Male breast cancer, a heterogeneous entity: Experience from a cancer center

Abstract

Background: Male Breast Cancer (MBC) represents 1% of all breast cancers, as well as less than 1% of malignant neoplasmin male. Methods: Describe male population with breast cancer (BC) in our institute from 2007 to 2017. Methods: Unicentric, retrospective and descriptive study with inclusion of all male individuals with diagnosis of invasive breast carcinoma. Data was obtained through clinical process review and analyzed with SPSS® . Results: There were included 66 cases of invasive male breast carcinoma with a median age at diagnosis of 66,5 years old, [24-88] and an initial ECOG PS of 0 in 73% (n=48). Locally advanced disease was diagnosis on 47% (n=30) of patients, meanwhile 44% of cases were early BC at the diagnosis. Stage IV disease occurred on 9% (n=6), and 6 %(n=4) of patients had bilateral BC. Themost frequent molecular subtype was Luminal B-Like (67% n=44), and cerB-2 overexpression occurred in 10,6% (n=7). Themost frequent symptom was breast lump (89% n=59). At the time of diagnosis, clinical suspected axillary lymph nodes were detected on 68% of the cases and gynecomastia was present in 28%. The percentage of cases observed after 6months of symptoms onset was 30%. Positive family history of neoplasms occurred on 71%of cases, including 26%with BC family history. Pre-existing neoplasia was observed in 20%of patients, namely prostate adenocarcinoma as the most frequent diagnosis. Near 53%of the cases were followed on familiar cancer risk appointment, with 4,5%, (n=3) of cases positive for BRCA2 pathologicmutations. Neoadjuvant chemotherapy was performed in 33% (n=22). Surgery was performed on 94% (n=62) of the patients.The pathologic response rate was 90%. In adjuvant setting, 70%(n=46) of patients received hormonotherapy and 47% (n=31) radiotherapy. Themedian time to recurrence was 33months, [11-147]. Near 23% (n=15) of patients progressed and the most frequent secondary location was bone (60%). Themedian OS was 8 years, 95%CI[6,5 -9,5]. Conclusions:MBC is diagnosed later, presenting a more advanced stage, and themajority of patients had expression of hormonal receptors. Despite the late diagnosis, good disease control was achieved. This study in addition to being in accordance with literature reflects the importance of follow-up in family risk consultation.