Molecular markers in male breast carcinoma

Daniel Rayson, Charles Erlichman, Vera J. Suman, Patrick C. Roche, Lester E. Wold, James N. Ingle, John H. Donohue

Research output: Contribution to journalArticle

119 Scopus citations

Abstract

BACKGROUND. In contrast to female breast carcinoma, information regarding the prevalence and prognostic information of new molecular markers is limited in male breast carcinoma. The objective of this study was to assess the degree of expression and prognostic value of estrogen receptors (ER), progesterone receptors (PR), androgen receptors (AR), bcl-2, p53 HER- 2/neu, cyclin D1, and MIB-1 in a cohort of male breast carcinoma patients. METHODS. A computerized search of the medical index, tumor registry, and tissue registry was used to identify 111 male patients with a diagnosis of primary adenocarcinoma of the breast seen between 1950-1992 at the Mayo Clinic. Of these, 77 patients had adequate tissue specimens available for the immunohistochemical analysis of the markers. Immunoperoxidase staining was performed by an automated avidin-biotin complex method. Progression free (PFS) and overall (OS) survival distributions were estimated using the Kaplan-Meier method. The log rank test was used to determine whether any patient characteristic, tumor feature, or molecular marker was associated significantly with PFS or OS. RESULTS. The majority of tumor specimens were positive for ER (91%), PR (96%), AR (95%), and bcl-2 (94%). Fewer positive specimens were found for cyclin D1 (58%), MIB-1 (38%), HER-2/neu (29%), and p53 (21%). The 5-year PPS and 10-year OS for the entire patient cohort was estimated to be 66% (95% confidence interval [CI], 57-77%) and 38% (95% CI, 29-50%), respectively. PFS was decreased significantly for those patients with tumors staining positively for MIB-1 (P = 0.012) or negatively for cyclin D1 (P = 0.009). OS was not found to differ significantly with respect to these markers. CONCLUSIONS. The nearly universal expression of hormone receptors in these tumors suggests a central role for endogenous hormones in male breast carcinoma. The high degree of AR expression would suggest that antiandrogen therapy should be explored further. The high frequency of bcl-2 positivity may implicate antiapoptotic mechanisms in the carcinogenesis of male breast carcinoma. The finding of decreased PFS in MIB-1 positive tumors supports the role of proliferative activity as a negative prognostic factor in male breast carcinoma. Positive cyclin D1 expression is associated with increased PFS in male breast carcinoma patients, which suggests that interactions among cell cycle regulatory proteins may be important in this disease.

Original languageEnglish (US)
Pages (from-to)1947-1955
Number of pages9
JournalCancer
Volume83
Issue number9
DOIs
StatePublished - Nov 1 1998

Keywords

  • Hormone receptors
  • Immunohistochemistry
  • Male breast carcinoma
  • Molecular markers

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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