Male breast cancer: clinical presentation, diagnosis and therapy. A 30-year experience at the Department of Obstetrics and Gynecology, Medical Center Mainz, Germany

Introduction:

Male breast cancer (MBC) is an uncommon malignancy with an incidence that accounts for about 1% of all breast cancer cases. Although the epidemiologic literature regarding female breast cancer is extensive, relatively little is known about the MBC. We illustrate the experience of our team regarding patients with MBC treated over a period of thirty years.

Methods:

The objective of our retrospective study is to report the epidemiologic, clinic-pathological characteristics and to analyze the different treatment modalities in a german population collected during a 30-year period at a single institution. We included cases of MBC treated at Mainz university hospital from 1988 to 2017. Collected data comprised age, clinical presentation and therapeutic protocol.

Results:

38 cases of MBC were collected with a median age of 69.4 years (range: 48 – 88 years). The main symptom was the appearance of a palpable nodule found in 33 patients (86.8%). Histologically, infiltrating ductal carcinoma represented 86.8% of all tumors. Lymph nodes metastases were diagnosed in 18 patients (47.3%). Both estrogen and progesteron receptors were positive in 100% of our series. Distant metastasis occured in 4 patients. The treatment consisted mainly of radical mastectomy followed by adjuvant radiotherapy and hormonal therapy with or without chemotherapy.

Conclusion:

Diagnosis and treatment of MBC is similar to that of female patients, but men tend to be treated with mastectomy rather than breast-conserving surgery. Because of high expression rates of hormone receptor positivity in MBC, the mainstay of adjuvant therapy or palliative treatment for advanced disease is endocrine, mostly tamoxifen.