title: Multivariate analysis of prognostic factors in male breast cancer in Serbia.
abstract: BACKGROUND
  The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis.
  
  
  METHODS
  In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used.
  
  
  RESULTS
  The mean age at diagnosis with breast cancer was 64.3±10.5 years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibited stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ≤2 cm, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival.
  
  
  CONCLUSIONS
  Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.
authors.affiliation: Institute of Epidemiology, Faculty of Medicine, Belgrade University, Belgrade, Serbia E-mail : sandra.grujicic@mfub.bg.ac.rs, ssipetic@yahoo.com.
authors.forename: Sandra Branko
authors.initials: SB
authors.lastname: Sipetic-Grujicic
authors.forename: Zafir Hajdar
authors.initials: ZH
authors.lastname: Murtezani
authors.forename: Zora Borivoje
authors.initials: ZB
authors.lastname: Neskovic-Konstatinovic
authors.forename: Jelena Milutin
authors.initials: JM
authors.lastname: Marinkovic
authors.forename: Vladimir Nikola
authors.initials: VN
authors.lastname: Kovcin
authors.forename: Zoran Gojko
authors.initials: ZG
authors.lastname: Andric
authors.forename: Sanja Vladeta
authors.initials: SV
authors.lastname: Kostic
authors.forename: Isidora Stojan
authors.initials: IS
authors.lastname: Ratkov
authors.forename: Jadranka Milutin
authors.initials: JM
authors.lastname: Maksimovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018567:Breast Neoplasms, Male / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D015409:Mastectomy, Radical; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D055771:Serbia / Q000453:epidemiology; D015996:Survival Rate; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013629:Tamoxifen