Male breast cancer.

This study comprises 27 cases of male breast cancer treated at the University Hospital from 1966 through 1978. Its incidence was 0.53% of all cancer in males and 3.2% of all mammary cancers. Mean age was 52 years old. Lump in the breast was the commonest presenting feature in all patients followed by skin ulceration in 44.4% of cases. The average duration of symptoms was 16 months. Twenty-five patients had infiltrating duct carcinoma and two had papillary carcinoma. Two cases were in stage I, 10 in stage II, 11 in stage III, and 4 in stage IV. Of the 12 patients in stages I and II who underwent radical mastectomy, the axillary lymph nodes were pathologically negative in stage I and positive in stage II. The nodes were clinically involved in stages III and IV. Simple mastectomy followed by radiotherapy were used in stage III cancer and all patients in stage IV cancer had only biopsy and palliative chemotherapy. Bilateral orchidectomy followed by estrogen gave only marginal benefit in terms of survival and objective regression. Only four patients, two each in stages I and II, are alive and well for more than five years. These include two cases of papillary carcinoma. Poor prognosis in this series was exclusively determined by axillary lymph node involvement, although other factors such as shorter span of symptoms, younger age group, higher incidence of skin involvement, and invasive nature of carcinoma also appear to be significant.