When people are diagnosed with breast cancer, they need to make decisions. Will surgery be enough or do they need chemotherapy? Should they have a lumpectomy or mastectomy? Doctors are guided in their recommendations by research into factors that affect survival. They can look at studies and suggest chemotherapy to a person with a small tumor that might in past decades have been treated solely with surgery. They know that certain tumor subtypes are more dangerous, and tailor treatment plans to suit the subtype. Accurate data about what factors make a tumor aggressive are essential to correct treatment recommendations.
However, surprisingly little research has been done on male breast cancer because these cancers represent only one percent of all breast cancers. Treatment plans are based on survival data for women, but does this information apply to men?
In 2013, a research study looked at 606 men diagnosed with breast cancer in California between 2005 and 2009. They found that 81 percent of the men had hormone receptor (HR) positive tumors, about 15 percent were HER2 positive, and almost four percent were triple negative. In women, HER2 positive and triple negative subtypes are associated with poorer survival, but this study found no correlation between tumor subtype and survival. The group with the poorest survival rates were non-Hispanic black men.
A more recent study looked at a larger group of men and analyzed more factors in their disease to understand better how male breast cancer differs from female breast cancer. The international study by scientists in Europe, Canada, and the United States examined 1,203 male breast cancer tumor samples from 23 centers in nine countries. The men were diagnosed between 1990 and 2010 and followed for a median time of seven years.
Unlike in women breast cancer patients, the grade of the tumor cells did not correlate to overall survival times. The study also looked at the number of tumor infiltrating lymphocytes (TIL) and the amount of fibrous tissue. Tumor infiltrating lymphocytes are part of the immune system, so it is not surprising that low levels of them led to worse outcomes for men in the study, just as they do for women. The proportion of fibrous tissue is how breast density is measured. High amount of fibrous tissue correlate with poor outcomes for both men and women. So while there are similarities between breast cancer in men and women, it appears there are significant differences that doctors need to take into account when making treatment recommendations.
Even if only one percent of breast cancer patients are men, that still translates to about 2,000 new cases diagnosed each year. Men need more accurate data about how their disease may differ from women’s breast cancer. Signing up for clinical trials and research trials can help gather the data necessary to make correct treatment choices.
If you are a man diagnosed with breast cancer, it is important to find a doctor who is up-to-date on the latest information about male breast cancer. You may have to travel to find one, but once an expert in male breast cancer has made treatment recommendations, you probably can be treated near your home.
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Phyllis Johnson is an inflammatory breast cancer survivor who serves on the Board of Directors for the Inflammatory Breast Cancer Research Foundation, the oldest 501(3)(c) organization focused on research for IBC. She is a list monitor for an online support group at www.ibcsupport.org. She stays current on cancer information through attendance at conferences such as the National Breast Cancer Coalition’s Project LEAD® Institute. A retired teacher, she has been writing about cancer issues at HealthCentral since 2007.