Journal Article
. 2020 Jul;16(3).
doi: 10.5152/ejbh.2020.5536.

Features, Outcomes, and Management Strategies of Male Breast Cancer: A Single Institution Comparison to Well-Matched Female Controls

Joseph Liu 1 Anupama Suresh 1 Marilly Palettas 2 Julie Stephens 2 Akaansha Ganju 1 Evan Morgan 1 Mahmoud Kassem 1 Yanjun Hou 3 Anil Parwani 3 Anne Noonan 1 Raquel Reinbolt 1 Jeffrey VanDeusen 1 Sagar Sardesai 1 Nicole Williams 1 Mathew Cherian 1 Gary Tozbikian 3 Daniel G Stover 1 Maryam Lustberg 1 Zaibo Li 3 Bhuvaneswari Ramaswamy 1 Robert Wesolowski 1 
  • PMID: 32656521
  •     32 References


Objective: The primary objective of this study was to delineate differences in management, overall and distant disease-free survival in males diagnosed with breast cancer and treated at The Ohio State University Comprehensive Cancer Center as compared to comprehensively matched female subjects. Secondary objectives included assessment of clinical and histopathologic features and recurrence score, as measured by Oncotype DX and the modified Magee equation #2.

Materials And Methods: This single institution retrospective study compared male and comprehensively matched female patients (1:2) with stage I-III breast cancer between 1994 and 2014. Recurrence risk was estimated using a modified Magee equation. Overall survival and distant disease-free survival were estimated and compared using Kaplan-Meier and Log-rank methods.

Results: Forty-five male breast cancer patients were included (stage I: 26.7%; stage II: 53.3%; stage III: 20.0%; hormone receptor positive: 97.8%; human epidermal growth factor receptor 2 negative: 84.4%) with a median age of 63.8 (43.0-79.4) years at diagnosis. Intermediate and low recurrence scores were most common in male and female patients respectively; mean score was similar between groups (20.3 vs. 19.8). The proportion of male breast cancer patients treated with adjuvant chemotherapy and post-mastectomy radiation was lower compared to female patients (42.2% vs. 65.3%, p=0.013; 22.7% vs. 44.4%, p=0.030, respectively). Overall survival and distant disease-free survival between male and female patients were similar.

Conclusion: Male breast cancer patient outcomes were similar compared to well-matched female patients suggesting that breast cancer specific factors are more prognostic than gender.

Keywords: Male breast cancer; matched-pair analysis; rare disease; recurrence score; survival analysis.

Current management of male breast cancer. A review of 104 cases.
P I Borgen, G Y Wong, +5 authors, W M McKinnon.
Ann Surg, 1992 May 01; 215(5). PMID: 1319699    Free PMC article.
Prognostic significance of tumor subtypes in male breast cancer: a population-based study.
José Pablo Leone, Julieta Leone, +3 authors, Bernardo Amadeo Leone.
Breast Cancer Res Treat, 2015 Jul 02; 152(3). PMID: 26126972
The 21-Gene Recurrence Score in Male Breast Cancer.
Gulisa Turashvili, Monica Gonzalez-Loperena, +4 authors, Hannah Y Wen.
Ann Surg Oncol, 2018 Mar 10; 25(6). PMID: 29520654    Free PMC article.
Male breast cancer. Evolution of treatment and prognostic factors. Analysis of 489 cases.
B Cutuli, C Cohen-Solal Le-Nir, +14 authors, Y Belkacemi.
Crit Rev Oncol Hematol, 2009 May 16; 73(3). PMID: 19442535
Dachshund 1 is Differentially Expressed Between Male and Female Breast Cancer: A Matched Case-Control Study of Clinical Characteristics and Prognosis.
Qiuxia Cui, Deguang Kong, +4 authors, Gaosong Wu.
Clin Breast Cancer, 2018 Feb 27; 18(5). PMID: 29478945
Male breast cancer: results of the treatments and prognostic factors in 397 cases.
B Cutuli, M Lacroze, +7 authors, V Moncho-Bernier.
Eur J Cancer, 1995 Nov 01; 31A(12). PMID: 8562148
Male breast cancer: a population-based comparison with female breast cancer.
William F Anderson, Ismail Jatoi, Julia Tse, Philip S Rosenberg.
J Clin Oncol, 2009 Dec 10; 28(2). PMID: 19996029    Free PMC article.
Molecular markers in male breast carcinoma.
D Rayson, C Erlichman, +4 authors, J H Donohue.
Cancer, 1998 Nov 07; 83(9). PMID: 9806653
Survival benefit of tamoxifen and aromatase inhibitor in male and female breast cancer.
Holm Eggemann, Udo Altmann, Serban-Dan Costa, Atanas Ignatov.
J Cancer Res Clin Oncol, 2017 Nov 04; 144(2). PMID: 29098396
Molecular Characterization and Mortality From Breast Cancer in Men.
Suleiman Alfred Massarweh, George W Sledge, +3 authors, Steven Shak.
J Clin Oncol, 2018 Mar 28; 36(14). PMID: 29584547    Free PMC article.
Breast carcinoma in men: a population-based study.
Sharon H Giordano, Deborah S Cohen, +2 authors, Gabriel N Hortobagyi.
Cancer, 2004 Jun 29; 101(1). PMID: 15221988
Highly Cited.
Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.
Paul A Harris, Robert Taylor, +3 authors, Jose G Conde.
J Biomed Inform, 2008 Oct 22; 42(2). PMID: 18929686    Free PMC article.
Highly Cited.
Localized therapy for male breast cancer: functional advantages with comparable outcomes using breast conservation.
Shannon Fogh, Lisa A Kachnic, +3 authors, Ariel E Hirsch.
Clin Breast Cancer, 2013 Jul 31; 13(5). PMID: 23891587
A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer.
Soonmyung Paik, Steven Shak, +12 authors, Norman Wolmark.
N Engl J Med, 2004 Dec 14; 351(27). PMID: 15591335
Highly Cited.
Contemporary systemic therapy for male breast cancer.
Katherine L Bradley, Scott Tyldesley, +2 authors, Diego Villa.
Clin Breast Cancer, 2013 Nov 14; 14(1). PMID: 24220158
Impact of oncotype DX recurrence score in the management of breast cancer cases.
Michaela T Nguyen, Alexander Stessin, +5 authors, Sandra J Shin.
Clin Breast Cancer, 2014 Feb 04; 14(3). PMID: 24486121
The Genomic Landscape of Male Breast Cancers.
Salvatore Piscuoglio, Charlotte K Y Ng, +19 authors, Jorge S Reis-Filho.
Clin Cancer Res, 2016 Mar 11; 22(16). PMID: 26960396    Free PMC article.
Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer.
C McCowan, J Shearer, +4 authors, T P Fahey.
Br J Cancer, 2008 Nov 06; 99(11). PMID: 18985046    Free PMC article.
Highly Cited.
Multidisciplinary meeting on male breast cancer: summary and research recommendations.
Larissa A Korde, Jo Anne Zujewski, +13 authors, Fatima Cardoso.
J Clin Oncol, 2010 Mar 24; 28(12). PMID: 20308661    Free PMC article.
Highly Cited.
Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer.
Soonmyung Paik, Gong Tang, +11 authors, Norman Wolmark.
J Clin Oncol, 2006 May 25; 24(23). PMID: 16720680
Highly Cited.
An analysis of male and female breast cancer treatment and survival among demographically identical pairs of patients.
C E Scott-Conner, P R Jochimsen, H R Menck, D J Winchester.
Surgery, 1999 Oct 16; 126(4). PMID: 10520928
Histopathologic variables predict Oncotype DX recurrence score.
Melina B Flanagan, David J Dabbs, +2 authors, Rohit Bhargava.
Mod Pathol, 2008 Mar 25; 21(10). PMID: 18360352
Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer.
Joseph A Sparano, Robert J Gray, +27 authors, George W Sledge.
N Engl J Med, 2018 Jun 05; 379(2). PMID: 29860917    Free PMC article.
Highly Cited.
Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer.
D J Slamon, W Godolphin, +7 authors, A Ullrich.
Science, 1989 May 12; 244(4905). PMID: 2470152
Highly Cited.
Adjuvant radiotherapy in male breast cancer.
H Stranzl, R Mayer, +4 authors, A Hackl.
Radiother Oncol, 2000 Jan 07; 53(1). PMID: 10624850
Male breast cancer: Austrian experience.
M Stierer, H Rosen, +7 authors, A Haid.
World J Surg, 1995 Sep 01; 19(5). PMID: 7571664
New approaches in the management of male breast cancer.
Darren K Patten, Laurence K Sharifi, Maisam Fazel.
Clin Breast Cancer, 2013 Jul 13; 13(5). PMID: 23845572
Male breast carcinoma. II. A study of the total material reported to the Swedish Cancer Registry 1958-1967 with respect to treatment, prognostic factors and survival.
R Hultborn, S Friberg, +2 authors, I Ragnhult.
Acta Oncol, 1987 Jan 01; 26(5). PMID: 3322330
Estrogen receptor breast cancer phenotypes in the Surveillance, Epidemiology, and End Results database.
William F Anderson, Nilanjan Chatterjee, William B Ershler, Otis W Brawley.
Breast Cancer Res Treat, 2002 Nov 01; 76(1). PMID: 12408373
Highly Cited.
Prediction of the Oncotype DX recurrence score: use of pathology-generated equations derived by linear regression analysis.
Molly E Klein, David J Dabbs, +4 authors, Rohit Bhargava.
Mod Pathol, 2013 Mar 19; 26(5). PMID: 23503643    Free PMC article.
The 21-gene recurrence score assay (Oncotype DX™) in estrogen receptor-positive male breast cancer: experience in an Israeli cohort.
Tal Grenader, Rinat Yerushalmi, +4 authors, David B Geffen.
Oncology, 2014 Jun 28; 87(1). PMID: 24970679
Post-mastectomy radiation in male breast cancer.
Anuradha Chakravarthy, Choong Ryul Kim.
Radiother Oncol, 2002 Nov 22; 65(2). PMID: 12443805