Highlights
- •We describe the largest male breast cancer series with central pathology review.
- •Lobular breast cancer is rare in male.
- •Histological grade was not associated with outcome, unlike what is known in females.
- •Mitotic-index, presence of fibrosis and lymphocytes correlated with outcome.
Abstract
Aim
Several prognostic histological features have been established in female breast cancer
(BC), but it is unknown whether these can be extrapolated to male BC patients. The
aim of this study was to evaluate the prognostic value of several histological features
in a large series of male BC.
Methods
Central pathology review was performed for 1483 male BCs collected through part 1
of the European Organisation for Research and Treatment of Cancer (EORTC) International
Male BC Program. Pathology review included histological subtype, grade, mitotic activity
index (MAI), presence of a fibrotic focus and density of tumour-infiltrating lymphocytes
(TILs). These features were correlated with clinical outcome. The relationship between
these features and surrogate molecular subtypes using immunohistochemistry was also
assessed.
Results
Median follow-up for overall survival (OS) was 7.1 years. Overall histological grade
was not significantly associated with OS (p = 0.129). MAI, the presence of a fibrotic
focus and a low TIL density however were correlated with unfavourable OS (p = 0.023,
p = 0.004 and p = 0.011, respectively). BC subtype correlated with TIL density (p = 0.015),
as we observed a higher density for human epidermal growth factor receptor type 2
(HER2) positive BC compared to luminal HER2-negative subtype. No association was observed
between subtype and fibrotic focus.
Conclusions
Histologic grade was not significantly correlated with clinical outcome in this series,
unlike what is seen in female patients. These results contribute to our understanding
of male BC and indicate the importance of further research on the optimisation of
risk stratification and treatment decisions for male BC patients.
Keywords
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Article info
Publication history
Published online: March 12, 2017
Accepted:
January 31,
2017
Received:
January 30,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
