Outcome of non-metastatic male breast cancer: 118 patients

Abstract

Studies concerning adjuvant systemic therapy and prognosis in male breast carcinoma (MBC) are limited. We aimed to evaluate outcome of the changing practices of adjuvant systemic treatment and survival in operable MBC patients over the last two decades. The medical records of 148 MBC patients followed between the years 1986 and 2009 at 7 cancer center were evaluated retrospectively. One hundred and eighteen operable non-metastatic patients had sufficient data were included the study. One hundred and eighteen operable MBC were found to be eligible. Median age was 60 (range 29-83) years. Thirty-two percent of the patients had T3-4 tumors. Half of the patients had axillary lymph node-positive disease. The proportion of positivity of estrogen receptor(ER), progesterone receptor (PgR), and HER2 status were 82.9, 75.8, and 23.4%, respectively. Only, 7 patients had triple negative (TN). Adjuvant hormonotherapy was advised for 76.8% whereas adjuvant chemotherapy for 73.7% of the patients. Median follow-up was 40.9 months (range 3.8-186 months). Locoregional and/or distant recurrence developed in thirty-eight patients (32.2%). Twenty-three patients died during the follow-up period. Five-year disease-free survival (DFS) was found to be 60%, whereas overall survival (OS) was 82%. Larger tumor size and lymph node positivity were statistically significant poor prognostic factors for OS. Although statistical insignificant, patients with HER2-positive tumors have worse DFS (52 vs. 120 months, log rank P = .73) and OS (85 vs. 144 months, log rank P = .30) than HER2-negative ones. Although the frequency of the use of adjuvant systemic therapy in MBC has been increasing and survival rates improving for the last decades, lymph node status and tumor size are still the most important determining factors for prognosis. There is a need for further prognostic information in men with HER2-positive or TN breast cancer.

Clinical and pathologic characteristics of BRCA-positive and BRCA-negative male breast cancer patients: results from a collaborative multicenter study in Italy

“…It is noteworthy that two of the four BRCA1 mutation carriers found in our series harbor the same mutation that was previously identified as a founder mutation in Central Italy [17]. Compared with previous studies, in our series age at diagnosis was lower and the percentage of cases with a positive first-degree FH was higher [18][19][20][21]. This could reflect the presence of MBC patients enrolled in a context of genetic counselling programs, which are more frequently characterized by familial cancer and younger age at diagnosis.…”

The Management and Outcomes of Male Breast Cancer

“…However, the positivity rates were similar in men when compared with postmenopausal women (25,26). Many studies have reported different rates of HER2 overexpression in MBC (27)(28)(29)(30). In our study, ER results were positive in 31 (83.8%) cases, PR results were positive in 30 (81.1%) cases, and HER2 results were positive in 13 (35.1%) cases.…”

Should Adjuvant Radiation Therapy Be Systematically Proposed for Male Breast Cancer? A Systematic Review

“…Adjuvant hormonal treatment and chemotherapy has increased over the past decades (24,26,36,38). The rate of patients who received chemotherapy varied between 3 and 85% (mean=26%) and hormonal therapy between 7 and 92% (mean=45%).…”