- The most common treatment for male breast cancer is mastectomy, at 71.3%, a rate much higher than for women.
- The 23.7% of males who get breast-conserving surgery (BCS) underuse radiotherapy (RT).
Why this matters
- These are among the treatment patterns documented in an analysis of the largest US database.
- Retrospective cohort (n=10,873) of patients entered into the US National Cancer Database, 2004-2014.
- Funding: NIH.
- Demographic factors:
- Average age, 63.7 years.
- Estrogen receptor positive (ER+) status, 88.7%.
- Most diagnosed with stage II (43.4%) and stage I (37.9%).
- Oncotype DX ordered, 34.9% of those with ER+, human epidermal growth factor receptor 2-negative tumors.
- 5-year OS, 79.1%.
- Treatment factors:
- Mastectomy, 71.3%.
- BCS, 23.7%.
- Adjuvant RT after BCS, 70.2%.
- Hormone therapy for ER+ tumors, 62.3%.
- Chemotherapy, 44.5%.
- Changes in treatment over time (2004-2014):
- No change in OS.
- Increases in the rate of total mastectomy, post-BCS RT, ordering of Oncotype DX testing, and use of endocrine therapy (all Ps<.05>
- Prognostic factors (upon multivariate analysis):
- Worse OS:
- Older age (HR, 1.04; P<.001>
- Black race (HR, 1.22; P=.003).
- Higher Charlson comorbidity index (HR, 2.22; P<.001>
- Worse OS:
- Better OS:
- Having progesterone-positive tumor (HR, 0.82; P=.002).
- Receipt of chemotherapy (HR, 0.67; P<.001>
- Receipt of radiotherapy (HR, 0.82; P<.001>
- Retrospective design.
- Lack of data on recurrence.