Male breast carcinoma: a single centre report of clinical parameters.

A total of 68 men (mean age 66.2 years) were treated for a primary carcinoma of the breast at Mount Vernon Hospital between January 1968 and June 1988. The mean duration of the symptoms before diagnosis was 13.3 months. The most common sign of presentation (60% of the patients) was a mass in the breast (mean size 3.9 cm). Thirty-three tumours (48.5%) were fixed to the skin and in nine the skin was ulcerated. Sixty-nine per cent of the patients had a T4 tumour and 51.5% had a palpable axillary node. Thirteen patients (19%) were treated by radiotherapy alone, 46 (67%) by surgery and postoperative radiotherapy, and nine (13.3%) by surgery alone. Sixty patients (88%) were in complete remission after the initial treatment and seven of these (12%) developed a local recurrence. The median follow-up was 54 months. The overall survival was 23% at 10 years and the corrected survival 42% at 10 years. Patients with no nodal disease at presentation had a better survival than those with N1 or N2 disease (55% versus 22% 10 years corrected survival, P < 0.002). The risk of nodal disease was strongly correlated by univariate analysis with the size of the tumour (P = 0.002) and the skin fixation (P = 0.005). The risk of metastatic dissemination was correlated with the nodal clinical involvement (P = 0.02) and the existence of a local recurrence (P = 0.003). In multivariate analysis, T and N stages were significantly associated with an increasing risk of treatment failure (P = 0.01). Forty-seven per cent of the patients with T4 tumours developed metastatic disease. This emphasizes the need for adjuvant systemic treatment for these patients.