| Objective Male breast cancer is rare and its incidence Is less than 1% of female breast cancer and also less than 0.1% of male cancer death. Owing to poor public-health education policy and poor level of medical awareness, male breast cancer often results in delayed diagnosis and treatment. The rarity of this disease precludes prospective and clinical trials for optimal treatment,and just retrospective study seems to be feasible. It shares many similarities with breast cancer in women, but some differences exist. The purposes of this study are: (1)to investigate the experience of male breast cancers at our hospital in the past 16 years, and (2)to review the literatures with regard to male breast cancer.Methods We retrospectively reviewed our medical records about male breast cancers over a 16-year period(from May 1992 to Nov 2007).Data were collected on paitent's demographics and tumor characteristics, including presentation symptoms, tumor size, lymph node involvement, tumor grading, and hormone receptor status. Treatment information was collected regarding local therapy and adjuvant systemic therapy with chemotherapy or hormone therapy. Patterns of disease recurrence and causes of death were recorded.Results The mean age of the 27 male breast cancer patients was 63.8 years(38～78 years), seemed older than female patients, and 12 of the patients had co-existing medical illness, including chronic lung diseases, DM, hypertension, renal insufficiency and gouty arthritis. In presentation symptoms, the painless lump in breast area is most common(23 p'ts, 85.2%). All patients had nipple-areola invasion by cancer, in whom twenty-one patients had a tumor larger than 2 cm. The majority of histopathologic diagnosis was infiltrating ductal carcinoma, the others are papillary carcinoma, medullary carcinoma and lymphoma. The tumor tended to be of low or intermediate grade. 17 out of the 21 patients (80.9%) had a hormone-receptor-positive disease(16ER(+)PR(+), 1ER(+)PR(-)), furthermore of whom, 7 patients had HER-2 over-expression(41.2%). All patients underwent modified radical mastectomy, in which mean operation time was 96 minutes, no intraoperated mortality or postoperative complications were noted. The mean hospital stay was 6.2 days(5～8 days). Then 11 patients received post-mastectomy irradiation therapy due to chest wall invasion. During the follow-up period, we found two patients had chest wall recurrence. Twenty-one patients received adjuvant systemic therapy(hormone therapy: 14 p'ts, chemotherapy: 1 p't, both:6 p'ts) and achieved a 5-year survival rate of 83.3%, better than that for those who did not receive systemic therapy (40%).In Comparison with female, male breast cancer seemed to have a higher likelihood of lung metastasis. With a mean follow-up duration of 59.6 months(7～180 months), the male breast cancer-specific 5-year survival rate was 73.9% and overall survival rate was 66.7%.Conclusions The mean age of male with breast cancer was older than that in the female counterparts and consequently more medical co-morbidities were noted. Men should be made more aware of the disease to achieve an early diagnosis, early treatment for further better outcome. In addition to surgery and radiation therapy, patients receiving adjuvant systemic therapy(hormone therapy or chemotherapy) had more survival benefit than those who did not. |
