Good News For Male Breast Cancer Patients

Worldwide, male breast cancer patients account for about one percent of new cases.¹ In the U.S. 2,710 new cases of invasive breast cancer will be diagnosed this year. About 530 men will die from breast cancer.²

While risk factors are similar to breast cancer in women, men don’t have the advantage of regular scanning to detect breast tumors. When men present with a breast lump to their primary care physicians, they are more often at a later stage and therefore can delay diagnosis.² Early-stage treatment modalities include a modified radical mastectomy or, to a much lesser extent, breast-conserving surgery, adjuvant chemotherapy, adjuvant endocrine therapy, and radiation therapy. Advanced breast cancer, on the other hand, is treated with adjuvant chemotherapy and endocrine therapy.

Male specific data

Just published at the San Antonio Breast Cancer Symposium, 2021, is a paper that takes a 20-year multi-center experience of male breast cancer patients from the years 2000 to 2020. The study patients were from databases of six hospitals. The researchers looked at clinical information including age, symptoms, family history, genetics, tumor characteristics, and the Oncotype DX score.They also looked at nodal involvement, stage, and hormonal receptor status. In all data from 64 patients, the median age at diagnosis was 68 years, which was assessed with a number of metrics. Ninety percent of the cohort were white, 20% had a family history of breast or ovarian cancer, and 4% had a BRCA2 mutation.^3,4

Patient tumor characteristics

The researchers found that 89% of patients presented with a breast mass, and four of these patients had nipple changes. At the time of diagnosis, nearly all patients (92%) had invasive ductal carcinoma, were ER (97%) and PR (87%) positive, and almost two-thirds had grade 2 tumors. Approximately eight percent had HER2-positive cancer. Nearly half of the patients had tumors between 2-5 cm, and the same percentage had lymph node involvement. In nearly all patients, the disease had not spread to other parts of the body.⁵

Treatment characteristics

Most patients underwent a mastectomy (87.5%,) the rest had breast-conserving surgery. Just 10 patients received neoadjuvant chemotherapy, while just over half had adjuvant radiation therapy. Most of the patients presented with palpable breast masses and, since the tumors are almost exclusively hormone receptor-positive, nearly all were prescribed adjunctive hormonal therapy.⁵

What does this mean?

The median follow-up was 71.5 months and the 5-year survival rate was nearly 87%. The 5-year relapse-free survival rate was almost 90%, while the 10-year survival rate was 58%. Interestingly, distant metastasis on initial diagnosis was the only factor determining shorter overall survival.⁵

This is one of the most detailed studies of male breast cancer to date, albeit with a small cohort. Despite this, it showed overall survival and relapse-free survival similar to historic reports in female breast cancer. This is one of the first studies to show this and should give heart to men diagnosed with the disease. In the future, as treatments for men benefit from more research projects that are targeted, outcomes could be even better.