SABCS: Earlier Diagnosis and Better Treatment Improve Male Breast Cancer Survival

Charles Bankhead
SAN ANTONIO, Dec. 17 -- Male breast cancer outcomes have improved substantially by earlier diagnoses and increased use of adjuvant therapies, two large French cohorts showed.
Action Points --->
Explain to patients that survival in male breast cancer has improved as a result of earlier diagnosis and better treatment.
Note that the findings were reported at a medical conference and as a published abstract and should be considered preliminary until they appear in a peer-reviewed journal.
Overall and disease-specific survival have become similar to that of breast cancer in women, Bruno Cutuli, M.D., of the Polyclinique de Courlancy in Reims, reported at the San Antonio Breast Cancer Symposium. Tumor stage at diagnosis and rates of metastasis and local recurrence are all significantly better.
"The number of patients who received chemotherapy and hormonal treatment increased by twofold and fourfold, respectively," said Dr. Cutuli. "Optimal locoregional treatment and greater use of chemotherapy and hormonal therapy dramatically improved survival in male breast cancer, which now approximates that of females."
Male breast cancer remains rare, accounting for less than 1% of breast cancer and less than 1% of male malignancies. Because there are so few cases, it has been difficult to study the evolution of male breast cancer.
Historically, male breast cancer has been diagnosed at more advanced stages, said Dr. Cutuli. Additionally, breast cancer in men appears to be more aggressive. Survival is lower in men compared with women, but death from comorbid and intercurrent conditions contributes to the survival disparity.
Dr. Cutuli presented data from two male breast cancer cohorts involving a total of 983 men. To evaluate recent trends in male breast cancer, investigators compared data on 397 men who were diagnosed and treated from 1960 to 1986 with data on 489 men who were diagnosed and treated during 1990 to 2005.
The proportion of cancers diagnosed at stage T1 rose from 22% in the first cohort to 39% in the second, and T3-4 diagnoses fell from 26% to 7% (P<0.0001). The stage shift was associated with increased overall survival at five years (65% versus 81%) and at 10 years (38% versus 59%). Disease-specific survival increased from 74% to 89% at five years and from 51% to 72% at 10 years.
The proportion of estrogen receptor-positive tumors increased from 79% to 92% and progesterone receptor-positive tumors from 77% to 89%. The frequency of axillary nodal involvement did not change from the first to second cohort, and mastectomy predominated in both cohorts (87% versus 91%).
The proportion of men receiving postoperative radiation therapy increased from 66% to 85% (P<0.0001). Significantly more men in the later cohort received adjuvant systemic therapy, as use of chemotherapy increased from 18% to 34% (P<0.0001) and hormonal therapy from 17% to 72% (P<0.00001).
The frequency of local recurrence decreased from 8% in the earlier cohort to 1.9% (P<0.0001), and the proportion of men with metastatic disease decreased from 42% to 23% (P<0.0001).
Dr. Cutuli had no disclosures.
Primary source: Breast Cancer Research and TreatmentSource reference:Cutuli B, et al "Male breast cancer (MBC): impact of early diagnosis and adjuvant treatments: analysis of 983 cases" Breast Cancer Res Treat 2007; 106(Suppl): Abstract 5048.