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Open Access Highly Accessed Research article

Matched-pair analysis of patients with female and male breast cancer: a comparative analysis

Robert Foerster1, Frank G Foerster2, Volkhard Wulff3, Birgit Schubotz4, Dieter Baaske5, Matthias Wolfgarten1, Walther C Kuhn1 and Christian Rudlowski1*

Author Affiliations

1 Department of Gynecology and Obstetrics, Center of Integrated Oncology, University Hospital Bonn, Siegmund-Freud-Str.25, 53113 Bonn, Germany

2 Department of Economical Sciences, University of Applied Sciences, Zwickau, and Outpatient Department of Gynecological Oncology and Palliative Care, Poliklinik GmbH, Chemnitz, Germany

3 Cancer Register of Southwest Saxony, Zwickau, Germany

4 Cancer Register of Chemnitz, Chemnitz, Germany

5 Department of Radiation Oncology, Klinikum Chemnitz, Chemnitz, Germany

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BMC Cancer 2011, 11:335  doi:10.1186/1471-2407-11-335

Published: 4 August 2011

Abstract

Background

Male breast cancer (MBC) is a rare disease accounting for approximately 1% of all breast carcinomas. Presently treatment recommendations are derived from the standards for female breast cancer. However, those approaches might be inadequate because of distinct gender specific differences in tumor biology of breast cancer. This study was planned in order to contrast potential differences between female and male breast cancer in both tumor biological behavior and clinical management.

Methods

MBC diagnosed between 1995-2007 (region Chemnitz/Zwickau, Saxony, Germany) was retrospectively analyzed. Tumor characteristics, treatment and follow-up of the patients were documented. In order to highlight potential differences each MBC was matched with a female counterpart (FBC) that showed accordance in at least eight tumor characteristics (year of diagnosis, age, tumor stage, nodal status, grade, estrogen- and progesterone receptors, HER2 status).

Results

108 male/female matched-pairs were available for survival analyses. In our study men and women with breast cancer had similar disease-free (DFS) and overall (OS) survival. The 5-years DFS was 53.4% (95% CI, range 54.1-66.3) in men respectively 62.6% (95% CI, 63.5-75.3) in women (p > 0.05). The 5-years OS was 71.4% (95% CI, 62.1-72.7%) and 70.3% (95% CI, 32.6-49.6) in women (p > 0.05). In males DFS analyses revealed progesterone receptor expression as the only prognostic relevant factor (p = 0.006). In multivariate analyses for OS both advanced tumor size (p = 0.01) and a lack of progesterone receptor expression were correlated (p = 0.01) with poor patients outcome in MBC.

Conclusion

Our comparative study revealed no survival differences between male and female breast cancer patients and gives evidence that gender is no predictor for survival in breast cancer. This was shown despite of significant gender specific differences in terms of frequency and intensity of systemic therapy in favor to female breast cancer.