Treatment Outcomes in Male Breast Cancer: A Retrospective Analysis of 161 Patients. Issue 6 (June 2018)

• Record Type: Journal Article
• Authors: Wan, B.A.; Ganesh, V.; Zhang, L.; Sousa, P.; Drost, L.; Lorentz, J.; Vesprini, D.; Lee, J.; Rakovitch, E.; Lu, F.-I.; Eisen, A.; Yee, C.; Lam, H.; Chow, E.
• Is Part Of: Clinical oncology. Volume 30:Issue 6(2018)
• Page Start: 354
• Page End: 365
• Publication Date: 2018-06
• Subjects: Breast cancer -- male -- treatment outcomes; Oncology -- Periodicals; Tumors -- Periodicals; Cancer -- Treatment -- Periodicals; Radiotherapy -- Periodicals; Neoplasms -- Periodicals; Cancer -- Radiotherapy; Cancer -- Treatment; Oncology; Medical radiology; Radiotherapy; Tumors; Electronic journals; Periodicals; 616.994
• DOI: 10.1016/j.clon.2018.02.026
• Languages: English
• ISSNs: 0936-6555

Abstract

Abstract: Aims: Male breast cancer is a rare disease with limited evidence-based guidelines for treatment. This study aimed to identify demographic, pathological and clinical factors associated with its prognosis. Materials and methods: A retrospective review of 161 male breast cancer patients diagnosed at a single institution from 1987 to June 2017 was conducted. Patient demographics, disease characteristics, treatment and outcome were extracted and included in competing-risk analysis and the univariate Cox proportional hazard model for univariate analysis. Factors with P < 0.10 were included in multivariable analysis. Results: The mean age at diagnosis was 67 years (standard deviation = 11.2) and the median follow-up duration was 5.3 years (range 0–25 years). There were 48 deaths, including 23 cancer-specific deaths. The actuarial median survival was 19.9 years. In multivariable analysis, factors associated with overall survival were size of tumours (hazard ratio 2.0; 95% confidence interval 1.4–2.7, P < 0.0001) and diagnosis of metastatic disease (hazard ratio 8.7; 95% confidence interval 1.9–40.6; P = 0.006). Of 138 patients without metastases at diagnoses, 11 had local-regional recurrence and 26 had distant metastases. In the multivariable model for local-regional recurrence, a more recent year of diagnosis was associated with reduced risk (hazard ratio 0.9, 95% confidence interval 0.8–1.0, P = 0.008), whereas more positive lymph nodes was associated with higher risk (hazard ratio 2.2, 95% confidence interval 1.2–4.0, P = 0.01). A higher risk of metastases was associated with more positive lymph nodes (hazard ratio 1.9; 95% confidence interval 1.1–3.3; P = 0.03) and tumour size (hazard ratio 1.8; 95% confidence interval 1.1–2.9; P = 0.01). A higher risk of any recurrence or metastases was associated with the number of positive nodes (hazard ratio 1.9; 95% confidence interval 1.2–3.0; P = 0.005) and tumour size (hazard ratio 1.6; 95% confidence interval 1.1–2.2; P = 0.01). Conclusion: In general, tumour size and more positive lymph nodes were associated with worse prognosis. Larger powered studies are needed to identify prognostic factors with smaller effect sizes. Highlights: This is one of the largest single-institutional retrospective analyses of male breast cancer, comprising of 161 patients. Total positive lymph nodes and invasive tumour size are independent predictors of local-regional recurrence and metastases. Demographic factors have limited prognostic capacity.