The stage, age at diagnosis, and hormone receptor status are three distinguishing variables that affect adjuvant systemic therapy decisions for male breast cancer patients. Men have a more advanced stage on presentation,13 increasing the risk of systemic relapse and the potential benefits of adjuvant treatment. However, they also present at a later age and therefore have more frequent comorbidities that may limit choices of systemic therapy. Fortunately, most male breast cancers are estrogen receptor positive, allowing for the use of hormone therapy, which leads to an improvement in survival.83 Chemotherapy has a more limited frequency of use in men (26.7%) compared with women (40.6%, P = 0.001)124 But has a role in more aggressive disease, providing the patient has an adequate performance status.139,140 To date, there has been only one prospective study evaluating systemic therapy in male breast cancer patients. In this report of 24 stage II patients receiving cyclophosphamide (Cytoxan), methotrexate, and 5-fluorouracil, the median survival was 98 months.139 In a retrospective review of 156 male breast cancer patients treated at the University of Texas M. D. Anderson Cancer Center, 51 of 135 patients with nonmetastatic breast cancer received either adjuvant chemotherapy, hormonal therapy, or both. For men with lymph node-positive disease, adjuvant chemotherapy was associated with a lower risk of death (hazard ratio [HR] of 0.78), although this difference was not statistically significant. However, overall survival was significantly better for men who receiVed adjuvant hormonal therapy (HR 0.45,


1.  SEER website: Http://seer. cancer. gov/csr/1975_2004/results_merged/ Topic_annualrates. pdf

2.  Hodgson NCF, Button JH, Franceschi D, et al: Male breast cancer: Is the incidence increasing? Ann Surg Oncol 11:751-755, 2004.

3.  Appelbaum AH, et al: Mammographic appearances of male breast disease. Radiographics 19:559, 1999.

4.  Evans GF, et al: The diagnostic accuracy of mammography in the evaluation of male breast disease. Am J Surg 181:96, 2001.

5.  Chin L, et al: Imaging characteristics of malignant lesions of the male breast. Radiographics 26:993, 2006.

6.  Goss PE, et al: Male breast carcinoma. Cancer 85:629, 1999.

7.  Bock K, et al: Validity of the breast imaging reporting and data system BI-RADS(TM) for clinical mammography in men. ROFO-Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildge-benden V|ROFO-Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren 173:1019, 2001.

8.  Morakkabati-Spitz N, Schild HH, Leutner CC, et al: Dynamic contrast-enhanced breast MR imaging in men: Preliminary results. Radiology 238:438-445, 2006.

9.  Brenner RJ, Weitzel JN, Hansen N, Boasberg P: Screening-detected breast cancer in a man with BRCA2 mutation: Case report. Radiology 230:553-555, 2004.

10.  Jemal A, Siegel R, Ward E, et al: Cancer statistics 2008. CA Cancer J Clin 58:71-96, 2008.

11.  Crichlow RW: Carcinoma of the male breast. Surg Gynecol Obstet 134:1011, 1972.

12.  Siddiqui T, et al: Cancer of the male breast with prolonged survival. Cancer 62:1632, 1988.

13.  Winchester DJ: Male breast cancer presentation, treatment, and survival. Society of Surgical Oncology, 51st Cancer Symposium, March 28, 1998, San Diego.

14.  Port ER, et al: Sentinel lymph node biopsy in patients with male breast cancer. Cancer 91:319, 2001.

15.  Boughey JC, Bedrosian I, Meric-Bernstam F, et al: Comparative analysis of sentinel lymph node operation in male and female Breast cancer patients. J Am Coll Surg 203:475-480, 2006.

16.  Burga AM, et al: Invasive carcinomas of the male breast: A morphologic study of the distribution of histologic subtypes and metastatic patterns in 778 cases. Virchows Arch 449:507, 2006.

17.  Cotran RS, Kumar V, Collins T: Pathologic basis of disease, 6th ed. Philadelphia, WB Saunders, 1999.

18.  Deutsch M, et al: Carcinoma of the male breast following thymic irradiation. Radiology 116:413, 1975.

19.  Borgen PI, et al: Current management of male breast cancer: A review of 104 cases. Ann Surg 215:451, 1992.

20.  Heller KS, et al: Male breast cancer: A clinicopathologic study of 97 cases. Ann Surg 188:60, 1978.

21.  Carlson HE: Gynecomastia. N Engl J Med 303:795, 1980.

22.  Williams MJ: Gynecomastia: Its incidence, recognition, and last Characterization in 447 autopsy cases. Am J Med 34:103, 1963.

23.  Russin VL, Lachowicz C, Kline TS: Male breast lesions: Gynecomastia and its distinction from carcinoma by aspiration biopsy Cytology. Diagn Cytopathol 5:243, 1989.

24.  Joshi MG, et al: Male breast carcinoma: An evaluation of prognosTic factors contributing to a poorer outcome. Cancer 77:490, 1996.

25.  Kumar PP, Good RR, Newland JR: Immunodiagnosis by prostatic Acid phosphatase to differentiate primary male breast cancer from metastatic prostate cancer. J Natl Med Assoc 78:782, 1986.

26.  Lo MC, Chomet B, Rubenstone AI: Metastatic prostatic adenocarcinoma of male breast. Urology 11:641, 1978.

27.  Gupta RK: Immunoreactivity of prostate-specific antigen in male breast carcinomas: Two examples of a diagnostic pitfall in discriminating a primary breast cancer from metastatic prostate carcinoma. Diagn Cytopathol 21:167, 1999.

28.  Ramamurthy L, Cooper RA: Metastatic carcinoma to the male breast. Br J Radiol 64:277, 1991.

29.  Allen FJ, Van Velden DJ: Prostate carcinoma metastatic to the Male breast. Br J Urol 67:434, 1991.

30.  Sahoo S, et al: Metastatic prostatic adenocarcinoma within a primary solid papillary carcinoma of the male breast. Arch Pathol Lab Med 125:1101, 2001.

31.  Karlsson CT, Malmer B, Wiklund F, Griinberg H: Breast cancer as a second primary in patients with prostate cancer—estrogen treatMent or association with family history of cancer? J Urol 176: 538-543, 2006.

32.  Bruscagnin A: A case of male breast metastasis from adenocarcinoma of the colon. Radiol Med (Torino) 93:463, 1997. [Italian]

33.  Joshi A, Kapila K, Verma K: Fine needle aspiration cytoloGy in the management of male breast masses: Nineteen years of experience. Acta Cytol 43:334, 1999.

34.  Verger E, et al: Metastasis in the male breast from a lung adenocarcinoma. Acta Oncol 31:479, 1992.

35.  Murata T, et al: Primary non-Hodgkin malignant lymphoma of the male breast. Jpn J Clin Oncol 26:243, 1996.

36.  Du Y, Long Y, Ma R: Tc-99m MIBI uptake by a male breast lymphoma accompanied by diffuse bone marrow metastases. Clin Nucl Med 24:454, 1999.

37.  Cutuli BF, et al: Cancer du sein chez l'homme: Frequence et types des cancers associes: Anterieurs, synchrones et metachrones. Bull Cancer 79:689, 1992.

38.  Esposito A, et al: A rare case of metastasis of choroidal melanoma in male breast: Mammographic and ultrasonographic diagnosis. Radiol Med (Torino) 88:487, 1994. [Italian]

39.  Nakamura S, et al: Pigmented Paget's disease of the male breast: Report of a case. Dermatology 202:134, 2001.

40.  Wong WW, et al: Primary non-Hodgkin lymphoma of the breast: The Mayo Clinic experience. J Surg Oncol 80:19, 2002.

41.  Ali S, et al: Giant myofibroblastoma of the male breast. Am J Surg Pathol 18:1170, 1994.

42.  Komaki K, et al: Stromal sarcoma of the male breast. Gan No Rinsho 30:167, 1984. [Japanese]

43.  Montella L: Sarcoma of the male breast. Rassegna Internazionale Di Clinica e Terapia 52:350, 1972.

44.  Ravakhah K, Javadi N, Simms R: Hamartoma of the breast in a Man: First case report. Breast J 7:266, 2001.

45.  Lee S, et al: Granular cell tumor of the male breast: Report of a case. Surg Today 30:658, 2000.

46.  Chachlani N, Yue CT, Gerardo LT: Granular cell tumor of the Breast in a male. Acta Cytol 41:1807, 1997.

47.  Kozak FK, Hall JG, Baird PA: Familial breast cancer in males: Case report and review of the literature. Cancer 58:2736, 1986.

48.  Demeter JG, Waterman NG, Verdi GD: Familial male breast carcinoma. Cancer 65:2342, 1990.

49.  Hauser AR, Lerner IJ, King RA: Familial male breast cancer. Am J Med Genet 44:839, 1992.

50.  Rosenblatt KA, Thomas DB, McTiernan A: Breast cancer in men: Aspects of familial aggregation. J Natl Cancer Inst 83:849, 1991.

51.  Anderson DE, Badzioch MD: Breast cancer in relatives of male breast cancer patients. J Natl Cancer Inst 84:1111, 1992.

52.  Couch FJ, Farid LM, DeShano ML, et al: BRCA2 germline mutations in male breast cancer cases and breast cancer families. Nat Genet 13:123, 1996.

53.  Thorlacius S, et al: Study of a single BRCA2 mutation with high carrier frequency in a small population. Am J Hum Genet 60:1079, 1997.

54.  Sverdlov RS, Barshack I, Bar Sade RB, et al: Genetic analyses of male breast cancer in Israel. Genet Test 4:313, 2000.

55.  Frank TS, et al: Clinical characteristics of individuals with germline mutations in BRCA1 and BRCA2: Analysis of 10,000 individuals. J Clin Oncol 20:1480, 2002.

56.  Hogervorst FB, et al: Rapid detection of BRCA1 mutations by the protein truncation test. Nat Genet 10:208, 1995.

57.  Montagna M, et al: Identification of seven new BRCA1 germline mutations in Italian breast and breast/ovarian cancer families. Cancer Res 56:5466, 1996.

58.  Struewing JP, et al: Detection of eight BRCA1 mutations in 10 breast/ovarian cancer families, including 1 family with male breast cancer. Am J Hum Genet 57:1, 1995.

59.  Borg A, et al: Germline BRCA1 and HMLH1 mutations in a family with male and female breast carcinoma. Int J Cancer 85:796, 2000.

60.  Tirkkonen M, Kainu T, Loman N, et al: Somatic genetic alterations in BRCA2-associated and sporadic male breast cancer. Genes Chromosomes Cancer 24:56, 1999.

61.  Tirkkonen M, et al: Distinct somatic genetic changes associated with tumor progression in carriers of BRCA1 and BRCA2 germline mutations. Cancer Res 57:1222, 1997.

62.  Hill A, et al: Localized male breast carcinoma and family history: An analysis of 142 patients. Cancer 86:821, 1999.

63.  Easton DF, et al: Cancer risks in two large breast cancer families linked to BRCA2 on chromosome 13q12-13. Am J Hum Genet 61:120, 1997.

64.  Hartmann LC, et al: Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med 340:77, 1999.

65.  Peralta EA, et al: Contralateral prophylactic mastectomy improves the outcome of selected patients undergoing mastectomy for breast cancer. Am J Surg 180:439, 2000.

66.  Meijers-Heijboer H, et al: Breast cancer after prophylactic bilateral mastectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med 345:159, 2001.

67.  Fackenthal JD, et al: Male breast cancer in Cowden syndrome patients with germline PTEN mutations. J Med Genet 38: 159, 2001.

68.  Klinefelter HF Jr, Reifenstein EC Jr, Albright F: Syndrome characterized by gynecomastia, aspermatogenesis without A-leydigism and increased excretion of follicle-stimulating hormone. J Clin Endocrinol 2:615, 1942.

69.  Hultborn R, et al: Prevalence of Klinefelter's syndrome in male breast cancer patients. Anticancer Res 17:4293, 1997.

70.  Volm MD, Gradishar WJ: How to diagnose and manage male breast cancer. Contemp Oncol 4:17, 1994.

71.  Crichlow RW: Breast cancer in males. Dis Breast 2:12, 1976.

72.  Medras M, et al: Breast cancer and long-term hormonal treatment of male hypogonadism. Breast Cancer Res Treat 96:263-265, 2006.

73.  Everson RB, et al: Familial male breast cancer. Lancet 1:9, 1976.

74.  Sasco AJ, Lowenfels AB, Pasker-de Jong P: Review article: Epidemiology of male breast cancer: A meta-analysis of published case-control studies and discussion of selected aetiological factors. Int J Cancer 53:538, 1993.

75.  Srinivasan G, Srinivasan U, Greiver P: Male breast carcinoma following estrogen therapy: Report of a case. J Ky Med Assoc 77:9, 1979.

76.  Schlappack OK, Braun O, Maier U: Report of two cases of male breast cancer after prolonged estrogen treatment for prostatic carcinoma. Cancer Detect Prev 9:319, 1986.

77.  Bartoli C, Zurrida SM, Clemente C: Phyllodes tumor in a male patient with bilateral gynaecomastia induced by oestrogen therapy for prostatic carcinoma. Eur J Surg Oncol 17:215, 1991.

78.  Olsson H, Ranstam J: Head trauma and exposure to prolactin-elevating drugs as risk factors for male breast cancer. J Natl Cancer Inst 80:679, 1988.

79.  Scheike O: Male breast cancer. Acta Pathol Microbiol Scand [A] 251(suppl):3, 1975.

80.  Salvidori B, et al: Prognosis of breast cancer in males: An analysis Of 170 cases. Eur J Cancer 30A:930, 1994.

81.  Guinee VF, et al: The prognosis of breast cancer in males. Cancer 71:154, 1993.

82.  Gough DB, et al: A 50-year experience of male breast cancer: Is outcome changinG? Surg Oncol 2:325, 1993.

83.  Ribeiro G: Male breast carcinoma: A review of 301 cases from the Christie Hospital and Holt Radium Institute, Manchester. Br J Cancer 51:115, 1985.

84.  Cutuli BF, et al: Male breast cancer: Results of the treatments and Prognostic factors in 397 cases, Eur J Cancer 31A:1960, 1995.

85.  Cutuli B, et al: Ductal carcinoma in situ of the male breast: AnalYsis of 31 cases. Eur J Cancer 33:35, 1997.

86.  Lagios MD, et al: Mammographically detected duct carcinoma in Situ: Frequency of local recurrence following tylectomy and prognosTic effect of nuclear grade on local recurrence. Cancer 63:619, 1989.

87.  Volm MD, et al: Pituitary adenoma and bilateral male breast cancer: An unusual association. J Surg Oncol 64:74, 1997.

88.  Crichlow RW, Galt SW: Male breast cancer. Surg Clin North Am 70:1165, 1990.

89.  Olsson H, et al: Hypophyseal tumor and gynecomastia preceding bilateral breast cancer development in a man. Cancer 53:1974, 1984.

90.  Forloni F, et al: Pituitary prolactin-secreting macroadenoma comBined with bilateral breast cancer in a 45-year-old male. J EndocriNol Invest 24:454, 2001.

91.  Wallace WA, Balsitis M, Harrison BJ: Male breast neoplasia in association with selective serotonin re-uptake inhibitor therapy: A report of three cases. Eur J Surg Oncol 27:429, 2001.

92.  Yoneda S, et al: Breast cancer developed in a male patient with liver cirrhosis bearing hepatocellular carcinoma. Am J Gastroenterol 95:556, 2000.

93.  Hiranuma T, et al: An autopsy case of synchronous primary cancer of the liver and male breast. Nippon Shokakibyo Gakkai Zasshi 84:1471, 1987. [Japanese]

94.  Sherif M, Ibrahim AS, El-Aaser AA: Prostatic carcinoma in Egypt: Epidemiology and etiology. Scand J Urol Nephrol Suppl 55:25, 1980.

95.  El-Gazayerli MM, Abdel-Aziz AS: On bilharziasis and male breast cancer in Egypt. Br J Cancer 17:556, 1963.

96.  Stenlund C, Floderus B: Occupational exposure to magnetic fields in relation to male breast cancer and testicular cancer: A Swedish case-Control study. Cancer Causes Control 8:184, 1997.

97.  Matanoski GM, Breysse PN, Elliot EA: Electromagnetic field expoSure and male breast cancer. Lancet 337:737, 1991.

98.  Greene MH, et al: Radiogenic male breast cancer with in vitro sensitivity to ionizing radiation and bleomycin. Cancer Invest 1:379, 1983.

99.  Casagrande JT, et al: A case-control study of male breast cancer. Cancer Res 48:1326, 1988.

100.  Anchez AG, Villanueva AG, Redondo C: Lobular carcinoma of the breast in a patient with Klinefelter's syndrome: A case with bilateral, synchronous, histologically differentiated breast tumors. Cancer 57:1181, 1986.

101.  Nance KVA, Reddick RL: In situ and infiltrating lobular carcinoma Of the male breast. Hum Pathol 20:1220, 1989.

102.  Andre S, et al: Male and female breast cancer—differences in DNA Ploidy, p21 and p53 expression reinforce the possibility of disTinct pathways of oncogenesis. Pathobiology 74:323-327, 2007

103.  Fleming RD, et al (eds): American Joint Committee on Cancer Staging manual, 5th ed. Philadelphia, JB Lippincott, 1997.

104.  Hittmar AP, Lininger RA, Tavassoli FA: Ductal carcinoma in situ (DCIS) in the male breast. Cancer 83:2139, 1998.

105.  Ernster VL, et al: Incidence of and treatment for ductal carcinoma in situ of the breast. JAMA 275:913, 1996.

106.  Rosner D, et al: Noninvasive breast carcinoma: Results of a national survey by the American College of Surgeons. Ann Surg 192:139, 1980.

107.  Axelsson J, Andersson A: Cancer of the male breast. World J Surg 7:281, 1983.

108.  Spence RAJ, et al: Long-term survival following cancer of the male breast in Northern Ireland: A report of 81 cases. Cancer 55:648, 1985.

109.  Sina B, Samorodin CS: Bilateral inflammatory carcinoma of the male breast. Cutis 33:501, 1984.

110.  Spigel JJ, et al: Male inflammatory breast cancer. Clin Breast Cancer 2:153, 2001.

111.  Desai DC, Brennan EJ Jr, Carp NZ: Paget's disease of the male breast. Am Surg 62:1068, 1996.

112.  Stretch JR, et al: Paget's disease of the male breast clinically and histopathologically mimicking melanoma. Histopathology 19: 470, 1991.

113.  Borgen PI, et al: Carcinoma of the male breast: Analysis of prognosis compared with matched female patients. Ann Surg Oncol 4:385, 1997.

114.  Stahlsberg H, et al: Histologic types and hormone receptors in breast cancer in men: A population-based study in 282 United States men. Cancer Causes Control 4:143, 1993.

115.  Ferno M, et al: Estrogen and progesterone receptor analyses in more than 4000 human breast cancer samples: A study with special reference to age at diagnosis and stability of analyses. Acta Oncol 29:129, 1983.

116.  Slavin JL, Baird LI: Fine needle aspiration cytology in male breast carcinoma. Pathology 28:122, 1996.

117.  Das DK, et al: Fine needle aspiration cytology diagnosis of male breast lesions: A study of 185 cases. Acta Cytol 39:870, 1995.

118.  Westenend PJ, Jobse C: Evaluation of fine-needle aspiration cytology of breast masses in males. Cancer 96:101, 2002.

119.  Gupta RK: Immunoreactivity of prostate-specific antigen in male breast carcinomas: Two examples of a diagnostic pitfall in discriminating a primary breast cancer from metastatic prostate carcinoma. Diagn Cytopath 21:167, 1999.

120.  Lopez-Rios F, et al: Breast carcinoma in situ in a male. Acta Cytol 42:742, 1998.

121.  Hirschman SA, et al: Intraductal carcinoma in a male breast: Diagnosis by nipple discharge cytology. Diagn Cytopathol 12:354, 1995.

122.  Ranieri E, et al: Male breast carcinoma in situ: Report of a case diagnosed by nipple discharge cytology alone. Anticancer Res 15:1589, 1995.

123.  Simmons RM: Male ductal carcinoma in situ presenting as bloody nipple discharge: A case report and literature review. Breast J 8:112, 2002.

124.  Scott-Conner CE, et al: An analysis of male and female breast cancer treatment and survival among demographically identical pairs of patients. Surgery 126:775, 1999.

125.  Spear SL, Bowen DG: Breast reconstruction in a male with a transverse rectus abdominis flap. Plast Reconstr Surg 102: 1615, 1998.

126.  Bass SS, et al: The role of sentinel lymph node biopsy in breast cancer. J Am Coll Surg 189:183, 1999.

127.  Giuliano AE, et al: Lymphatic mapping and sentinel lymphade-nectomy for breast cancer. Ann Surg 220:391, 1994.

128.  Hill ADK, et al: Lessons learned from 500 cases of lymphatic mapping for breast cancer. Ann Surg 229:528, 1999.

129.  Winchester DJ, et al: Sentinel lymphadenectomy for breast cancer: Experience with 180 consecutive patients: Efficacy of filtered technetium 99m sulphur colloid with overnight migration time. J Am Coll Surg 188:597, 1999.

130.  Schwartz GF, et al: Proceedings of the consensus conference of the role of sentinel lymph node biopsy in carcinoma of the breast, April 19-22, 2001, Philadelphia. Cancer 94:2542, 2002.

131.  Gennari R, et al: Sentinel node biopsy in male breast cancer: Future standard treatment? Eur J Surg 167:461, 2001.

132.  Cimmino VM, Degnim AC, Sabel MS, et al: Efficacy of sentinel lymph node biopsy in male breast cancer. J Surg Oncol 86: 74-77, 2004.

133.  Goyal A, Horgan K, Kissin M, et al: Sentinel lymph node biopsy in male breast cancer patients. Eur J Surg Oncol 30:480-483, 2004.

134.  De Cicco C, Baio SM, Veronesi P, et al: Sentinel node biopsy in male breast cancer. Nucl Med Commun 25:139-143, 2004.

135.  Simmons RM, Smith SM, Osborne MP: Methylene blue dye as an alternative to isosulfan blue dye for sentinel lymph node localizaTion. Breast J 7:181, 2001.

136.  Erlichman C, Murphy KC, Elhakim T: Male breast cancer: A 13-Year review of 89 patients. J Clin Oncol 2:903, 1984.

137.  Mambo NC, Gallager HS: Carcinoma of the breast: The prognostic significance of extranodal extension of axillary disease. Cancer 39:2280, 1977.

138.  Zabel A, Milker-Zabel S, Zuna I, et al: External beam radiotherapy in the treatment of male breast carcinoma: Patterns of failure in a single institute experience. Tumori 91:151-155, 2005.

139.  Bagley CS, et al: Adjuvant chemotherapy in males with cancer of the breast. Am J Clin Oncol 10:55, 1987.

140.  Patel HZ, Buzdar AU, Hortobagyi GN: Role of adjuvant chemotherapy in male breast cancer. Cancer 64:1583, 1989.

141.  Giordano SH, Perkins GH, Broglio K, et al: Adjuvant systemic therapy for male breast carcinoma. Cancer 104:2359-2364, 2005.

  • Contact
  • Category: Women's diseases