Analysis Of Clinicopathological Features And Prognostic Factors Of Male Breast Cancer Compared With Female Breast Cancer Patients

Objective:The objective of the study was to compare disease-free survival and overall survival in a group of matched males and females with breast cancer, and to analyze possible treatment-and gender-related differences.Methods:We retrospectively analyzed the data of150operable male breast cancer patients treated in our hospital from December1972to June2012. Each male breast cancer patient recorded in the database was matched with two female breast cancer patients of equal stage. Matching criteria included the main potential prognostic factors such as pathology of invasive ductal carcinoma in MBC and FBC, age at diagnosis (±5years), date of diagnosis (±5years) and identical clinical stage of the primary cancer at diagnosis. A statistical comparison of female-matched pair survival data was performed with the paired t-test. DFS and OS were calculated using the Kaplan-Meier method from the time of diagnosis. The log-rank test was used to assess survival difference between the groups. Actuarial curves were compared by the two-tailed log-rank test. The statistical analysis was performed using SPSS software version17.0. A P value of<0.05was considered significant for both tests.Results:The mean age at diagnosis was58.6±9.7years for males and57.2±10.3years for females. The median follow-up was69months for males and81months for females. Significant differences were identified for tumor location, hormone receptor status and hormone therapy between the two groups. Monofactorial analysis demonstrated that tumor size, lymph node state, American Joint Committee on Cancer stage, type of surgery and adjuvant chemotherapy treatment were prognostic factors in male breast cancer patients. In the multivariate analysis, tumor size, lymph node state and type of surgery were independent prognostic factors in male breast cancer. The5-and10-year disease-free survival rates were65.6%and40.1%for males, and74.9%and51.5%for females, respectively. The5-and10-year overall survival rates were72.9%and53.9%for males, and83.2%and68.5%for females, respectively. There was significantly difference in disease-free survival and overall survival between the two matched groups (P=0.002). Conclusions:(1)Univariate analysis showed that, impact of tumor size, lymph node state, AJCC stage, type of surgery and adjuvant chemotherapy treatment on OS rate were significant for MBC. The multivariate analysis revealed that tumor size, lymph node state and type of surgery were independent prognostic factors in male breast cancer. A lower number of male patients underwent endocrine therapy in comparison to female patients, however, we observed that hormonal treatment had no statistically significant impact on5-year DFS and OS of male patients. Consequently, hormone-receptor positivity does not translate into better prognosis for ER-positive MBC.(2)When matched for age and stage, MBC patients had significantly lower5-and10-year DFS and OS rates compared with FBC Patients, which demonstrates that biological differences may contribute to the worse prognosis. These results suggest that early detection, adequate treatment, close follow-up, prevention and treatment of comorbid disease and second neoplasm would be the mainstay for improving survival of MBC patients(3) Future studies should focus on the tumor biology and treatment and outcome-related investigations of MBC to determine whether optimum treatment parallels that of FBC. These fundamental observations may assist physicians in evaluating the survival potential of patients and in directing them toward the appropriate therapeutic decision.