ARRS 2022 Abstracts


E1147. Primary Breast Cancer in Men: Features and Biology
  1. Cherie Kuzmiak; University of North Carolina
Primary breast cancer in men accounts for 0.7% of all breast cancers and only 0.17 % of all cancer in men. Although the incidence of breast cancer in men has increased by approximately 26% over the past 25 years, information on this disease is still limited. Thus, the purpose of this study was to assess the clinical presentation, imaging phenotypes and pathology, including molecular subtype characteristics, of primary breast cancer in men diagnosed at our institution.

Materials and Methods:
A retrospective review of our database of male patients with the diagnosis of primary breast cancer, who had undergone mammography or ultrasound, were included in this study. The medical records and clinical, imaging, and pathology information were reviewed, and data were recorded. Statistical analysis was performed.

A total of 29 patients with 30 primary breast cancers were identified. One (3.4%) patient had a bilateral cancer. The median patient age was 65.2 years. Ten (34.5%) patients had a genetic mutation and two (6.9%) were of Ashkenazi Jewish descent. One (3.4%) patient had a history of chest irradiation and one (3.4%) had a history of breast cancer. The mean cancer size was 2.3 cm. Twenty-five (86.2%) patients presented with a palpable mass, and of these patients 32.0% (8/25) also had nipple inversion. All patients underwent mammography. At mammography, 63.3% (19/30) of the cancers were characterized as a mass without calcifications, 30.0% (9/30) as a mass with calcifications, 3.3% (1/30) as calcifications, and 3.3% (1/30) was occult on imaging. An irregular, high density, spiculated mass was the most common mammographic finding (20/28, 71.4%). In all nine cases that had calcifications associated with a mass, the calcifications were fine pleomorphic in appearance. The calcification-only case was characterized as grouped amorphous. Sonographic features were typically of a hypoechoic, irregular mass with spiculated margins (23/28, 82.1%). Pathology demonstrated eight (26.7%) invasive ductal carcinomas (IDCs), 15 (50.0%) IDCs with ductal carcinoma in situ (DCIS), two (6.7%) invasive papillary carcinomas, two (6.7%) mucinous carcinomas, one (3.3%) invasive lobular cancer, and two (3.3%) cases of DCIS, papillary subtype. All 28 invasive cancers were of luminal molecular subtype: 78.6% (22/28) luminal-A (HR+HER2-) and 21.4% (6/28) luminal-B (HR+HER2+).

Male patients diagnosed with primary breast cancer have a unique spectrum of clinical, imaging phenotypes, and pathologic findings, including molecular subtype characteristics.