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Breast Cancer in Men Often Underestimated and Under-treated

Male breast cancer occasionally is misdiagnosed as gynaecomastia, which affects about a third of men at some point over the course of a lifetime, thereby causing the diseae to be discovered at later stages in men than in women. "It is perhaps ironic,that tumours in men are easier to feel than they are in women, yet the disease is being discovered at a later stage in men than in women".//Thus men tend to have more advanced disease at diagnosis.
A population-based sample of over 2,500 men with breast cancer were analysed to determine the factors that have prognostic significance in men with breast cancer. Men were found to have larger tumours and more lymph-node involvement, and they were more likely to have estrogen- and progesterone-positive tumours as well as ductal and papillary histology.

Tumour stage and size had a clear prognostic significance in men, as it does in women. Tumour grade also was of prognostic importance, with multivariate 10-year disease-specific survival rates of 93%, 66% and 53% for grades I, II and III disease, respectively (P<0.0001).

Patients with progesterone-positive tumours had significantly better 10-year survival than those with progesterone-negative disease -- 81% versus 71%. Those with estrogen-positive tumours had a trend towards improved 10-year survival, but the difference was not statistically significant. It was found that over half the men with breast cancer were over age 65 at first diagnosis. "survival was similar between 1,762 men without nodal involvement and 762 men with node-positive disease." The respective median survival in these groups was 139 months and 136 months.

Breast cancer is rare in men; there were about 1,600 cases in the US in 2002, accounting for about 1% of all breast cancer cases. Thus all men should be aware that they can develop breast cancer. "A man who has a breast lump needs a full evaluation, and [a lump] shouldn't be dismissed just because [the patient] is a man and not a woman."

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