Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

Background: The aim of this study was to analyze the demographic and clinical characteristics of male breastcancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis.Materials and
Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method,long-rank test and Cox proportional hazards regression model were used.
Results: The mean age at diagnosiswith breast cancer was 64.3±10.5 years with a range from 35-84 years. Nearly 80% of the tumors showed ductalhistology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages IIIand IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring≤2 cm, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse.Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% ofindividuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%).Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy weregiven to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for malebreast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictivemodel, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and norelapse occurrence were significant independent predictors for good overall survival.
Conclusions: Results ofthe treatment would be better if disease is discovered earlier and therefore health education and screening arean imperative in solving this problem.