Metastatic Male Breast Cancer: A Retrospective Cohort Analysis

Abstract

Background: Metastasized male breast cancer (MMBC) is a rare disease. Given its low incidence, data regarding tumor biology, current treatment options, and survival rates are scarce. Patients and Methods: A chart review was performed of MMBC patients consecutively registered in regional cancer registries in Germany between 1995 and 2011. Tumor characteristics, treatment, and survival rates were documented and statistically evaluated. Results: 41 men with MMBC represented 25.6% of a total of 160 patients with MBC. 16 (39%) patients showed primary metastases, and 25 (61%) had recurrent metastases. Median survival from occurrence of metastasis was 32 months. Median overall survival (OS) was 68 months. 68.3% (n = 28) of the cohort received systemic therapy favoring endocrine therapy (n = 25, 61.9%). Prolonged metastatic OS (p = 0.02) was observed in patients having had a systemic treatment. Metastatic patients having received endocrine treatment showed significantly prolonged survival rates. Furthermore, patients receiving palliative chemotherapy had a significant survival benefit compared to those in whom chemotherapy was omitted. Conclusion: Our results suggest that systemic treatment in the form of both palliative chemotherapy and endocrine therapy improves outcome of MMBC. Therefore, it seems reasonable that treatment of MMBC should be based on the guidelines for female breast cancer.

Patterns of recurrence and treatment in male breast cancer: A clue to prognosis?

“…The positive survival impact of chemotherapy and endocrine therapy in advanced disease was previously reported in male and was also corroborated in our study. In MBC patients, palliative treatments are based in female standards, remaining some doubts about the need of combination of GnRH analogs to aromatase inhibitors or the rule of fulvestrant in these patients.…”

“…Like FBC patients, visceral metastases, in lung or liver, have a poor prognosis when compared to bone (exclusively). 24 Brain metastasis at the time of first recurrence seems rare in MBC patients, described in two patients (7.32%) in Foerster et al 16 series. However, in this study, there were 15 patients (39%) with synchronous metastasis at diagnosis (stage IV) and 5 patients (16.7%) with HER2 positive disease, which could bias these results.…”

“…Cancer recurrence is a critically important but missing variable in national cancer registries and the majority of hospitals report incomplete information for more than half of their patients . In MBC, data from epidemiological series had a large range for recurrence rate, varying from 7.8% to 60.9% reflecting also a huge variation in sample sizes, from 25 to 489 patients. Two of the largest published series reported, similar to us, a recurrence rate of 29.0% and 29.8% (142 events in 489 patients and 16 events in 91 patients).…”

Male Breast Cancer in the Age of Genetic Testing: An Opportunity for Early Detection, Tailored Therapy, and Surveillance

“…In comparison with female breast cancer, male breast cancer has been shown to have a higher propensity for lymphatic invasion (63%) (33). Male breast cancer involves the skin more frequently than female breast cancer (40% vs 5%-10%), invades the nipple more frequently (48% vs 5%-10%), and is more commonly associated with axillary nodal metastasis (60%-80% vs 10%-15%), all of which have been shown to be important predictors of adverse survival (33,(35)(36)(37)(38)(39) (Fig 5). However, male breast cancer is also more likely than female breast cancer to be luminal A-like and luminal B-like molecular subtypes that are ER receptor positive and is less likely to be of the basal-like subtype, all of which are good prognostic indicators (9).…”

Efficacy of chemotherapy in metastatic male breast cancer patients: a retrospective study

“…Thirdly, MBC is a disease of elderly men [ 1 ], for whom the harm possibly deriving from chemotherapeutic agents along with the often co-existing comorbidities refrain from using chemotherapy. Finally, information gathered on the use of chemotherapy in this population are scarce and stem from retrospective, small-sized studies either reporting on outdated drugs/regimens [ 17 , 18 ] or with no clear focus on chemotherapy efficacy [ 19 ].…”