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Breast cancer in men has been shown to carry a worse prognosis than in females, even after controlling for tumour stage and grade. Older men with breast cancer are at increased risk of cancer-associated mortality, as are the very few aged ≤25 years. Men without a partner are vulnerable to worse outcome and sociodemographic status (SES) impacts on survival with the lowest SES group surviving for only 5.9 years compared with 8.2 years for those in the highest SES. The apparent ethnic differences in survival of MBC in the US are largely socio-economic, not genetic. Men with high grade cancers experienced poorer disease-free survival when compared with those having low grade tumours. Males with node negative luminal A tumours fared significantly better than node negative luminal B cases (5-year OS respectively 100% versus 67%). Prognostic markers specific for MBC include the male-simple genomic subgroup and N-acetyltransferase-1 (NAT1). Because of the rarity of HER2-enriched and basal subtypes there is very little information on prognosis. Oncotype DX, PAM50, Recurindex and 90-gene expression have proved to be useful in determining prognosis in subsets of MBC. The 5-year overall survival was 25% in BRCA2 carriers versus 86% in sporadic cases. Androgen receptor AR positivity is an adverse prognostic factor with a 10-year overall survival of 10% versus 37% in AR-ve cases. Hypoxia-inducible factor-1a overexpression is a major predictor of survival: overexpression 50% versus 78% non-expression. The function of GATA3 in MBC is controversial but the impact of GATA3 mutation needs investigating. Hippo transducers TAZ/YAP, and target CTGF measured on tumour tissue microarrays showed that TAZ/CTGF and YAP/CTGF positive tumours had reduced overall survival compared with negative cases and these were independent prognostic variables on multivariate analysis. Multiple prognostic nomograms have been constructed with estimates for up to 8 years but CancerMath and PREDICT+ are able to give validated estimates of survival for up to 15 years.

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Determination of Prognosis

  • 章节

  • 发表日期：

    2025年

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  • Ian Fentiman

摘要

Breast cancer in men has been shown to carry a worse prognosis than in females, even after controlling for tumour stage and grade. Older men with breast cancer are at increased risk of cancer-associated mortality, as are the very few aged ≤25 years. Men without a partner are vulnerable to worse outcome and sociodemographic status (SES) impacts on survival with the lowest SES group surviving for only 5.9 years compared with 8.2 years for those in the highest SES. The apparent ethnic differences in survival of MBC in the US are largely socio-economic, not genetic. Men with high grade cancers experienced poorer disease-free survival when compared with those having low grade tumours. Males with node negative luminal A tumours fared significantly better than node negative luminal B cases (5-year OS respectively 100% versus 67%). Prognostic markers specific for MBC include the male-simple genomic subgroup and N-acetyltransferase-1 (NAT1). Because of the rarity of HER2-enriched and basal subtypes there is very little information on prognosis. Oncotype DX, PAM50, Recurindex and 90-gene expression have proved to be useful in determining prognosis in subsets of MBC. The 5-year overall survival was 25% in BRCA2 carriers versus 86% in sporadic cases. Androgen receptor AR positivity is an adverse prognostic factor with a 10-year overall survival of 10% versus 37% in AR-ve cases. Hypoxia-inducible factor-1a overexpression is a major predictor of survival: overexpression 50% versus 78% non-expression. The function of GATA3 in MBC is controversial but the impact of GATA3 mutation needs investigating. Hippo transducers TAZ/YAP, and target CTGF measured on tumour tissue microarrays showed that TAZ/CTGF and YAP/CTGF positive tumours had reduced overall survival compared with negative cases and these were independent prognostic variables on multivariate analysis. Multiple prognostic nomograms have been constructed with estimates for up to 8 years but CancerMath and PREDICT+ are able to give validated estimates of survival for up to 15 years.