Male breast cancer (MBC )  is an uncommon malignancy . Its incidence is low as compared to female breast cancer with an estimated incidence rate of 0.5 -1% of all breast cancer cases [2,3] . According to regional cancer centre in eastern Uttar Pradesh , MBC accounted for 0.5% of all cancer cases diagnosed in males and 2.5 % of all breast cancer cases[4].Disease is most commonly seen in elderly in sixth or seventh decade and risk increases progressively with age [2]. As compared to female, the male breast cancer occur later in life with higher stage and more estrogen receptor  positive tumors [5] Reason for late age at presentation may be attributed to genetic susceptibility, hormonal ,environmental and social factors . In our society , where any  breast pathology is seen as embarrassment  for a male, delay in visiting physician  for any palpable lump in breast   can lead to delay in diagnosis , advanced cancer stage at time of presentation and will significantly affect the treatment , prognosis and survival of the patient. .Due to low incidence in males ,no programme has been framed to bring  the awareness that breast cancer can occur in males too.

The objective of this study was to ascertain the clinic-pathological aspects of male breast cancer at a tertiary care hospital in eastern part of India.

This was a retrospective study . Five cases of MBC were identified during the study period lasting from January 2019 to December 2024.We analysed the socio-demographic profile, the clinical history ,examination findings ,stage of disease at presentation, pathological characteristics and hormonal status differently. The student's t-test was applied to assess the significance of differences between the mean values of two continuous variables, whereas the Mann-Whitney test was employed for nonparametric distributions. A chi-square analysis was performed to assess the variations in proportions of categorical variables between two or more groups. The Fisher exact test (2-tailed) was utilized in 2x2 tables instead of the chi-square test, especially when the sample size was constrained. A one-way analysis of variance (ANOVA) was employed to compare multiple group means and determine the presence of significant differences among them. Multivariate stepwise regression analysis was performed to identify drivers of in-hospital outcomes for acute myocardial infarction (AMI). A p-value below 0.05 was considered significant.

MBC accounted for 0.5% of all the  cancer cases diagnosed in males . Median age of presentation was 62 years  ranging from  45 to 78 years. Tumor was localised to right breast in 4 and left breast in 1 case. Most common presentation was  breast lump, 1 patient presented with breast lump along with nipple retraction  and 2  presented with breast lump along with axillary lymphadenopathy . None of the patient had family history of breast cancer or any other malignancy. On histopathological examination  (HPE), all patients had invasive ductal carcinoma (IDC).Most  patients presented in advanced  stage. 1 patient presented in stage II ,2 in stage III and 2 presented in stage IV  with distant metastasis. Out of two patients with distant metastasis, one patient presented with  metastasis to liver and other with metastasis to bone.

  Estrogen and progesterone (ER/PR) hormone receptor  was available in for 2 patients only . Both  patients had positive ER/PR status in immunohistochemistry . (Table 1)

Table 1 : Clinicopathological characteristics of male  patients with carcinoma breast.

Table 2  Sociodemographic characteristics

The incidence of MBC in our series is 0.5% of all cancer cases in males .   The 4  studies of MBC available from India show variable rate of incidence . Sundriyal et al have reported an incidence of 1.03% of all breast cancer. Chikaraddi SB et al have reported an incidence of 0.4% of all breast cancers. Rai B et al reported an incidence of MBC of 0.5% from north India while Pothamsetty RK et al from eastern part of Uttar Pradesh reported an incidence of MBC of  0.5 % of all cancer cases and 2.5% of all breast cancer cases.[4,6-8]

Most cases of MBC are diagnosed in elderly people usually at 6^th and 7^th decade . As compared to MBC women have a younger age at diagnosis [8]. The median age of presentation in our study is 62 years which is consistent with other cases reported from India.[4-7]

Positive family history of breast cancer is associated with increased risk of MBC .However in our study we did not find positive family history in any of our patients. Most patients presented with palpable lump. Nipple involvement was seen in only one case. Other studies have shown nipple involvement as an early event in a number of patients [6,10,11]].The discordant results may be due to the smaller number of patients in our study.

Similar to females ,histopathology showed that most of the MBC are IDC .Most patients presented with advanced stage of disease.  This might be due to their low socio-economic status ,lack of awareness of early signs of the disease and lack of early detection by mammography [4]

ER/PR receptor status was available in 2 cases only . Results from National Cancer Institute’s Surveillance,epidemiology ,and End Results (SEER) database that more than 90% of the MBC are ER positive. [5]

Less number of cases, retrospective nature  and lack of ER/PR and Her-2 /neu status in all cases  is the drawback of our series .This can be attributed to the rarity of disease.

Male breast cancer is a rare disease and occurs in elderly population and most of them presented in advanced stage and is agrresive in nature. Social awareness and education are needed so that the early signs of MBC are taken seriously. A comprehensive multi-disciplinary and multi centric study is needed for better understanding of behaviour  and clinical spectrum of the disease.

Conflict of interest : None.

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