Study Shows Male Breast Cancer Treatment Survival is the Same as in Women

Breast cancer is recognized as one of the leading health threats to women, but many people don't realize that it can and does occur in men also. While it is much less common in men than in women, it is equally serious when it happens.

Medical College of Wisconsin researchers William L. Donegan, MD, and Philip N. Redlich, MD, PhD, conducted a study of breast cancer in 156 men treated in 15 hospitals in Southeastern Wisconsin, comparing them to 434 cases in women. The study showed that the disease in men is remarkably similar to that in women and that the treatments are also similar. While men in this study had a lower survival rate than women, factors besides breast cancer could have been responsible; national statistics show similar survival rates.

Nationally, about 1% of breast cancer cases appear in men. As in women, breast cancer in men is primarily a disease related to aging: the mean age at which men develop the disease is 60-65, about five years older than for women. There are several other risk factors:

• "Feminization" of men genetically or by environmental exposure. That includes conditions that reduce testicular function such as inflammation of or injury to the testes, undescended testes, and gynecomastia (an abnormal enlargement of the breasts in men).
• Exposure of the breasts to irradiation.
• Genetic inheritance. Male breast cancer does not seem to be linked with an abnormality in a gene called BRCA1 as it is in women, but it does seem to be linked with another defective gene, BRCA2.

Virtually all the types of breast cancer present in women have also been identified in men. As in women, the stage and involvement of lymph nodes are the most important factors in prognosis. Generally treatment of breast cancer in men is much the same as in women. Surgery, a mastectomy (a modified radical mastectomy), is the first step. Since a large percentage of men's breast cancers are estrogen and progesterone positive, many men are also treated with Tamoxifen. It can, however, have significant side effects in men including hot flashes, mood swings and impotence. Radiation therapy and chemotherapy are also used.

Early studies showed a lower survival rate for men with breast cancer than for women. However, when these studies were analyzed in more detail, especially in the area of stage of cancer, the findings suggested that, for similar age and stage of disease, survival is the same for men and women.

In the Medical College study, the Milwaukee men averaged 7.9 years older at diagnosis than the women. Men in this study didn't have the survival rate enjoyed by women - their overall survival rate was 33.2% less than for the women, 26% less for operable cases. The lower survival rates may be due to the men's older age and the fact that many of them died from causes unrelated to their cancer, Drs. Donegan and Redlich pointed out. The men in this study were responsive to hormone therapy and chemotherapy, suggesting that these treatments are just as important to men as to women.

Dr. Donegan, Professor of Surgery at the Medical College, practices at Sinai Samaritan Medical Center and Froedtert Hospital, and Dr. Redlich, Associate Professor of Surgery at the Medical College, treats patients at Froedtert Hospital. Their studies of male breast cancer are published in Surgical Clinics of North America, Ca: a Cancer Journal for Clinicians, and Cancer.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.