Male breast cancer: Study offers insight on treatment and prognosis

Male breast cancer (MBC) comprises one percent of all breast cancer cases, yet no prospective randomized clinical trials specifically focused on MBC have been successfully completed.

Breast cancer usually occurs in women, but men can get it, too. Men also have breast tissue, thus they can also develop breast cancer.

Less than one percent of all breast cancer cases develop in men, and only one in a thousand men will ever be diagnosed with breast cancer. A few investigations recommend that the occurrence of Male Breast Cancer (MBC) is on rising, however, and there is an increasing appreciation that the tumor biology of MBC contrasts from that of female breast cancer.

According to a recent study led by Kathryn Ruddy, MD, MPH, and Siddhartha Yadav, MBBS, at Mayo Clinic in Rochester, male breast cancer has evolved over the years. Moreover, certain patient-, tumor-, and treatment-related factors are linked with better survival.

Scientists investigated data from the National Cancer Database on men determined to have stage I-III breast cancer between 2004 and 2014.

Almost 10,873 patients with MBC were involved in the study with a median age at diagnosis of 64 years. Breast-conserving surgery was performed in 24 percent of patients, and 70 percent of patients undergoing breast conservation received radiation. Forty-four percent of patients got chemotherapy, and 62 percent of patients whose tumors expressed the estrogen receptor received anti-estrogen therapy.

During the study period, there was a significant increase in the rates of total mastectomy, contralateral prophylactic mastectomy, and post-breast conservation radiation, as well as an increase in the rate of genomic testing on tumors and the use of anti-estrogen therapy. Tamoxifen is the standard anti-estrogen medication recommended for the treatment of hormonally sensitive MBC, but this study was not able to assess specific medications used.

Factors related to worse overall survival were older age, black race, multiple comorbidities, high tumor grade, and stage, and undergoing a total mastectomy. Residing in higher-income zones; having tumors that express the progesterone receptor; and receiving chemotherapy, radiation, and hostile to estrogen treatment were related to better overall survival.

Dr. Ruddy said, “Our study highlights unique practice patterns and factors associated with prognosis in MBC, furthering our understanding of the treatment and prognosis of MBC. The racial, economic, and age-related health disparities we found could inform future efforts to target interventions to optimize outcomes in men with breast cancer.”

The study is published in the journal Cancer.

REFERENCEWiley

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