Male breast cancer (MBC) is an uncommon malignancy with an estimated incidence of less than 1 % of all breast cancer cases. It is a disease of elderly arising in 6th to 7th decade. Patients usually present at an advanced stage with early skin and nodal involvement. Age, testicular disorders, liver cirrhosis, exogenous estrogens, BRCA -2 mutations are proposed etiological factors. There are four Population based cancer registries (PBCR) in Punjab, India. Amongst them two are predominantly urban (Chandigarh and SAS Nagar) and two are predominantly rural (Sangrur and Mansa). Sangrur PBCR is based at Homi Bhabha Cancer Hospital (under aegis of Tata Memorial Center, Mumbai). The aim of this study is to look into the incidence and clinico-pathological characteristics of M.B.C at our institute, mainly catering to a rural population.
A total of 1735 breast cancer cases registered over a period of 4 ½ years from January 2015 to July 2019 were screened. Online records were accessed.
A total of 34 M.B.C cases were identified amounting for 1.9% of all breast cancer cases. All patients were from Punjab except one. 44.1% were from district Sangrur. If we look at district wise ratio of MBC to total breast cancer cases then Barnala (2.3) is followed by Mansa (2.1) followed by Sangrur (2.09). Mean Age was 62.5 years. Mean BMI (N=20) was 23.9. Family history was not significant in any case. Tumor was localized to right in 64.7 % cases. Most of the tumors were central in location (70.6%). Main complaint was lump in 58.8%. 16 patients were metastatic,10 were LABC, 8 were early stage. All were infiltrating ductal carcinoma. 27 were ER +ve, 25 were PR +ve, 1 was her2neu positive, 1 was Triple negative. 7 patients were Luminal A, 8 were Luminal B, 1 was Basal, 6 were unknown due to missing information,12 were Luminal A/B. 13 patients were treated radically, 9 were palliative & 12 patients defaulted. 4 patients with oligo-metastatis treated radically were alive at last presentation. 2 patients underwent palliative mastectomy.
Our ratio of M.B.C to breast cancer cases is 1.9 % which is higher than average of 1%. Study period in our series is only 4 1/2 years unlike others, usually more than a decade, with equivalent number of cases. Unlike other studies our burden of metastatic disease was more.
Sachin Khandelwal.
Has not received any funding.
All authors have declared no conflicts of interest.