[188] Male Breast Carcinoma: Clinicopathologic and Molecular Analysis of 89 Cases

Dana Jaggessarsingh, Jeffrey Catalano, Muzaffar Akram, Edi Brogi, Melissa Murray. Memorial Sloan-Kettering Cancer Center, New York, NY

Background: Male breast cancer(MBC) is a rare disease and remains under studied despite evidence of rising incidence. We investigated the molecular subtype profiles of MBCs and subsequent clinical outcome.
Design: We searched our institutional database over a 20 year period (1992-2012) for MBC. Tissue microarrays were constructed from 89 invasive MBC and immunoperoxidase stains (IHC) were performed. Patient(pt) clinical and follow-up(F/U) data were extracted from the e-medical records.
Results: Median age is 64y(range 32-96y); 3 (3%)pts were <40y. Initial presentation was palpable mass 76, nipple discharge 3, nipple retraction 7, and 3 identified on imaging performed for other conditions. 27 pts had a personal history of carcinoma and 20 pts had a family history of BC in a 1stº relative. All pts were surgically treated; 82(92%) mastectomies, 7(8%) excisions. Tumor types were 72(80.9%) ductal NOS, 7(7.9%) papillary, 6(6.7%) micropapillary, 3(1.1%) mucinous features, 1(1.1%) lobular. Lobular CA was confirmed by E-cadherin and p120 IHC on whole tissue sections. Mean tumor size was 2.1 cm(range 0.8-4.7cm). 82 pts had lymph node(LN) biopsy(BX); 60(73%) sentinel LN BX. Most pts had positive LNs 53(65%). 87 MBCs were Luminal A phenotype and 2 were Luminal B. Clinical FU and IHC results are in Table 1. Most MBCs were AR(72/80, 90%) and EZH2 63/84(75%) positive. Recurrence or distant metastasis occured in 9(10%). After a F/U ranging from 7 days to 17 yrs, 6.7% are alive with disease, 3.4% are dead of disease and 76.4% are alive with no disease.

 Luminal A N=87(%)Luminal B N=2(%)
Age(mean, y)6560
Size(median, cm)2.12.1
NG 339 (45)2(100)
LVI39(45)2(100)
LN BX81(93)1(50)
LN+53(65)0
Ki-67>15%19 (24.4)(N=78)1 (50)
Ki-67≤15%59 (75.6)(N=78)1 (50)
AR+70 (89.7)(N=78)2 (100)
Bp5380 (100)(N=80)2 (100)
EZH261 (74.4)(N=82)2 (100)
Id1 & Id400
Median FU (y)2.653.05
Local recurrence only20
Distant metastasesBone(3)Lung(2)Brain+Bone(1)Lung+Bone(1) Mediastinum(1)Pleura(1)0
Patient statusDOD(3) AWD(6) NED(67) AUK(2) DOC(8) DUC(1)NED(2)
NG-nuclear grade; NED-no evidence of disease; DOD-dead of disease; AWD-alive with disease; DOC-dead other causes; AUK-alive unknown; DUC-dead unknown cause


Conclusions: In our cohort Luminal A was the most common phenotype, while luminal B was extremely rare. No basal-like or Her2 overexpressing tumors were found. Distant metastases/recurrences and LN+ were only seen in the Luminal A subtype. EZH2, a marker of aggressive BC, is positive in 75% MBC; however majority of pts are NED. With the incidence of MBC rising molecular subtypes, IHC and clinical outcomes should be further studied.
Category: Breast

Wednesday, March 6, 2013 1:00 PM

Poster Session VI # 27, Wednesday Afternoon

 

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