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Objective: To determine the characteristics and risk factors of breast cancer patients in a tertiary care setting., Methods: The retrospective, cross-sectional study was conducted at the Sindh Institute of Urology and Transplantation, Karachi, and comprised data of all patients diagnosed with breast cancer from March 2017 to December 2021. Demographic characteristics, clinical presentation, stage of the disease and histopathological characteristics were noted. Data related to all the variables was not available in all cases. Data was analysed using SPSS 23., Results: Of the 690 patients, 683(99%) were females and 7(1%) were males. The mean age at presentation was 49.3±13.5 years, while the mean duration of symptoms was 10.24±17.64) months. Most of the females were married 642(93%) and multiparous 484(70.9%), while 293(42.5%) had breastfed their children for >1 year, and 412(59.7%) had no history of contraception use. The most common stage at presentation was stage II (48.6%), and most patients had grade II 395(57.2%) invasive ductal carcinoma, with Luminal A molecular subtype noted in 287(41.6%) cases., Conclusions: The characteristics of breast cancer in the sample had certain distinctions compared to other populations. It is important to integrate all datasets and develop guidelines appropriate to Pakistani population.

Our aim was to describe clinicopathologic features of secretory carcinoma on a cohort of cases. We retrieved reported cases of secretory carcinoma of breast (SCB) in the Section of Histopathology, Department of Pathology & Microbiology, Aga Khan University Hospital Karachi, from May 2004 to December 2011. The slides were reviewed, and clinicopathologic features were noted. A total of 8 cases of SCB were found. The age ranged from 17 to 60 years (median, 41 years) with a female to male ratio of 7:1. Lumpectomy was done in 6 cases, and mastectomy, in 2 cases. The tumor size ranged from 2.5 to 10 cm (mean, 5.5 cm). Histologically, abundant extra- and intracellular secretory material was seen in all cases. Most of the tumors showed mixtures of patterns with dominant microcystic and papillary patterns. In situ component was seen in only 1 case. Lymph node metastases were seen in both cases with lymph node sampling. In conclusion, SCB is a rare type of ductal breast carcinoma. The papillary pattern of SCB is rare according to published data but was seen in most of our cases. In situ secretory carcinoma is even rarer, and to date, we have seen a single case only. Although most occur in women, these can be seen in men as well., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Male breast cancer incidence rises with age with peak in the 6th & 7th decade. It is one of the rare diseases and accounts for less than 1% of all malignancies worldwide. It is usually diagnosed in the late stage with poor prognosis., Objective: The purpose of this study was to know the demographic pattern and tumour characteristic of breast cancer in men reported at Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar., Methods: Retrospective data was collected from the (IRNUM), Peshawar for a period of three years (2006-2008). The evaluation was done from the histopathological reports of mastectomy and biopsy specimens. All male patients in the age group 26-86 year with breast cancer were included in the study. The age of the patients and tumour characteristics recorded were size, grade, type, skin involvement and stage., Results: Total number of male patients with breast cancer were 31 (2.1%) out of the total patients with breast malignancy during the study period with the mean age of 58.3 years. Tumour size ranged from 2 to 12 Cm. with average of 3.6 Cm. Invasive ductal carcinoma was found in 87%, papillary carcinoma in 6.5%, each of malignant fibrous histocytoma and sarcoma in 3.2% cases. Maximum number of patients was of grade II (41%).Patients in whom stage of the disease was known were 22 cases with 45.5% had stage III disease and 32% had stage IV disease. Skin involvement was found positive in 8 (25.8%)., Conclusion: Due to poor health care system breast cancer is diagnosed in a late stage of the disease and prognosis is poor.

Objective: To study routine histological as well as immunohistochemical prognostic markers including ER, PR, p-53 and Her-2/neu in male breast carcinoma and compare the above parameters with breast carcinoma in female patients of the same population. Association of the immunohistochemical markers with histological prognostic markers was also studied., Methods: Cross-sectional descriptive study was carried out from January 2004 to May 2007 at AFIP, Rawalpindi on 55 cases of male breast carcinoma. Assessment of tumour size on gross examination followed by microscopic evaluation of tumour grade and lymph node metastasis was done. Immunohistochemistry was performed for ER, PR, Her-2/neu and p-53., Results: The male breast cancer patients had a mean age at diagnosis of 57 years with a mean tumour size of 4.25cm, constituting 4.7% of malignancies in men. Infiltrating ductal carcinoma was the predominant subtype with 47 (87.3%) cases. Majority of the tumours were grade II (64.2%) followed by grade III (32.1%). Out of 28 cases with axillary clearance; lymph node metastasis was present in 20 (71%) cases. ER and PR expression was seen in 81% and 79.3% cases respectively while Her-2/neu expression was seen in 24.5%. p-53 was expressed in 14 (26.4%) patients. No association of immunohistochemical markers was seen with lymph node and tumour grade., Conclusion: Male breast cancer has a higher incidence and occurs in a decade younger than the Western population with a larger tumour size and higher number of patients with lymph node metastasis. Men have a higher ER, PR expression as compared to female breast cancer patients without any association with histological prognostic markers. Her-2/neu and p-53 expression in males is comparable to the West but their prognostic role in terms of survival and treatment strategies needs to be ascertained by follow up studies.

Objective: The aim of present study was to assess the status of estrogen and progesterone receptors, HER2/neu, p53 and ki-67 in male breast carcinomas in our institute., Study Design: A descriptive study, carried out in the Department of Pathology (Histopathology), Army Medical College, Rawalpindi, Pakistan from June 2008 to January 2009., Subjects and Methods: In this study 45 cases of male breast carcinoma, including all the histological subtypes were assessed with original pathology reports of each case investigated for the age, laterality of breast, histological type of tumour and tumour grade. Tumour blocks of each case were retrieved for immunohistochemical staining of estrogen and progesterone receptors and HER2/neu, ki-67 and p53 scoring was accomplished using established protocols., Results: The majority of the cases were above 65 years of age. Histologically, the invasive ductal carcinoma was the predominant lesion. In total 95.5% of the cases were estrogen and progesterone (ER and PR) receptor positive. The HER2/neu staining was positive in 84.4% cases. According to the percentage of nuclear staining, 77.7% of the cases were p53 positive and 35.6% of the cases had strong nuclear staining intensity. A total of 55.5% of the tumours showed proliferation by ki-67., Conclusion: The majority of male breast carcinomas in Pakistan are ER and PR positive and demonstrate immunoreactions for prognostic markers. The results point to a relatively aggressive nature of such lesions in our institute.

In Pakistan, malignant diseases are increasing day by day, but no epidemiological cancer study on large scale has been designed. The main objective of this study was to provide a baseline data on frequency, morphological types, gender and age distribution etc., of breast cancer in North-West Frontier Province and Federally Administered Tribal Areas of Pakistan, and to compare it with the published data. In this context, 2134 breast cancer patients (2059 female and 75 male) registered at Institute of Radiotherapy and Nuclear Medicine, Peshawar from 1995 to 2001, were studied. Crude incidence, standardized incidence ratios (SIR, world) and age-specific incidence rates (ASIR) were determined both for male and female patients. Same morphological distribution was found in both genders. Moreover, breast cancer was found to be the most common malignancy among the women (96.49%). Male to female breast cancer ratio was found to be 3.5 times higher than the reported data. The highest ASIR of approximately 10.6/100,000 per year among women was observed in the age group of 55-59 years. In men, the highest ASIR of 0.84/100,000 per year was observed in the age group of 65-69 years. The SIR (world) for women was 3.15/100,000 per year, while for male this was 0.13/100,000 per year.

Among Asian countries, Pakistan has the highest rates of breast and ovarian cancer. To assess the contribution of the BRCA1 and BRCA2 germ line mutations to these high rates, we conducted the first study of 176 Pakistani breast and ovarian cancer patients, selected on family history and on age of diagnosis. Comprehensive BRCA mutation screening was performed using a range of techniques, including denaturing high-pressure liquid chromatography, single strand conformational polymorphism analysis and protein truncation test, followed by DNA sequencing. Thirty deleterious germ-line mutations were identified in the 176 families (17.0%), including 23 in BRCA1 and 7 in BRCA2. Four mutations, 185delAG, 185insA, S1503X and R1835X, were recurrent; these accounted for 52% of all identified BRCA1 mutations. Haplotype analyses suggested founder effects for 3 of these. The prevalence of BRCA1 or BRCA2 mutations was 42.8% for families with multiple cases of breast cancer, and was 50.0% for the breast/ovarian cancer families. The prevalence of mutations was 11.9% for single cases of early-onset breast cancer (< or =30 years) and was 9.0% for single cases of early-onset ovarian cancer (< or =45 years). Our findings show that BRCA mutations account for a substantial proportion of hereditary breast/ovarian cancer and early-onset breast and ovarian cancer cases in Pakistan., (Copyright 2006 Wiley-Liss, Inc.)

Carcinoma of the male breast, histologically identical to that seen in females, is a rare malignant epithelial tumour. We retrospectively studied 141 cases of male breast carcinoma diagnosed during a ten year period (1992-2001). These tumours comprised 0.7% of all cancers, 1.1% of all malignancies in males and 5.9% of all breast carcinomas in both genders. A male to female ratio of 1:16 was observed. The peak incidence was in the age group between 50-60 years and majority of the patients were below 60 years. Most of the patients presented with a painless lump and infiltrating ductal carcinoma was the main histological type. While compared with our previous similar analysis, a highly significant increase (p< 0.0001) was found for total numbers of breast carcinoma in both sexes and total number of malignancies in males.

Objective: This study was carried out to observe the prevalence breast diseases of males in our setup., Method: All cases of male breast disease diagnosed from 1991-97., Results: One hundred and fifty (150) cases of male breast diseases were diagnosed. Age of the patients ranged from 4 to 90 years, with mean age 38.75 years (median = 33 years). Gynecomastia was the most common pathological abnormality of the male breast (58.66%). Most of the patients presented in the 3rd decade of life. Amongst the malignant conditions, infiltrating ductal carcinoma was most prevalent (82%). Most of the patients with malignancy presented in the 5th and 6th decades of life., Conclusion: Gynecomastia was the most prevalent male breast disorder, followed by infiltrating ductal carcinoma. Our findings correspond with that of world literature.

Carcinoma of breast is one of the less frequent malignancies in males. In this study 50 cases of malignant tumours of male breast diagnosed during a 10 years period (1980-1989) are analysed retrospectively. The malignant breast tumours in males were about 3% of all breast malignancies in both sexes and 0.34% of all types of malignant tumours diagnosed during the study period. One male breast was involved for every 33 female cases. The peak incidence was between 5th to 7th decade with mean age of 58.54 years. The mean duration of symptoms was 13.69 months and 46.15% cases reported to the hospital after one year of their symptoms. Clinically, a painless lump in the breast was most frequently seen, followed by ulceration of the skin. Histologically, the infiltrating duct carcinoma (grade III) was the predominant lesion and one case of Paget's disease of the breast was also seen.