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Male breast cancer: Clinico-pathological study with evaluation of biologic markers.

777 Background: In contrast with female breast cancer, there is limited data on the expression of biologic markers and significance of clinicopathologic features in male breast cancer.


METHODS
We reviewed pathology and clinical data for 33 evaluable patients with MBC from 1981-1999. Immunohistochemical staining for ER, PR, AR, and cyclin D1 was performed.


RESULTS
Mean patient age was 61 years (range 35-80). 70% were Caucasian, 18% Hispanic, 12% African-American. 27% had a family history of breast/ovarian cancer in first-degree relatives. Patients presented as follows: with gynecomastia (33%), with a painless mass (33%), with nipple inversion/discharge (27%). Mean tumor size was 1.7 cm (range 0.1- 5.0 cm). The tumor was retroareolar/central in 67% patients. 88% had invasive ductal carcinoma while 12% had intracystic papillary DCIS. Tumor grade was as follows: high-grade (15), intermediate-grade (17), and low-grade (1). 40% had lymphovascular invasion, 15% presented with dermal involvement, and 12% had nipple involvement. Regarding evaluable biological markers: 86% were ER+, 75% PR+, 89% AR+, 67% cyclin D1+. OS was 85% (FU range 15-240 months), DFS was 64%. Overall survival and disease free survival for each biomarker is provided in the table below.


CONCLUSIONS
The majority of tumors highly expressed ER, PR, AR, and cyclin D1, which may have important therapeutic implications for patients with male breast cancer. Patients with tumors that did not express AR and cyclin D1 performed poorly. Larger future studies will hopefully help to elucidate the prognostic implications of hormone receptor and cell cycle regulator expression in this population. [Figure: see text] No significant financial relationships to disclose.