Male breast carcinoma in Israel: Higher incidence but possibly better prognosis in Ashkenazi Jews

BACKGROUND. Little information is available regarding male breast carcinoma. However, cumulative data have suggested a propensity for the disease among Ashkenazi Jews. Because Ashkenazi Jews comprise one of the major ethnic groups in Israel, the authors conducted a local study to shed more light on the features of this rare disease. METHODS. From 1960 to 2000, 131 men with breast carcinoma were treated at the Rabin Medical Center or the Rambam Medical Center, and, from 1980 to 1997, 470 patients with this diagnosis were recorded in the Israel Cancer Registry. These two data bases were used to analyze the epidemiologic and clinicopathologic characteristics of male breast carcinoma in Israel. RESULTS. Seventy-eight percent of the 131 Jewish patients were Ashkenazi. Most of their clinical characteristics were similar to those of their Sephardic counterparts. However, there was a statistically significant difference in the pattern of comorbidity between these groups (P = 0.000), and there was a trend toward a younger age at onset and more advanced tumor stage at the time of diagnosis for the Sephardim. It also was found that Sephardic origin was associated with poorer outcome (P = 0.03). Analysis of the Cancer Registry data base revealed an 80% increase in the risk of the disease for Ashkenazi Jews compared with Sephardic Jews (odds ratio, 1.8; 95% confidence interval, 1.4-2.3; P = 0.001). Survival analysis from this source suggested a poorer outcome for Sephardic Jews compared with Ashkenazi Jews (62% vs. 64.3% estimated 5-year survival rates, respectively; P = 0.08). CONCLUSIONS. Analyses of two independent data bases, patient charts, and a cancer registry indicate that breast carcinoma seems to be more prevalent among Ashkenazi Jewish men. At the same time, affected Ashkenazi patients may have a more favorable outcome than their Sephardic counterparts.