The 21-Gene Recurrence Score in Male Breast Cancer

Reid

Clinical Cancer Research

et al. 2020

Background: Prognostic value of Oncotype DX Breast Recurrence Score (RS) in male breast cancer patients is understudied. We evaluated associations of RS with overall mortality in male breast cancer patients and compared it to female counterparts. Methods: With a cohort of 848 male and 110,898 female breast cancer patients identified from the National Cancer Database (2010-2014), we estimated hazard ratios (HR) and 95% confidence intervals (CI) for overall mortality associated with RS using Cox regression models. RS was evaluated continuously, as well as by categorization following respective traditional (≤17, 18-30, ≥31) and TAILORx (≤10, 11-25, ≥26) cutoffs. Results: RS was positively associated with mortality in male patients (HR=1.13, 95%CI: 1.02 to 1.26 per unit RS increment) up to RS >21, after which the risk plateaued. Among female patients, mortality began to increase with RS only when RS >23 (HR=1.02, 95%CI: 1.01 to 1.02 per unit of RS increment). The intermediate-(HR=5.37, 95%CI: 1.79 to 16.11) and high-risk diseases (HR=4.28, 95%CI: 1.22 to 14.97) defined by TAILORx, but not traditional cutoffs established for female patients, were associated with elevated mortality risk in men even after adjustment for demographic, clinical characteristics and treatments, except chemotherapy.

Section: Discussionsupporting

confidence: 89%

Sex Disparity Observed for Oncotype DX Breast Recurrence Score in Predicting Mortality Among Patients with Early Stage ER-Positive Breast Cancer

Reid

Clinical Cancer Research

et al. 2020

“…The application of the 21-gene breast recurrence score (RS) may shed some light on the option of chemotherapy. After testing 38 MBC patients, Turashvili et al [32] found similar RS distribution in MBC and FBC patients. Besides, RS testing was declared to play a prognostic role in MBC [7].…”

Section: Discussionmentioning

confidence: 93%

Characterization and prognosis of estrogen receptor-positive/progesterone receptor-negative male breast cancer: a population-based study

Wei

Zhang

2018

World J Surg Onc

BackgroundThe aim of this study was to explore the characteristics and prognostic information of estrogen receptor-positive/progesterone receptor-negative (ER+/PR−) male breast cancer.MethodsUsing the US National Cancer Institute’s Surveillance, Epidemiology, and End Results database, we compared the demographics, clinical characteristics, and outcome of estrogen receptor-positive/progesterone receptor-positive (ER+/PR+) patients with ER+/PR− male breast cancer patients from 1990 to 2010. Two thousand three hundred twenty-two patients with ER+/PR+ tumors and 355 patients with ER+/PR− tumors were included in our study.ResultsER+/PR− patients were younger (P = 0.008) and more likely to be African American (P < 0.001) while presented with higher histological grade (P < 0.001), larger tumor size (P = 0.010), and more invasion to the lymph nodes (P = 0.034) and distant sites (P < 0.001), thus later stage (P = 0.001). Despite higher chance of receiving chemotherapy (51.0% vs 36.5%, P < 0.001), ER+/PR− patients experienced significantly worse breast cancer-specific survival (BSCC) (P < 0.001) and shorter overall survival (OS) (P = 0.003). Multivariate Cox model confirmed that tumor size, lymph node invasion, metastasis, and surgery were independent prognostic factors of both BSCC and OS for ER+/PR− male breast cancer. Age at diagnosis and chemotherapy were significantly associated with OS but not with BSCC.ConclusionER+/PR− male breast cancer was more aggressive and experienced shorter survival than ER+/PR+ patients. The prognosis was mainly associated with tumor size, lymph node invasion, metastasis, and surgery.

“…Turashvili et al reviewed 38 male patients with BC and showed that 7.9% of patients had a high RS. 15 Our study found that the 21-gene RS was not often utilized and was medical oncologist-dependent. When oncotype DX was utilized, there was an even distribution of low, intermediate, and high RSs.…”

Section: Discussionmentioning

confidence: 77%

Male Breast Cancer: 13-Year Single Institution Experience

Srour

Amersi

Mirocha

et al. 2020

The American Surgeon™

Due to the low incidence of male breast cancer (BC), there are few studies evaluating outcomes. We evaluated the clinicopathologic features and outcomes of male BC. Male patients with BC from January 2006 to December 2018 were identified. Of 49 patients, mean age was 64 (range 33-94) years. Of the 27 (55.1%) patients who had genetic testing, 9 (33.3%) had a Breast Cancer gene (BRCA) 1 or 2 mutation. The majority of patients had a mastectomy (n = 43/49, 87.8%) and had invasive ductal carcinoma (n = 47/49, 95.9%). 20 patients (n = 20/43, 46.5%) had positive lymph nodes. 41 (n = 41/47, 87.2%) patients had estrogen receptor positive disease. The majority of patients were pathologic stage 2 (n = 21/46, 45.7%), followed by stage 1 (n = 15/46, 32.6%), stage 3 (n = 6/46, 13.0%), and stage 4 (n = 4/46, 8.7%). Eight patients had the 21-gene recurrence score performed. Of patients with stage 1-3 BC, 10 (n = 10/43, 23.3%) patients had recurrence. With median follow-up of 4.1 (range .6-10.6) years, 5-year overall survival was 82.9% and 5-year disease-free survival was 65.9%. In conclusion, our cohort of patients with male BC had a high incidence of BRCA mutations and most commonly had high-grade estrogen positive stage 2 tumors. Breast conserving surgery was utilized in 4% of patients and genomic testing utilized in 55% of patients.