Early Stage Still Important Prognostic Indicator in Nonmetastatic Male Breast Cancer

The use of adjuvant anthracyclines/taxanes and trastuzumab for male breast cancer has been increasing in the last 10 years, but disease stage at the time of diagnosis still remains an important prognostic factor for survival, according to study findings presented at ESMO Congress 2019 in Barcelona, Spain.

Investigators examined the medical records of 261 male patients with breast cancer who were followed from 1986 to 2018 at 8 cancer centers. For this investigation, 222 men with nonmetastatic breast cancer (median age 61 years) at the time of diagnosis met study criteria. Among the 222 men, 91% had invasive ductal carcinoma, 30.6% had T3-4 tumors, and 50% had axillary lymph node-positive tumors.

The largest proportion of men had ER positive disease (82.5%), 73.1% were progesterone receptor-positive and 18.4% were HER2-positive. In this cohort, 10 men had triple-negative breast cancer and 55 men had at least one comorbid chronic illness. In terms of treatment, 83.9% of the men underwent a modified radical mastectomy and 79.9% received adjuvant radiotherapy. The median follow-up was 55 months.

The researchers found that during follow-up the locoregional and/or distant recurrence rate was 36.9%, and 34.5% of the men died during follow-up. Among the 77 deaths, 52 were due to metastatic breast cancer. The 5-year disease-free survival (DFS) rate was 66.6% and the overall survival (OS) rate was 73.5%.

The study demonstrated that DFS was significantly longer for men with early-stage male breast cancer (stage I/II tumor) compared with men with stage III disease (median not reached vs 78 months). Overall survival was also worse for men with stage III disease (median 103 months vs 153 months).

Reference

Arslan UY, Aslan F, Ayhan, et al. Outcome of non-metastatic male breast cancer: 222 patients. Presented at: ESMO Congress 2019; September 27-October 1, 2019; Barcelona, Spain. Abstract 199P.