e11610 Background: Most cases of breast cancer are diagnosed at early stage of disease, therefore treatment is oriented to increase the relapse-free survival (RFS) and overall survival (OS). The prognosis, in comparison to other malignancies, has improved in the last decades as a result of mammographic screening. The objective of this study was to evaluate the incidence of local and distant recurrence, RFS and OS in women with EBC. Methods: From 01/1978 to 12/2004, 929 women with EBC were identified, 350 were stage I and 579 stage II (AJCC 2002). RFS was analyzed from the date of initial diagnosis to the date of local or distant recurrence. OS was estimated from the date of initial diagnosis to the last follow-up or date of death. Multivariate regression analyses were carried out using proportional hazard model proposed by Cox. RFS and OS were evaluated by the product-limit method of Kaplan and Meier, and differences between curves were assessed by means of log-rank test. Results: Median age was 51 years (28–92). Conservative surgery was performed in 69.7% of patients (pts). The median number of nodes examined was 17. Hormone receptors were ER+ in 65% and PR+ in 62% of pts. Adjuvant radiation therapy was administered to 73% of pts, whereas adjuvant chemotherapy to 29% and adjuvant hormone therapy to 18.5% of cases. Combined chemotherapy and hormone therapy was given to 34% of women. The median follow-up was 8.4 years (0.3–30). Local recurrence was documented in 37 pts (3.8%) whereas 269 developed metastatic disease (29%). Bilateral breast cancer was seen in 102 cases (10.9%) and 91 pts (9.7%) developed 2nd malignancies. RFS rate at 5, 10, 15, 20 and 25 years was 71%, 67%, 65%, 65% and 64% respectively. OS at 5, 10, 15, 20 and 25 years was 82%, 62%, 49%, 39% and 28% respectively. Factors that had an effect in OS demonstrated by the multivariate regression analysis were: histologic grade, tumor size, ER status, vascular and nodal involvement (p < 0.001). Conclusions: Clinical outcomes in EBC in our experience are similar to that reported in international literature. This group of pts continues to have a good prognosis as shown by the OS rate at 5, 10, 15, 20 and 25 years, although high percentage of pts continue to have recurrence and die from breast cancer after 5, 10, 15, 20 and 25 years of follow-up. No significant financial relationships to disclose.
Background: Male breast cancer (MaBC) is a relatively uncommon disease, representing less than 1% of all breast cancers. Given its rarity, information about prognostic factors is unclear and mainly extrapolated from data from female breast cancer. This represents an important challenge for the risk assessment and treatment decisions in men. The aim of this study was to analyze the characteristics of patients with MaBC and factors associated with prognosis over the past decade. Methods: We evaluated men with microscopically confirmed invasive breast cancer diagnosed between 2003 and 2012, reported to the Surveillance, Epidemiology and End Results (SEER) 18 registries program. Patients (pts) with other primary malignancy either before or after breast cancer were excluded. Pt characteristics were compared between tumor grades. Univariate and multivariate analyses were performed to determine the effects of each variable on overall survival (OS). Results: We included 2992 pts. Median age was 65 years (range 23-97). Median follow-up was 36 months (range 0-119). At diagnosis, ductal histology represented 85% of cases, ER positive 95.1% and PR positive 86%. Thirty-one percent were Stage I, 42% stage II, 18% stage III and 9% stage IV. Only 12.8% of pts had breast conservation and 23.7% received adjuvant radiotherapy. Tumor grade distribution was: 12.4% grade 1, 51.5% grade 2 and 36% grade 3/4. Pts with grade 3/4 tumors were more likely mixed ductal and lobular histology (p<0.0001), more often ER and PR negative (p<0.0001), presented with more advanced stage (p<0.0001), were more likely to have mastectomy and radiotherapy (p<0.0001 and p=0.001, respectively) and to die from breast cancer (p<0.0001). Univariate analysis showed that older age, black race, grade 3/4 tumors, stage IV disease, no surgery, no radiotherapy, ER negative tumors, PR negative tumors and unmarried pts had worse prognosis. Most deaths in the ER negative group occurred within the first 5 years (OS rate at 5 years 66.2%). OS rates between ER positive and ER negative groups were similar after 7.5 years (60.9% and 61.9%, respectively). In multivariate analysis, older age, grade 3/4 tumors, stage IV disease, no surgery, no radiotherapy, ER negative tumors and unmarried pts had shorter OS. Univariate pMultivariate pAge<0.0001<0.0001Race0.0001NSGrade<0.00010.006Stage<0.0001<0.0001Surgery<0.00010.0001Radiation0.020.004ER0.030.04PR0.005NSMarital status<0.0001<0.0001HistologyNS Conclusions: MaBC is most commonly diagnosed at early stages of disease. Tumors are frequently ductal in histology with high rates of ER positivity, however grade 1 is uncommon. We observed significant differences in pt characteristics according to tumor grade. The main difference in OS by ER status is seen during the first 5 years. Age at diagnosis, tumor grade, stage, surgery, radiotherapy, ER and marital status have clear influence on OS in MaBC over the past decade. Citation Format: Leone JP, Zwenger AO, Iturbe J, Leone J, Leone BA, Vallejo CT, Bhargava R. Prognostic factors in male breast cancer: A population-based study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-19-01.
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