki, J. Younus et al., “The impact of post-mastectomy radiation therapy on male breast cancer patients—a case series,” International Journal of Radiation Oncology, Biology, Physics, vol. 82, no. 2, pp. 696–700, 2012.
[33]
S. Liukkonen, T. Saarto, H. M？enp？？, and J. Sj？str？m-Mattson, “Male breast cancer: a survey at the Helsinki University Central Hospital during 1981–2006,” Acta Oncologica, vol. 49, no. 3, pp. 322–327, 2010.
[34]
S. Fogh, A. E. Hirsch, J. P. Langmead et al., “Use of tamoxifen with postsurgical irradiation may improve survival in estrogen and progesterone receptor-positive male breast cancer,” Clinical Breast Cancer, vol. 11, no. 1, pp. 39–45, 2011.
[35]
H. Visram, F. Kanji, and S. F. Dent, “Endocrine therapy for male breast cancer: rates of toxicity and adherence,” Current Oncology, vol. 17, no. 5, pp. 17–21, 2010.
