Anticancer Res. 2013 May;33(5):2227-31.

Prognostic factors for male breast cancer: similarity to female counterparts.

Edward Yu, Larry Stitt, Olga Vujovic, Kurian Joseph, Avi Assouline, Joseph Au, Jawaid Younus, Francisco Perera, and Patricia Tai.

Department of Oncology, Division of Radiation Oncology, 790 Commissioners Road East, London ON, N6A 4L6, Canada. edward.yu@lhsc.on.ca

 

Abstract

AIM: To assess whether prognostic factors in male (MBC) and female (FBC) breast cancer have similar impact on survival.

PATIENTS AND METHODS: Charts for men and women diagnosed with breast cancer referred to the London Regional Cancer Program (LRCP) were reviewed. Patients with distant metastatic diseases were excluded. Data on prognostic factors including age, nodal status, resection margin, use of hormonal therapy, chemotherapy with/without hormone and radiation therapy (RT), overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) were analyzed. Survival estimates were obtained using the Kaplan-Meier methodology. The Cox regression interaction was used to compare male and female differences in prognostic factors.

RESULTS: From 1963-2006 there were 75 cases of MBC and 1,313 of FBC totaling in 1,388 breast cancer cases. The median age of the cohort was 53 (range=23-90) years. The median follow-up was 90 (range=0.4-339) months. Of the prognostic factors considered, nodal status had a significant Cox regression interaction. For OS, p=0.001 with hazard ratios of 0.83 (95% confidence interval CI=0.42-1.64) and 2.88 (95% CI=2.36-3.52) for males and females, respectively. For CSS p=0.041 with hazard ratios of 1.22 (95% CI=0.45-3.27) and 3.52 (95% CI=2.76-4.48) for males and females, respectively. For node-positive cases, distant disease recurrence-free survival was worse for MBC (log rank, p<0.001).

CONCLUSION: This large series showed that the nodal status influences survival differently in MBC and FBC. The findings of this study need confirmation from a more complete prospective database and further investigations on improving high-risk node-positive MBC management are warranted.

KEYWORDS: Male, breast cancer, female, prognostic factors, survival

PMID: 23645780

 

Supplement:

Our center experience with MBC (Male Breast Cancer) is that although it is not common, about 1% of all breast cancer, approximately 2240 new cases of MBC were diagnosed in United States in 2013 and410 men died from this disease[1]. MBC patients with high risk post mastectomy needed radiation therapy to improve local disease recurrence[2] (Figure 1) and potential benefit in overall survival[3].

Unlike FBC (Female Breast Cancer), MBC patients were older in diagnosis. Their breast tumors were often low to intermediate grade and estrogen-receptor positive. MBC patients were less often to receive chemotherapy[4]. The fact that high risk MBC patients with nodal involvement experienced more distance disease recurrence than their female counterparts is not entirely clear. The result of the present featured article is to call for global attention for men with breast cancer, besides to develop a specific screening tool to identify fit patients with MBC who would be able to receive more aggressive treatment, to work collaboratively and internationally for further support with innovative MBC research to improve the disease outcome.

 

References:

  1. American Cancer Society; www.cancergov/cancer topics/types/breast, last accessed 2014.
  2. Yu E., Suzuki H., Younus J. et al., The impact of post mastectomy radiation therapy on MBC- a case series. Int J Radiat Oncol Bio Phys 82(2):696-700, 2012.
  3. Sroufe R.L.,Schwartz D., Rineer J et al., A population-based study of the impact of post-mastectomy radiation on survival for male breast cancer. J Radiat Oncol 1:337-345, 2012.
  4. Yu E.,Stitt L., Vujovic O. et al., Prognostic factors for male breast cancer : Similarity to female counterparts. Anticancer Res 33:2227-2232,2013.

Edward Yu-fig1

Figure 1. Loco-regional (Intensity Modulated) Radiation Therapy for high risk MBC to improve disease outcome.

 

 

Contact information:

Edward Yu, MD, PhD, FRCP(C).

Director, The International Oncology Collaborative Research Group,

Associate Scientist, Lawson Health Research Institute,

Radiation Oncologist, London Health Science Center,

790 Commissioners Road East, London, Ontario. Canada.

E-mail: Edward.yu@lhsc.on.ca

Tel :519-685-8500

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