General Medical Information

Male Breast Cancer

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

1. 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.

2. Jaiyesimi IA, Buzdar AU, Sahin AA, et al.: Carcinoma of the male breast. Ann Intern Med 117 (9): 771-7, 1992.

3. Hultborn R, Hanson et al.: Prevalence of Klinefelter’s syndrome in male breast cancer patients. Anticancer Res 17 (6D): 4293-7, 1997 Nov-Dec.

4. 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.

5. Thorlacius S, Tryggvadottir L, Olafsdottir GH, et al.: Linkage to BRCA2 region in hereditary male breast cancer. Lancet 346 (8974): 544-5, 1995.

6. Winer EP, Morrow M, Osborne CK: Malignant tumors of the breast. In: DeVita VT, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001, pp 1651-1716.

7. 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.

8. 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.

9. Ravandi-Kashani F, Hayes TG: Male breast cancer: a review of the literature. Eur J Cancer 34 (9): 1341-7, 1998.