Male breast cancer in Chinese population: a comparison to the Caucasian counterparts

Abstract

Introduction: Breast cancer is uncommon in men. There is limited knowledge about male breast cancer in Chinese population. In Hong Kong about 11 cases of male breast cancer is diagnosed annually. This study aims to be the first to perform a 12 year review of the clinical presentation and outcome of Chinese male breast patients and comparison to Caucasian population.

Material and Methods: A retrospective study of patients with male breast cancer treated in Hong Kong (HK) was performed and compared with that from the SEER database.

Results: A total of 86 medical records of male breast cancers treated in 16 hospitals during this 12 year study period in HK and 2350 records from the SEER database were retrieved and reviewed. There is significant difference in the mean age of diagnosis of breast cancer where men in HK are diagnosed at a younger age (64 vs 67, p = 0.019) and significantly more are diagnosed at age younger than 49 in HK (p = 0.016). For the HK cohort, only 3% had a family history of breast cancer. The most common presentation was presence of a breast lump. Although invasive carcinomas are the most common cancers in both groups, it is significantly more likely for the HK cohort to be diagnosed with in situ cancer (p =\0.001). It is also more likely for HK men to present with a low grade cancer (p = 0.004). Tumor size is similar in the two cohorts but it is significantly more likely for Caucasian cohort to have nodal involvement but there is no differenceswith the overall staging. Majority (80.2%) of HK male have ER positive cancers and 15.1% were cerbB2 receptor positive. Only 2.2% were triple negative cancers. The mean follow up was 55 months (1–179) months for the HK cohort and 5-year overall survival is better in men age under 49 years old (90.9% vs 67.7%, p = 0.031). Interestingly 15 patients in the HK cohort also had a second primary cancer not of breast origin.

Conclusions: Male breast cancer in Chinese men present with breast cancer at an earlier age compared to Caucasian, with lower grade cancers and less nodal involvement. Overall survival is better in the younger age group. Although a majority of our cohort did not have family history of breast cancer, there was a high incidence of second primary cancer not of breast origin.