Male Breast Cancer - Outcome

Analysis of survival outcome in male breast cancer is difficult due to the rarity of the disease. Most series span a large number of years and diagnostic tools and treatment techniques vary widely within the study period. Variations in staging also contribute to the lack of comparability of the data.

Despite these difficulties, however, clinical factors such as T stage and nodal status have been identified as significant predictors of outcome in male breast cancer. Erlichman et. al. (16) compared the survival of 65 patients with T1, T2 or T3/T4 lesions. The five year survival rates were 70%, 54% and 11% respectively. Patients with T1 lesions did significantly better than patients with T3 and T4 lesions (p=0.31). There was no statistically significant difference between T1 and T2 lesions (p=0.96). In the same study, survival was also examined as a function of nodal status. The five-year survival rate for node-negative patients was 77% whereas it was 37% for the node-positive patients (p=0.05). Finally, the time between onset of symptoms and initiation of treatment was also found to be a good predictor of survival. Both Rebeiro (15) and Borgen (21) showed that duration of symptoms correlated inversely with survival (i.e. the longer the duration of symptoms, the poorer the survival).

The reported outcome of treatment by clinical stage for male breast cancer is widely variable. Overall survival at 10 years for Stage I patients has ranged from 38-71%, 10-53% for Stage II patients and 5-27% for Stage III patients. No Stage IV patients were reported) alive at 10 years (14,15,18,24). These data suggest that survival may be worse for male breast cancer patients than for comparably staged female breast cancer patients. However, this generalization remains controversial and a number of studies show that this is not the case (13,22,23). In a large series of four Nordic countries, Adami et. al. (22) showed that the survival rate was equivalent for males and females in two countries and worse for male patients in the two other countries.

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