Diagnosis and management of male breast cancer.
BACKGROUND
Male breast cancer (MBC) is rare with an incidence of 1% of all breast cancers. The evidence about the treatment is derived from the data on the management of the female breast cancer because conduction of randomized, controlled trials is impossible due to the rarity of the disease. In this study, we review the special features, overall management, diagnosis, and treatment of patients with MBC managed under our care with a brief review of the current literature.


METHODS
During the period 1998 to 2006, we managed 1103 new patients with breast cancer in St Mary's Hospital. Among these, 14 patients were men. We retrospectively reviewed the case notes, histology, and follow-up notes of all the newly diagnosed patients with MBC.


RESULTS
In this series, 28.6% had only in situ disease. Moreover, in 78.6% there was an in situ component present. One patient was found to have a cancer on the microdochectomy specimen after an operation for single duct nipple discharge, and in a second patient the cancer was found in the gynecomastia operation specimen. All ten invasive tumors were estrogen receptor positive (ER +ve), whereas eight were progesterone receptor positive (PgR +ve). With a median follow-up of 35 months, there was one locoregional recurrence and one disease-associated death.


CONCLUSIONS
In situ cancer may not be as rare as previously reported among patients with MBC. Increased patient awareness and early assessment by a specialist is a key to early diagnosis and improved outcomes.
Lanitis
Sophocles
S
Breast Care Unit/Mary Stanford Wing 5th Floor, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed streed, W2 1NY, London, UK. drlanitis@yahoo.com
Rice
Alexandra J
AJ
Vaughan
Alexander
A
Cathcart
Paul
P
Filippakis
George
G
Al Mufti
Ragheed
R
Hadjiminas
Dimitri J
DJ
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018567:Breast Neoplasms, Male / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
D000970:Antineoplastic Agents
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