To the Editor.—Breast cancer (BrCa) is rare in males, presents at a higher stage, has higher rates of estrogen (ER) and progesterone (PR) receptor positivity, and has a higher recurrence score (RS) than BrCa in women.13  The most common form of BrCa is invasive ductal carcinoma; invasive lobular carcinoma (ILC) is exceptionally rare in men.4  We used Surveillance, Epidemiology, and End Results (SEER) registries of breast cancer diagnosed between January 1, 2004, and December 31, 2015 (dates with linked RSs) to investigate clinicopathologic characteristics including RS and outcome of male ILC. In comparison to ILC in women, ILC in men was more likely to be hormone receptor and triple (hormone receptor and HER2 [human epidermal growth factor receptor 2]) negative and grade 3, and less likely to be T1 (≤2 cm) and stage I (Table). Males and females with ILC had similar proportions of high-risk (>25) RSs (Figure 1). Breast cancer–specific mortality was significantly worse for men than women with ILC (Figure 2). In multivariate analyses adjusted for age, grade, and stage, men with ILC had worse breast cancer–specific mortality than women as a group as well as in the hormone receptor–positive HER2-negative subgroup; however, these trends did not reach statistical significance (data not shown). In this largest population-based study including RS, unlike male breast carcinomas in general, ILCs were more likely to be hormone receptor negative and triple negative with worse breast cancer–specific survival than for women with ILC.

Figure 1.

Recurrence score (RS) distribution among male (n = 8) and female (n = 12 765) patients with invasive lobular carcinoma tested with RS.

Figure 1.

Recurrence score (RS) distribution among male (n = 8) and female (n = 12 765) patients with invasive lobular carcinoma tested with RS.

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Figure 2.

Breast cancer–specific mortality comparing invasive lobular carcinoma diagnosed in female versus male patients.

Figure 2.

Breast cancer–specific mortality comparing invasive lobular carcinoma diagnosed in female versus male patients.

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Clinical and Pathologic Characteristics of Male Invasive Lobular Carcinoma

Clinical and Pathologic Characteristics of Male Invasive Lobular Carcinoma
Clinical and Pathologic Characteristics of Male Invasive Lobular Carcinoma
1.
Fentiman
IS.
The biology of male breast cancer
.
Breast
.
2018
;
38
:
132
135
.
2.
Leone
J,
Zwenger
AO,
Leone
BA,
Vallejo
CT,
Leone
JP.
Overall survival of men and women with breast cancer according to tumor subtype: a population-based study
.
Am J Clin Oncol
.
2019
;
42
(2)
:
215
220
.
3.
Altman
AM,
Kizy
S,
Yuan
J,
et al
Distribution of 21-gene recurrence scores in male breast cancer in the United States
.
Ann Surg Oncol
.
2018
;
25
(8)
:
2296
2302
.
4.
Senger
JL,
Adams
SJ,
Kanthan
R.
Invasive lobular carcinoma of the male breast—a systematic review with an illustrative case study
.
Breast Cancer (Dove Med Press)
.
2017
;
9
:
337
345
.

Competing Interests

The authors have no relevant financial interest in the products or companies described in this article.