Male breast cancer in a single-center experience: Diagnosis, clinicopathological features, and treatment strategies

OBJECTIVE: Although breast cancer is the most common cancer type in women worldwide, it is a rare tumor in men, accounting for less than 1% of all male cancers. Therefore, the characteristics of the tumor, the management of the disease, and our overall survival data are quite limited.
METHODS: We retrospectively analyzed the data of 51 male patients diagnosed and treated for breast cancer, whose follow-up processes continue, at our hospital. We examined in detail the patients’ age, comorbid diseases, history of concomitant malignancies, family history, stage of the disease, tumor size, lymph node status, estrogen receptor (ER)/progesterone receptor (PR) along with Human Epidermal Growth Factor Receptor-2 (HER-2) status. Additionally, we analyzed the type of surgery, history of radiotherapy, and chemotherapy and hormonal treatments in the adjuvant and metastatic periods.
RESULTS: In our study, where we determined a median survival time of 122 months (29–214), we found that the stage at diagnosis, Eastern Cooperative Oncology Group (ECOG) performance status, and discontinuation of adjuvant endocrine therapy significantly affected survival. While the median survival was not reached in stage 1 patients at diagnosis, the median survival times for stage 2, 3, and 4 patients were 118, 83, and 39 months, respectively. The differences between the groups were statistically significant (p=0.005). Similarly, the median survival was not reached for patients with an ECOG performance status of 0, but it was 84 months for those with a status of 1 and 98 months for those with a status of 2. The differences among these three groups were also statistically significant (p=0.001). The median survival was not reached for patients who completed adjuvant endocrine therapy, whereas it was 83 months for those who discontinued the therapy, with the difference being statistically significant (p=0.021). Besides these data, the presence of perineural invasion was found to be a factor close to statistical significance in terms of survival (p=0.066). Histological subgroups, grade, lymphovascular invasion, adjuvant chemotherapy, and Ki-67 were not significant parameters for survival.
CONCLUSION: Despite the differences in the stage at diagnosis, response to treatments, lower awareness of the disease, older age at diagnosis, and consequently, the increase in accompanying comorbid diseases, male breast cancer is managed according to studies and guideline recommendations for female breast cancer due to the lack of sufficient randomized studies. By presenting our clinical experience, we have emphasized the necessity for further studies in this field.

Tek merkez deneyimiyle erkek meme kanseri: Taný, klinik ve patolojik özellikler ile tedavi stratejileri

Amaç: Meme kanseri dünya genelinde kadýnlarda en sýk görülen kanser türü olmasýna raðmen erkeklerde nadir görülen bir tümördür ve tüm erkek kanserleri içinde <%1 orana sahiptir. Bu nedenle tümör karakteristiði, hastalýðýn yönetimi ve genel sað kalým verilerimiz oldukça sýnýrlýdýr.
Gereç-Yöntem: Merkezimizde meme kanseri tanýsý ile tedavi almýþ ve takip süreçleri devam eden 51 erkek hastaya ait verileri retrospektif olarak inceledik. Hastalarýn yaþý, komorbid hastalýklarý, eþlik eden malignite öyküsü, aile öyküsü, hastalýðýn evresi, tümör çapý, lenf nodu durumu, östrojen rseptörü(ER)/progesterone reseptörü(PR) ile beraber insan epitelyal büyüme faktörü-2 (HER-2) durumu detaylý bir þekilde incelendi. Ayný zamanda cerrahi þekli, radyoterapi öyküsü ile adjuvan ve metastatik dönemde kemoterapi ve hormonal tedaviler analiz edildi.
Bulgular: Medyan sað kalým süresi 122 ay (29-214) saptadýðýmýz çalýþmamýzda taný evresi, Doðu kooperatif onkoloji grubu (ECOG) performans statüsü ve adjuvan endokrin tedaviyi býrakmanýn sað kalýmý anlamlý derecede etkilediðini tespit ettik. Taný anýnda evre 1 hastalarda medyan saðkalýma ulaþýlamazken, evre 2, 3 ve 4 hastalarýn medyan sað kalýmý sýrayla 118,83 ve 39 ay saptandý. Gruplar arasýndaki farklar istatistiksel anlamlýlýk göstermekteydi (p=0.005). Benzer þekilde ECOG performans statüsü 0 olan hastalarýn da medyan sað kalýmýna ulaþýlamadý ancak 1 olan hastalarýn sað kalýmý 84, 2 olan hastalarýn ise 98 ay olduðu görüldü ve yine üç grup arasýnda istatistiksel anlamlý farklýlýk tespit edildi (p=0.001). Adjuvan endokrin terapiyi tamamlayan hastalarýn da medyan sað kalýmýna ulaþýlamadý ancak tedaviyi tamamlamadan býrakan hastalarýn medyan sað kalýmý 83 ay idi aradaki fark istatistiksel anlamlýydý (p=0.021). Bu veriler dýþýnda perinöral invazyon varlýðý istatistiksel anlamlýlýða yakýn (p=0.066) olarak sað kalým açýsýndan bir faktör olarak saptandý. Histolojik alt grup grup, grade, lenfovasküler invazyon, adjuvan kemoterapi ve KÝ-67 ise sað kalým üzerinde anlamlý birer parametre olarak saptanmadý.
Sonuç: Erkek meme kanseri tanýdaki evresi, tedavilere yanýtý, hastalýk ile ilgili genel farkýndalýðýn azlýðý, daha ileri taný yaþý ve buna baðlý eþlik eden komorbid hastalýklarýn artýþý gibi farklýlýklara raðmen yeterli randomize çalýþmalarýn eksikliði nedeni ile kadýn meme kanseri çalýþmalarýna ve kýlavuz önerilerine göre yönetilmektedir. Kliniðimizdeki deneyimimizi sunarak bu alanda yapýlacak ileri çalýþmalarýn gerekliliðini vurgulamýþ olduk. (NCI-2024-6-7)