Features, Outcomes, and Management Strategies of Male Breast Cancer: A Single Institution Comparison to Well-Matched Female Controls

Abstract

Objective: The primary objective of this study was to delineate differences in management, overall and distant disease-free survival in males diagnosedwith breast cancer and treated at The Ohio State University Comprehensive Cancer Center as compared to comprehensively matched female subjects.Secondary objectives included assessment of clinical and histopathologic features and recurrence score, as measured by Oncotype DX and the modifiedMagee equation #2.Materials and Methods: This single institution retrospective study compared male and comprehensively matched female patients (1:2) with stageI-III breast cancer between 1994 and 2014. Recurrence risk was estimated using a modified Magee equation. Overall survival and distant disease-freesurvival were estimated and compared using Kaplan-Meier and Log-rank methods.Results: Forty-five male breast cancer patients were included (stage I: 26.7%; stage II: 53.3%; stage III: 20.0%; hormone receptor positive: 97.8%; human epidermal growth factor receptor 2 negative: 84.4%) with a median age of 63.8 (43.0-79.4) years at diagnosis. Intermediate and low recurrence scoreswere most common in male and female patients respectively; mean score was similar between groups (20.3 vs. 19.8). The proportion of male breast cancerpatients treated with adjuvant chemotherapy and post-mastectomy radiation was lower compared to female patients (42.2% vs. 65.3%, p=0.013; 22.7%vs. 44.4%, p=0.030, respectively). Overall survival and distant disease-free survival between male and female patients were similar.Conclusion: Male breast cancer patient outcomes were similar compared to well-matched female patients suggesting that breast cancer specific factorsare more prognostic than gender.