Prognostic Factors for Carcinoma of the Male Breast

Abstract

Male mammary carcinoma (MMC) affects approximately 1000 men in the United States each year. Aside from the impact of estrogen-receptor positivity on the clinical course of this tumor, relatively little information exists in published form on the ability of special pathologic studies to predict its biologic behavior. The authors analyzed 26 cases of invasive ductal MMC, comparing overall survival with tumor size, histologic grade (Page and Anderson), immunohistologic estrogen receptor protein status, DNA ploidy, expression of S 100 and gross cystic disease fluid proteins, and immunohisto chemically-detected amplification of the c-erbB-2 (HER-2/neu) oncoprotein. Tumor size and amplification of c-erbB-2 oncoprotein emerged as the statistically significant predictors in this group; MMCs of <2 cm had a more favorable prognosis than large tumors. Estrogen receptor protein was seen in 80% of cases; c-erbB-2 amplification was present in 35%; 80% were DNA-aneuploid; and S 100 and gross cystic disease fluid were observed in 38% and 62% of cases, respectively. The latter data are virtually identical to those on histologically similar tumors in women, but all except c-erbB-2 failed to achieve statistical prognostic value in this study. Substrata of histologic grades among MMCs were numerically too small to subject to statistical assessment. These findings suggest that no substantive differences exist between the pathologic features of male and female breast cancers. They also indicate that adjunctive laboratory studies are currently unhelpful in the prognostication of MMC. Int J Surg Pathol 2(3):199-206, 1995