retrospective study of treatment and outcome in 39 cases of male breast cancer

ABSTRACT

Optimal management if male breast cancer [MBC] is not clearly established and treatment guidelines are scarce. We evaluated our own results in the treatment of male breast cancer patients with respect to local control [LC], overall survival [OS] and possible prognostic factors for survival. Thirty-nine patients with MBC were retrospectively studied to evaluate the results in this type of tumor; 94.8% had invasive ductal carcinoma [IDC], 2.6% invasive papillary carcinoma [IDC] and 2.6% invasive lobuler carcinoma [ILC]. The distribution according to stage was 12.8%, 46.2%, 30.7% and 10.3% in Stages I, II, III and IV, respectively; 7.7% underwent radiotherapy [RT] +/- hormonotherapy [HT], 22.8% had chemotherapy [CT], 61.8% had chemoradiotherapy [CRT] +/- HT and 7.7% had HT in addition to surgery. The distant metastases rate was 36% and the local recurrence rate was 5%. All the local recurrences and the distant metastases had occurred after the first two years. The 2-year disease free survival [DFS] and OS rates were 87.2% and 89.7%, respectively, and the 5-year DFS and OS rates were 65.8% and 80.1%, respectively. In a univariate analysis for OS, statistical significance was found for lymph node metastases [P=.00001], stage [P=.0098] and age [P=.03], while presence of RT in the treatment modality [P=.6849], and tumor size [P=.4439] demonstrated no significance. The presence of lymph node metastases significantly impaired OS [P=.004] and DPS [P=.014] in the multivariate analysis. Postoperative radiotherapy was important in the management of MBC to improve LC resulting in one local failure, but did not improve OS and DFS. The presence of lymph node metastases significantly impaired OS and DFS