Male Breast Cancer: a 24 Year Experience of a Tertiary Care Hospital in Pakistan

Background: Male breast cancer accounts for less than 1% of all cancers found in men. It usually presentsat a later age and stage as compared to female breast cancer. Treatment strategies are extrapolated from themanagement of female breast cancer. Our study here looked at 18 patients diagnosed with and treated for malebreast cancer at The Aga Khan University Hospital in Pakistan. We compared our findings with the existingdata from Asian and Western countries. Materials and Methods: A retrospective study was conducted looking atpatients with male breast cancer between January 1986 and December 2009. Patient and disease characteristicswere analyzed and 5 year overall survival was calculated using Microsoft Excel and SPSS. Results: The averageage at diagnosis was 52 years (38-67 years). Twelve (66.7%) patients had axillary lymphadenopathy. Stage IIdisease was the most common stage at presentation (9 patients, 50%). Infiltrating ductal carcinoma was seen in16 patients (88.8%). Seven lesions were positive for both estrogen and progesterone receptors. Sixteen patientshad surgery in the form of either modified radical mastectomy or radical mastectomy. Radiation was used in7 patients in an adjuvant setting. The five year overall survival for stage I, II, III and IV disease was 100% vs78% vs 50% vs 0%( p<0.05). Five year overall survival was 61%. None of the other prognostic factors werestatistically significant. Median follow up was 15 months (3-202 months). Conclusions: Male breast cancer maybe on a slow rise but is still an uncommon disease. Tumor stage and lymph node status are important prognosticmarkers. Public awareness and screening may help in detecting the disease at an earlier stage. Prospective trialsare needed to improve the management of this disease.