breast cancer in men; comparison of male vs female breast cancer

Etiology

risk factors

• older age
• black
• family history of breast cancer
• genetic predisposition (see Genetics
• radiation exposure
• increased serum estradiol
• Klinefelter's syndrome
• gynecomastia
• liver disease
• obesity
• testicular anomaly

Epidemiology

• median age at diagnosis = 67 years vs 62 years for women

Pathology

• 1% invasive lobular type vs 12% for women
• 99% estrogen receptor + vs 83% for women
• 9% HER2+ vs 17% for women
• 97% androgen receptor + vs 16% for women
• 42% with lymph node involvement at diagnosis vs 33% for women
• median tumor diameter at diagnosis = 20 mm vs 15 mm for women

Genetics

increased risk associated with

• BRCA1 gene mutation (1%) vs 65% for women
• BRCA2 gene mutation (7%) vs 45% for women
• CHEK2 gene mutation
• PALB2 gene mutation

mutations in DNA repair genes more likely in men than women

Management

• surgery
• tamoxifen*
• genetic couseling all patients vs selected patients for women

* vs tamoxifen or aromatase inhibitor for postmenopausal women

More general terms

• breast cancer