Characterization of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program Journal Article

Authors: Cardoso, F.; Bartlett, J. M. S.; Slaets, L.; van Deurzen, C. H. M.; van Leeuwen-Stok, E.; Porter, P.; Linderholm, B.; Hedenfalk, I.; Schröder, C.; Martens, J.; Bayani, J.; van Asperen, C.; Murray, M.; Hudis, C.; Middleton, L.; Vermeij, J.; Punie, K.; Fraser, J.; Nowaczyk, M.; Rubio, I. T.; Aebi, S.; Kelly, C.; Ruddy, K. J.; Winer, E.; Nilsson, C.; Dal Lago, L.; Korde, L.; Benstead, K.; Bogler, O.; Goulioti, T.; Peric, A.; Litière, S.; Aalders, K. C.; Poncet, C.; Tryfonidis, K.; Giordano, S. H.
Article Title: Characterization of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program
Abstract: Background: Male breast cancer (BC) is rare, managed by extrapolation from female BC. The International Male BC Program aims to better characterize and manage this disease. We report the results of part I, a retrospective joint analysis of cases diagnosed during a 20-year period. Methods: Patients with follow-up and tumor samples, treated between 1990 and 2010, in 93 centers/9 countries. Samples were centrally analyzed in three laboratories (the United Kingdom, the Netherlands and the United States). Results: Of 1822 patients enrolled, 1483 were analyzed; 63.5% were diagnosed between 2001 and 2010, 57 (5.1%) had metastatic disease (M1). Median age at diagnosis: 68.4 years. Of 1054 M0 cases, 56.2% were node-negative (N0) and 48.5% had T1 tumors; 4% had breast conserving surgery (BCS), 18% sentinel lymph-node biopsy; half received adjuvant radiotherapy; 29.8% (neo)adjuvant chemotherapy and 76.8% adjuvant endocrine therapy (ET), mostly tamoxifen (88.4%). Per central pathology, for M0 tumors: 84.8% ductal invasive carcinomas, 51.5% grade 2; 99.3% estrogen receptor (ER)-positive; 81.9% progesterone receptor (PR)-positive; 96.9% androgen receptor (AR)-positive [ER, PR or AR Allred score ≥ 3]; 61.1% Ki67 expression low (<14% positive cells); using immunohistochemistry (IHC) surrogates, 41.9% were Luminal-A-like, 48.6% Luminal-B-like/HER-2-negative, 8.7% HER-2-positive, 0.3% triple negative. Median follow-up: 8.2 years (0.0-23.8) for all, 7.2 years (0.0-23.2), for M0, 2.6 years (0.0-12.7) for M1 patients. A significant improvement over time was observed in age-corrected BC mortality. BC-specific-mortality was higher for men younger than 50 years. Better overall (OS) and recurrence-free survival (RFS) were observed for highly ER+(P=0.001), highly PR+(P=0.002), highly AR+ disease (P=0.019). There was no association between OS/RFS and HER-2 status, Ki67, IHC subtypes nor grade. Conclusions: Male BC is usually ER, PR and AR-positive, Luminal B-like/HER2-negative. Of note, 56% patients had T1 tumors but only 4% had BCS. ER was highly positive in > 90% of cases but only 77% received adjuvant ET. ER, PR and AR were associated with OS and RFS, whereas grade, Ki67 and IHC surrogates were not. Significant improvement in survival over time was observed. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Keywords: immunohistochemistry; human tissue; aged; major clinical study; overall survival; outcome assessment; follow up; cancer grading; sentinel lymph node biopsy; epidermal growth factor receptor 2; aromatase inhibitor; cohort analysis; retrospective study; cancer mortality; cancer hormone therapy; breast carcinoma; partial mastectomy; tamoxifen; androgen receptor; neoadjuvant chemotherapy; taxane derivative; estrogen receptor; progesterone receptor; trastuzumab; adjuvant radiotherapy; male breast cancer; recurrence free survival; retrospective analysis; consortium; radical mastectomy; estrogen receptor positive breast cancer; human epidermal growth factor receptor 2 positive breast cancer; human; male; priority journal; article; progesterone receptor positive breast cancer; clinical and biological characteristics
Journal Title: Annals of Oncology
Volume: 29
Issue: 2
ISSN: 0923-7534
Publisher: Oxford University Press  
Date Published: 2018-02-01
Start Page: 405
End Page: 417
Language: English
DOI: 10.1093/annonc/mdx651
PROVIDER: scopus
PMCID: PMC5834077
PUBMED: 29092024
Notes: Article -- Export Date: 2 April 2018 -- Source: Scopus
Citation Impact
MSK Authors
  1. Clifford Hudis
    892 Hudis
  2. Melissa P Murray
    114 Murray