Male breast cancer: a different disease than female breast cancer?
An estimated 1,450 new cases of male breast cancer were diagnosed in the United States in 2004 compared with 215,990 new cases of breast cancer in women and only 470 men as compared with 40,110 women died as a result of breast cancer. (1) These facts show the lower incidence of breast cancer in men and its comparable higher cancer-specific death rate.
Despite the increasing incidence of male breast cancer, it remains an uncommon cancer, accounting for less than 1% of all cancers in men. Because of the rarity of this cancer, randomized ran·dom·ize
tr.v. ran·dom·ized, ran·dom·iz·ing, ran·dom·iz·es
To make random in arrangement, especially in order to control the variables in an experiment. and prospective data are lacking. All studies are based on a small series of patients. Optimal management is not clearly established and is based on treatment guidelines that have been extrapolated from the data on female breast cancer.
We know that male breast cancer differs from female breast cancer with respect to age at diagnosis (men are older at the time of diagnosis than women), (2) and frequency of histologic subtypes (the majority of men have invasive ductal carcinoma Ductal carcinoma
A type of cancer that accounts for as much as 80% of breast cancers. These tumors feel bigger than they look on ultrasound or mammogram.
Mentioned in: Breast Ultrasound
ductal carcinoma , but lobular carcinoma is rare in men when compared with women, probably due to lack of terminal lobules Lobules
A small lobe or subdivision of a lobe (often on a gland) that may be seen on the surface of the gland by bumps or bulges.
Mentioned in: Fibrocystic Condition of the Breast in the male breast). (2) In addition, male and female breast cancers differ in regards to expression of steroid hormone receptors (men are more likely to have estrogen and progesterone receptor positive progesterone receptor positive Oncology A status of breast CA cells that have a receptor to which progesterone can attach; up to 80% of Pts with PR+ breast and endometrial CAs respond–ie, have a better prognosis–to hormonal manipulation tumors), (2) molecular markers (CerbB-2 and BCL-2 protooncogenes may have no prognostic significance in men, while in women it is associated with poor and favorable prognosis, respectively), (3) and genetics (as in women, men with BRCA-2 mutations are predisposed to develop breast cancer but BRCA-1 mutation does not seem to be a risk factor for breast cancer in men, although it has been described in affected men). (4,5)
Men generally present with larger tumors, more frequent lymph node involvement and higher stage disease than women. This may be due to the fact that women are diagnosed by screening mammography mammography, diagnostic procedure that uses low-dose X rays to detect abnormalities in the breasts. The early diagnosis of breast cancer made possible by the routine use of mammography for screening women increases a woman's treatment alternatives and improves her , with smaller, early stage tumors, or it may be due to lack of awareness of breast carcinoma in males. (2) As with female breast cancer, axillary ax·il·lar·y
Relating to the axilla.
Located in or near the armpit.
Mentioned in: Mastectomy
of or pertaining to the armpit. lymph node status, tumor size, histologic grade and hormone receptor status have been shown to be significant prognostic factors in men with breast cancer, with lymph node involvement being the most important negative prognostic factor. (2,3) A number of studies have suggested that clinical outcomes for male and female breast cancer are similar when matched for age, treatment and stage of disease. (3)
Since the epidemiology and biology of male breast cancer differs significantly from female breast cancer, it would be prudent to say that it is a different disease when compared with female breast cancer. However, based on the available evidence at this time, men with breast cancer should be treated similarly to women, with appropriate surgery, nodal Having to do with nodes. See node.
NODAL - Interpreted language implemented on Norsk Data's NORD-10 computers. Used by CERN and DESY high energy physics labs to control their accelerator hardware, PADAC and SEDAC. Included trackball input, graphics. assessment, radiotherapy, chemotherapy and hormonal manipulation. Only prospective national clinical trials through cooperative groups would further enhance our understanding of the biology and treatment of this uncommon disease.
1. Jemal A, Tiwari RC, Murray T, et al. American Cancer Society American Cancer Society,
n.pr established in 1913, this national volunteer-based health organization is committed to the elimination of cancer through prevention and treatment and to diminishing cancer suffering through advocacy, scholarship, research, . Cancer statistics, 2004. CA Cancer J Clin 2004;54:8-29.
2. Giordano SH, Cohen cohen
(Hebrew: “priest”) Jewish priest descended from Zadok (a descendant of Aaron), priest at the First Temple of Jerusalem. The biblical priesthood was hereditary and male. DS, Buzdar AU, et al. Breast carcinoma in men: a population based study. Cancer 2004;101:51-57.
3. Giordano SH, Buzdar AU, Hortobagyi GN. Breast cancer in men. Ann Intern Med 2002;137:678-687.
4. Wooster R, Neuhausen SL, Mangion J, et al. Localisation (programming) localisation - (l10n) Adapting a product to meet the language, cultural and other requirements of a specific target market "locale".
Localisation includes the translation of the user interface, on-line help and documentation, and ensuring the images and of breast cancer susceptibility gene, BRCA-2, to chromosome13q12-13. Science 1994;265:2088-2090.
5. Struewing JP, Brody LC, Erdos MR, et al. Detection of eight BRCA-1 mutations in 10 breast/ovarian cancer families, including 1 family with male breast cancer. Am J Hum Genet genet: see civet. 1995;57:1-7.
Ashok Kumar Malani, MD
From St. Joseph Oncology Inc., St. Joseph, MO.
Reprint requests to Ashok Kumar Malani. MD, St. Joseph Oncology Inc., 901 North Riverside Road, Suite 200, St. Joseph, MO 64507. Email: firstname.lastname@example.org
Accepted August 25, 2005.