Twenty-nine male breast
cancers (MBC) were studied to determine the relationship between expression of several prognostic factors and clinical outcome. Immunohistochemistry employing a labeled
streptavidin-
biotin method was used to detect the presence of
estrogen (ER) and
progesterone receptors (PR),
cathepsin D (CD), c-erbB-2
oncoprotein,
epidermal growth factor receptor (EGFR), and p53; results were visually semiquantitated.
DNA ploidy was evaluated by image analysis (CAS 200) of 5 μm fixed embedded Feulgenstained tissue sections. For
proliferating cell nuclear antigen (
PCNA), nuclear immunostain was quantitated as percentage positive nuclear area (PPNA) by image cytometry (CAS 200). The frequency of expression was ER, 26/29 (89.7%); PR, 19/29 (65.5%); CD, 25/29 (86.2%); c-erbB-2, 5/29 (17.2%); EGFR, 4/29 (13.8%); and p53, 9/29 (31%). Twenty-one (72.4%) were
aneuploid; the mean PPNA for
PCNA was 37.87% (control 13%). Of 20 patients, 10 (50%) MBC had
lymph node metastases; 6 (21%) had distant
metastases to lung (1) and bone (5). Five of the patients died of MBC. Excluding the patients with only
ductal carcinoma in situ, the 1-and 5-year survival rates were 90.5% and 56.3%, respectively. In this comprehensive study of a large number of available prognostic markers, their frequency (with the exception of higher ER and CD) and prognostic significance were similar to that in female
breast carcinoma. Among clinical and standard pathologic unfavorable prognostic indicators, age ≥ 62 years was significant (p = .004). Trends toward reduced survival were associated with axillary
lymph node metastases (p = .145), ER negativity (p = .058), PR negativity (p = .116), and
aneuploid DNA content (p = .201).