Male breast cancer: Epidemiological evaluation and clinical outcomes.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13619-e13619
Author(s):  
Edla Renata Cavalcante ◽  
Katia Regina Marchetti ◽  
Jamile Almeida Silva ◽  
Laura Testa
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Sao Paulo ◽  
Male Breast ◽  
Rank Test ◽  
São Paulo ◽  
Male Population ◽  
Female Population

e13619 Background: Male breast cancer (BC) is a rare neoplasia, with a risk of 1:1.000 in USA. Data from Sao Paulo Cancer Registry has shown that BC adjusted incidence rates is about 1.21 per 100,000 at the period from 2001 to 2005, but there is no incidence data for the whole country. Methods: We conducted a unicentric retrospective cohort, with histologically proven male BC patients whose first appointment was between 2008 and 2018 at Instituto do Câncer do Estado de São Paulo in Brazil. The primary endpoint was OS according to metastatic status and initial staging. OS and RFS were analyzed by Kaplan–Meier method and the difference calculated by log-rank test; reported hazard ratios by univariate Cox Models and P-values by score test. Multivariate analysis was calculated through COX regression. Results: 89 male BC patients were accessed, average age at diagnosis was 63.3 yeas-old. 84.2% had carcinoma of no special type (88,7% estrogen positive receptor, 84,2% progesterone positive receptor). When Charlson Comorbidity Index (CCI) was calculated, most (23.5%) were ≥ 7 (10-year survival: 0%), being 17.9% stage IV. Mastectomy was performed at 73% patients, 38.2% received adjuvant chemotherapy; 44.9% received adjuvant radiotherapy and 64% received adjuvant endocrine therapy (94.7% tamoxifen). For metastatic disease, endocrine therapy was the first option in 52%. Median OS was 75 months (95% CI, 39.2-110.7) in M0 and 39 months (95% CI, 25,2–52,8) in M1 ( p = 0.001). CCI showed be an independent death factor (HR 0.37, 95% CI, 0.17-0.8, p = 0.011). Median RFS was 97 months [95% CI, 47.3–146.7]. When BMI was evaluated for patients with obesity (> 30) there was no difference in disease relapse ( p = 0.29). Conclusions: Our results are consistent with those from previous literature, regarding histology, biomarkers and later stage at diagnosis. A quarter of our patients had high CCI and this could had impacted on best treatment option choices. Treatment approaches use to be similar from those of female population. However, as disease biology and hormonal physiology are different between gender, there is a lack of specific protocols and trials in male population.

scholarly journals Survival and prognostic factors of breast cancer in women in the state of São Paulo

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Raissa Janine de Almeida ◽  
Carolina Terra de Moraes Luizaga ◽  
Cristiane Murta-Nascimento
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Clinical Stage ◽  
Sao Paulo ◽  
The State ◽  
Rank Test ◽  
São Paulo ◽  
Historical Cohort ◽  
Female Population

Introduction: Breast cancer is the first most common malignancy in the female population worldwide. Monitoring the survival of women with breast cancer has been a strategy often adopted at the international level as a measure to assess public policy progress for disease control. Objectives: To estimate the probability of five-year survival and to investigate the prognostic factors of women with breast cancer included in the São Paulo State Cancer Hospital Records Base (RHC-SP), established in 2000 and maintained by the Oncocentro Foundation of São Paulo (Fundação Oncocentro de São Paulo – FOSP). Material and methods: This is a historical cohort. The sample consisted of women with breast cancer diagnosed between 2002 and 2012 and included in the RHC-FOSP. The event studied was specific mortality from breast cancer. Live cases at the end of follow-up (December 31st, 2017), loss of follow-up and those who died from causes other than breast cancer were considered censures on the date of the last contact or date of death. Survival analysis was performed using the Kaplan-Meyer method and the survival curves were compared using the log-rank test. Hazard ratios (HR) and respective 95% confidence intervals (95%CI) were also estimated using the Cox's proportional hazards model. This study was approved by the Human Research Ethics Committee of the School of Medicine of Botucatu, UNESP. Results: In the period between 2002‒2012, 53,146 cases of invasive breast cancer were registered at RHC-FOSP. The median age of women at diagnosis was 55.9 years. By the end of the follow-up (December 31st, 2017), 20,683 patients died and 71.4% were due to breast cancer. The probability of specific survival for the entire cohort at 5 and 10 years was 76.1% (95%CI 75.7‒76.5%) and 64.8% (95%CI 64.2‒65.3%), respectively. In the multivariate analysis, the factors associated with the prognosis were: age at diagnosis, year of diagnosis, educational level, grouped clinical stage and histological type. Conclusion: Specific survival for breast cancer in the state of São Paulo is significantly associated with several characteristics. The knowledge of these characteristics can contribute to the development of public policies in the area.

scholarly journals Cytoplasmic DDX3 as prognosticator in male breast cancer

2021 ◽  
Author(s):  
Carmen C. van der Pol ◽  
Cathy B. Moelans ◽  
Quirine F. Manson ◽  
Marilot C. T. Batenburg ◽  
Elsken van der Wall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Female Breast Cancer ◽  
Male Breast ◽  
Rank Test ◽  
Lymph Node Status ◽  
Molecular Characteristics ◽  
Cox Regression Analysis

AbstractMale breast cancer (MBC) is a rare disease. Due to its rarity, treatment is still directed by data mainly extrapolated from female breast cancer (FBC) treatment, despite the fact that it has recently become clear that MBC has its own molecular characteristics. DDX3 is a RNA helicase with tumor suppressor and oncogenic potential that was described as a prognosticator in FBC and can be targeted by small molecule inhibitors of DDX3. The aim of this study was to evaluate if DDX3 is a useful prognosticator for MBC patients. Nuclear as well as cytoplasmic DDX3 expression was studied by immunohistochemistry in a Dutch retrospective cohort of 106 MBC patients. Differences in 10-year survival by DDX3 expression were analyzed using log-rank test. The association between clinicopathologic variables, DDX3 expression, and survival was tested in uni- and multivariate Cox-regression analysis. High cytoplasmic DDX3 was associated with high androgen receptor (AR) expression while low nuclear DDX3 was associated with negative lymph node status. Nuclear and cytoplasmic DDX3 were not associated with each other. In a univariate analysis, high cytoplasmic DDX3 (p = 0.045) was significantly associated with better 10-year overall survival. In multivariate analyses, cytoplasmic DDX3 had independent prognostic value (p = 0.017). In conclusion, cytoplasmic DDX3 expression seems to be a useful prognosticator in MBC, as high cytoplasmic DDX3 indicated better 10-year survival.

Management of Male Breast Cancer: ASCO Guideline

2020 ◽  
Vol 38 (16) ◽  
pp. 1849-1863 ◽  
Author(s):  
Michael J. Hassett ◽  
Mark R. Somerfield ◽  
Elisha R. Baker ◽  
Fatima Cardoso ◽  
Kari J. Kansal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Male Breast Cancer ◽  
Early Stage ◽  
Metastatic Cancer ◽  
Male Breast ◽  
Eligibility Criteria ◽  
Early Stage Disease ◽  
First Line Therapy ◽  
History Of

PURPOSE To develop recommendations concerning the management of male breast cancer. METHODS ASCO convened an Expert Panel to develop recommendations based on a systematic review and a formal consensus process. RESULTS Twenty-six descriptive reports or observational studies met eligibility criteria and formed the evidentiary basis for the recommendations. RECOMMENDATIONS Many of the management approaches used for men with breast cancer are like those used for women. Men with hormone receptor–positive breast cancer who are candidates for adjuvant endocrine therapy should be offered tamoxifen for an initial duration of five years; those with a contraindication to tamoxifen may be offered a gonadotropin-releasing hormone agonist/antagonist plus aromatase inhibitor. Men who have completed five years of tamoxifen, have tolerated therapy, and still have a high risk of recurrence may be offered an additional five years of therapy. Men with early-stage disease should not be treated with bone-modifying agents to prevent recurrence, but could still receive these agents to prevent or treat osteoporosis. Men with advanced or metastatic disease should be offered endocrine therapy as first-line therapy, except in cases of visceral crisis or rapidly progressive disease. Targeted systemic therapy may be used to treat advanced or metastatic cancer using the same indications and combinations offered to women. Ipsilateral annual mammogram should be offered to men with a history of breast cancer treated with lumpectomy regardless of genetic predisposition; contralateral annual mammogram may be offered to men with a history of breast cancer and a genetic predisposing mutation. Breast magnetic resonance imaging is not recommended routinely. Genetic counseling and germline genetic testing of cancer predisposition genes should be offered to all men with breast cancer.

scholarly journals Breast cancer in women: characterization of cases included in the hospital cancer records of the state of São Paulo and factors associated with advanced stadiums

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Raissa Janine de Almeida ◽  
Arthur Felipe Decker ◽  
Carolina Terra de Moraes Luizaga ◽  
Cristiane MurtaNascimento
Keyword(s):  
Breast Cancer ◽  
Clinical Stage ◽  
Sao Paulo ◽  
Age At Diagnosis ◽  
Outcome Variable ◽  
São Paulo ◽  
Female Population ◽  
Level Of Education ◽  
Factors Associated ◽  
Advanced Stages

Introduction: Breast cancer is a worldwide public health problem, being the most common malignancy in the female population. It is a potentially curable disease if diagnosed early. The advanced stage at the time of diagnosis is associated with increased morbidity and low survival of these women. Objectives: To describe the sociodemographic, clinical, and anatomopathological characteristics of breast cancer cases in women included in the São Paulo State hospital cancer database (registros hospitalares de câncer de São Paulo – RHC-SP), established in 2000 and maintained by the Fundação Oncocentro de São Paulo (FOSP) and to investigate the factors associated with the clinical stage at the time of diagnosis. Material and methods: The study design was a series of cases. The sample consisted of women with breast cancer diagnosed between 2000-2014 and included in the RHC-FOSP. The outcome variable was the clinical stage (stage 0-II versus III-IV). The explanatory variables were: age at diagnosis and education level. This study was approved by the Human Research Ethics Committee of the Botucatu Medical School, UNESP. Results: The study included 84,987 women with in situ and invasive breast cancer diagnosed between 2000-2014. The mean age of women at diagnosis was 56.7 years (95%CI 56.6–56.8 years). Sixty-five percent of the cases have complete elementary school or less and the most frequent histological type was ductal carcinoma (77.2%). During the study period, there was a small decrease in the proportion of tumors in more advanced stages, from 39.8% in 2000 to 32.6% in 2014. There was a statistically significant association between the variables age at diagnosis and level of education with the clustered clinical stage of women. Women of older age and those with a higher level of education had reduced odds ratios for tumors in more advanced stages at the time of diagnosis. Conclusion: These findings may contribute to the development of policies for the identification of breast tumors at an earlier stage.

Predictors of adjuvant radiation therapy in the treatment of male breast cancer and its impact on outcomes: A propensity matched analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12516-e12516
Author(s):  
Veli Bakalov ◽  
Thejus Thayyil Jayakrishnan ◽  
Stephen Abel ◽  
Christie Hilton ◽  
Bindu Rusia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Breast Conservation ◽  
Male Breast ◽  
Breast Conservation Surgery ◽  
P Value ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy

e12516 Background: Male breast cancer (MBC) accounts for 1% of all breast cancers and there is a paucity of data on factors impacting the treatment strategies and outcomes. We hypothesized that adjuvant radiation therapy (Adj-RT) may improve survival outcomes and sought to examine predictive factors for Adj-RT receipt. Methods: We queried the National Cancer Database (NCDB) for patients with stages I-III MBC treated with surgery (breast conservation surgery- BCS or mastectomy-MS) within 180 days of diagnosis (years 2004-2015). Multivariable logistic regression identified predictors of adjuvant radiation therapy receipt. Multivariable Cox regression evaluated predictors of survival. Propensity matching for adj-RT accounted for indication biases. Results: We identified 6,217 patients meeting the eligibility criteria (1457 BCS vs. 4760 MS). The majority of patients were white (85%) and within the age range of 50-80 years (74%). Although Adj-RT was omitted for 30% of BCS patients, the utilization was higher compared to MS (OR=26, p-value=0.001). The predictors of Adj-RT use were – African American race, higher stage, higher grade, presence of lymphovascular invasion and ER/Her-2 positivity for the entire cohort and higher age, urban location and higher income for BCS. Adj-RT was associated with lower mortality in the propensity matched model (overall HR for BCS=0.28, p-value<0.001; overall HR for MS=0.62,p-value=0.001) and is shown in the table. Conclusions: This study demonstrates there may be an association between decreased mortality and Adj-RT in MBC undergoing BCS. Although this implies that Adj-RT should be routinely delivered, it appears to be omitted frequently and its use requires further investigation. The study also suggests a benefit to Adj-Rt after MS for stage-III MBC. [Table: see text]

scholarly journals Poor prognosis of male triple-positive breast Cancer patients: a propensity score matched SEER analysis and molecular portraits

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Biyuan Wang ◽  
Hui Wang ◽  
Andi Zhao ◽  
Mi Zhang ◽  
Jin Yang
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Current Knowledge ◽  
Male Breast ◽  
The Cancer Genome Atlas ◽  
Breast Cancer Patients ◽  
Molecular Features

Abstract Background The purpose of this study was to explore clinicalpathology features, molecular features and outcome of male breast cancer patients who expressed ER, PR as well as HER-2, namely triple-positive male breast cancer (TP-MBC), and compared them with triple-positive female breast cancer patients (TP-FBC). Methods TP-MBC and TP-FBC from 2010 to 2017 were selected from the Surveillance, Epidemiology, and End Results database (SEER). Kaplan-Meier plotter and multivariable Cox regression model were applied to analyse the difference between TP-MBC and TP-FBC on cancer-specific survival (CSS) and overall survival (OS). Propensity score matched (PSM) analysis was used to ensure well-balanced characteristics. 7 cases TP-MBC and 174 cases TP-FBC patients with the genomic and clinical information were identified from the cohort of The Cancer Genome Atlas (TCGA) and the Memorial Sloan Kettering (MSK). Result 336 TP-MBC and 33,339 TP-FBC patients were taken into the study. The percentages of TP-MBC in MBC patients were higher than the rates of TP-FBC in FBC patients from 2010 to 2017 except 2012. Compared with TP-FBC, more TP-MBC were staged III (17.9% vs. 13.5%) or stage IV (11.0% vs. 6.9%). TP-MBC were more frequently to be older than 65-years-old (47.0% vs. 29.3%), Balck (15.2% vs. 10.8%), ductal carcinoma (91.7% vs. 84.4%) and metastases to lung (4.5% vs. 2.1%) or bone (8.6% vs. 4.7%). TP-MBC had worse OS and CSS than TP-FBC in all stages (P < 0.001). In multivariable prediction model of TPBC, male patients had a higher risk than female. Lastly, the worse OS (P < 0.001) and CSS (P = 0.013) were seen in the 1:3 PSM analysis between TP-MBC and TP-FBC. Genomic analysis revealed that TP-MBCs have some notable rare mutations, like ERBB2, ERBB3, RB1, CDK12, FGFR2, IDH1, AGO2, GATA3, and some of them are not discovered in TP-FBC. Conclusion TP-MBC had a worse survival than TP-FBC, and there were different genomic features between two groups. Current knowledge and treatment to TP-MBC maybe inadequate and remain to be explored.

scholarly journals A CASE OF MALE BREAST CANCER THAT DEVELOPED DURING ENDOCRINE THERAPY FOR PROSTATE CANCER

2009 ◽  
Vol 70 (4) ◽  
pp. 1006-1010
Author(s):  
Masako TAMAKI ◽  
Takako KAMIO ◽  
Masako YAMAGUCHI ◽  
Kei AOYAMA ◽  
Tetsuya OOCHI ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Endocrine Therapy ◽  
Male Breast Cancer ◽  
Male Breast

scholarly journals Potential Benefits of Pre-emptive PGx Testing in Male Breast Cancer Patients

2019 ◽  
Vol 10 (4) ◽  
pp. 18
Author(s):  
Heather Randles ◽  
Nina Abraham ◽  
Michael J. Schuh
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Male Breast Cancer ◽  
White Male ◽  
Recurrent Breast Cancer ◽  
Adjuvant Endocrine Therapy ◽  
Male Breast ◽  
Breast Cancer Patients ◽  
Potential Benefits ◽  
Recurrent Breast

The objective is to report a case of recurrent breast cancer in a poor CYP2D6 metabolizer male patient on tamoxifen, and how pharmacogenomic (PGx) testing can play an important role in selecting appropriate adjuvant endocrine therapy. The case examined here is a 60-year-old white male diagnosed with recurrence of breast cancer. The patient was prescribed tamoxifen four years prior as adjuvant endocrine therapy after initial treatment with surgery. PGx testing ordered at the time of recurrence revealed patient is a poor metabolizer of CYP2D6, which may decrease the efficacy of tamoxifen. The results prompted a change in therapy to an aromatase inhibitor (AI). This case illustrates the potential benefits of preemptive PGx testing in a male breast cancer patient to assist in selecting appropriate adjuvant therapy based on how the patient metabolizes medications. In addition, PGx testing encourages patient involvement by emphasizing the association of genetics in determining treatment. The ultimate goal in performing these tests is to individualize treatment to improve safety and efficacy while minimizing adverse drug reactions.   Article Type: Case Study

scholarly journals Clinicopathologic characteristics and prognosis for male breast cancer compared to female breast cancer

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Nan Yao ◽  
Wenzai Shi ◽  
Tong Liu ◽  
Sarah Tan Siyin ◽  
Weiqi Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Competing Risks ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Female Breast Cancer ◽  
Male Breast ◽  
Limited Information ◽  
Female Breast ◽  
Her 2

AbstractMale breast cancer (MBC) is rare. Due to limited information, MBC has always been understudied. We conducted a retrospective population-based cohort study using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. The clinical and biological features of female breast cancer (FBC) patients were compared with MBC patients. Cox regression models and competing risks analyses were used to identify risk factors associated with cancer-related survival in MBC and FBC groups. Results showed that MBC patients suffered from higher TNM stages, tumor grades, and a higher percentage of hormone receptor-positive tumors, compared with FBC patients (all p < 0.05). In addition, the breast tumor locations varied a lot between males and females (p < 0.05). FBC patients were associated with superior overall survival than MBC patients. Results from multivariate cox regression and competing risks analyses showed age, race, T, N, M-stages, tumor grades, estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) overexpression were independent prognosis factors in FBC patients (all p < 0.05). MBC patients had similar risk factors to FBC patients, but PR and HER-2 status did not independently influence survival (all p > 0.05). Tumor location was an independent prognostic factor for both gender groups.

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