Revista de oncología clínica y experimental

A Single Centre Detailed Clinicopathological, Immunohistochemical and Follow Up Study of Male Breast Cancer Patients from Western India

Anjali Sharma1, Ajay Sharma2, Sanjeev Patni1, Ajay Bapna1, Nidhi Patni1, Anil Gupta1, Lalit Mohan Sharma3, Naresh Somani1, Naresh Ledwani1, Shashikant Saini1, Naresh Jakhotia1, Mudit Sharma1, Shubham Verma3 and Vandana Nunia4*

Aim: The clinicopathological features, Immunohistochemical (IHC) characteristics, estimated recurrence, treatment and survival outcomes of Male Breast Cancer (MBC) patients were analyzed.

Methods: We have retrospectively evaluated the tumor registry data of 71 MBC (1.11% of total breast cases) patients from 2010 to 2018. Statistical analysis included the new Magee Equation 2 (nME2) for the calculation of Estimated Recurrence Score (ERS), Kaplan-Meier method to analyze survivals and cox survival model for multivariate prognostic analysis.

Results: Chief complaints, history, gross and microscopic characteristic of MBC patients were investigated. MBC molecular subtypes included luminal subtype A (57.74%), luminal subtype B (26.76%), HER-2 (12.67%) and TNBC (2.81%). Male breast cancer patients were more likely to be invasive carcinoma of No Special Type (NST) (95.77%), ER positive (84.50%) PR positive (77.46%) and Her 2/Neunegative (72.97%). Low, intermediate and high estimated recurrence scores were reported in 20, 37 cases and 14 cases respectively. In the follow up study metastasis was reported in 13 cases and recurrence in 5 cases and metachronous multiple primary tumor in 2 cases. Out of 71 cases 55 were effectively followed up, 5-year Overall Survival (OS) and Disease Free Survival (DFS) rates were 72.72% and 63.63% respectively. Multivariate analysis showed lymphovascular invasion, molecular subtypes, metastasis, age, tumor size, Ki-67 and intra-ductal components to be prognostic factors for survival of MBC.

Conclusion: Male breast cancer has a lower incidence rate and poor prognosis. MBC patients exhibited large tumor size, node positivity, metastasis, high percentage of hormonal receptor positivity, high Nottingham grade and estimated recurrence score. More emphasis should be placed on early diagnosis to
improve survival.

Abbreviations: MBC: Male Breast Cancer; IHC: Immunohistochemistry; ER: Estrogen Receptor; PR: Progesterone Receptor; HER2: Human Epidermal Growth
Factor Receptor 2; TNBC: Triple-Negative Breast Cancer; nME2: new Magee Equation 2; PET Scan: Positron Emission Tomography Scan; CT Scan: Computerized Tomography Scan; BRCA: Breast Cancer Gene; Invasive carcinoma (NST): Invasive carcinoma of No Special Type (NST); pTNM: Tumor, Nodes, and Metastases; ERS: Estimated Recurrence Score; OS: Overall Survival; DFS: Disease Free Survival.