Male breast cancer

Abstract

The disease male breast cancer has been evaluated on the basis of data concerning 265 cases registered in Denmark over the period from 1 January 1943 to 1 July 1972. The data were obtained by review of hospital records, survey of microscopic preparations and examinations of surviving patients. The results are compared to results reported in the literature. The recent material is the second largest series hitherto published. Male breast cancer comprises 0.8 per cent of all cases of breast cancer in Denmark. The average age at establishment of diagnosis was 65.2 years in 257 cases of breast carcinoma, which is considerably higher than that found in women. The duration of symptoms in breast cancer is considerably longer in males than in females, 16 per cent having a duration of symptoms of 2 years or more. In only 13 per cent was a palpable tumour the only symptom on admission. Twenty-seven percent had ulceration. Ulceration and fixation to the underlying tissue are not, as commonly presumed, early symptoms in male breast cancer. According to the TNM classification, 35 per cent of 253 cases were in clinical stage I, 11 per cent in stage II, 42 per cent in stage III, and 12 per cent in stage IV. Duration of symptoms and histological grade of malignancy were of significant importance or the stage on admission. Assessed on the basis of the distribution into stages, the clinical appearance of the disease showed a significant improvement from the period 1943-1957 to the period 1958-1972. Attempts should be made to differentiate the disease from gynecomastia which is much more frequent. Only during the early stages of breast cancer, however, will there be differential diagnostic problems as the majority of patients do not present themselves until unequivocal clinical signs of malignancy are present. The series has been reviewed with regard to the presence of gynecomastia. Certain facts appear to support the theory that gynecomastia may be a premalignant state. A series of 30 patients with breast cancer were screened for the Klinefelter syndrome. One positive case was found. By pooling series of male breast cancer, in which such screening has been made, it was found that the incidence of the Klinefelter syndrome is higher among men with breast cancer than in the normal male population. Calculated on the basis of the general public were better informed about the existence of this disease and the value of its early diagnosis and treatment, the prognosis should undoubtedly by improved.