Survival Prognostic Factors of Male Breast Cancer in Southern Iran: a LASSO-Cox Regression Approach

e11618 Background: Treatment for male breast cancer is based on the results of large clinical trials for female breast cancer. Although peculiar differences do exist between men and women, very little is known about the prognostic factors in male breast cancer, even though female breast cancer practical conducts are widely used in male breast cancer. The rarity of this condition makes very difficult to produce randomized trials. Methods: This study is populational and epidemiological and evaluated male breast cancer patients from January 1974 to December 2001 about its prognostic characteristics. Data were collected retrospectively and the sample has been described using descriptive statistics methods. Survival curve was built using Kaplan-Meier method. Staging system was standardized as in the sixth edition of American Joint Committee on Cancer, independently on when the diagnose was made. Due to differences throughtout 35 years on therapeutic on breast cancer, treatment options were categorized in groups to make the survival evaluation possible. Results: From 45 patients with male breast cancer, 91% presented ductal histology, 26% were negative axillary, 9.1% were T1, 25% were T2, 4.5% were T3, 50% were T4 and 12.12% presented with distant metastasis at diagnose. Seventy nine percent were submitted to radical local treatment, while 34% had not been submitted to any kind of systemic treatment (neoadjuvant, adjuvant e hormone therapy). Forty percent of patients have not presented distant recurrence, while 58.3% have not presented local recurrence. A median survival of 126 months has been observed to the analyzed population, ranging from 69–182 months. Five-year survival was 72% and 10-year survival was 54%. These data agreed with the available data in the published literature. Conclusions: Male breast cancer appears to behave biologically and clinically very similar to female breast cancer, but differences do exist and need to be elucidated. Randomized multi-center clinical trials become necessary, as systematic reviews, to build higher statistic power studies. No significant financial relationships to disclose.

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

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e12516 ◽

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]

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