Carcinoma of breast in males in Turkey: a Turkish oncology group study.

Abstract #4132 Purpose : Compared to breast carcinoma in women breast carcinoma in males is frequent and information in males is limited. The aim of this multicentric study is to evaluate the treatment results of male patients with breast cancer treated in cancer centers in Turkey.
 Methods : Between 1973-2006, 167 male breast cancer patients who were treated, analyzed retrospectively respect to clinical presentation, treatment, survival and prognostic factors. Median age was 61 (range: 32-90), 51.5% were found in right breast. Majority of the tumors were occured in the central(36.5%) and upper outer quadrant (32.9%). Except one patient, all of them underwent mastectomy. Stage distrubution was as follows; Stage I 9%, Stage II 34.7 %, stage III 44.9%, stage IV 4.8% and 11 patients (6.6%) can not be staged due to Tx or Nx status. The most common histologic type was invasive ductal carcinoma (89.8%). Contralateral breast cancer developed in 3 patients. Of the patients 81.4% (136) received adjuvan radiotherapy for the whole breast and also to the periferial lymphatics for patients carrying high risk factors. Median total dose was 50 Gy with a daily fraction dose of 2 Gy. Five patients were treated with radiotherapy due to recurrences, 3 patients were treated for metastases and one patient was treated for curative intent. Radiation therapy was not given to 22 patients. Adjuvant chemotherapy and hormonal therapy were used in 83 and 70 patients, respectively.
 Results : During a median follow-up duration of 66 months (range: 1-237 months) . Isolated local-regional recurrence and distant metastases were observed in 13.2% and 34.1% of cases, respectively. Five-years overall survival, disease free survival and local control were, 66.1%, 63.4%, 89%, respectively. The prognostic factors influencing overall survival were presence of positive axillary lymp node (p=0.000), T stage (p=0.000), lymph node ratio (>50%) (p=0.001), AJCC stage (p=0.000), skin invasion (p=0.00), nipple invasion (p=0.027) and blood vessel invasion (0.006) in the univariate analysis. In the multivarian analysis, the only prognostic factor which has impact on overall survival was AJCC stage (p=0.023). No prognostic factor was found to be significant for disease free survival and local control.
 Conclusion: In the present study positive axillary lymp node, T stage, Lymph node ratio (>50%), AJCC stage (p=0.000), skin invasion, nipple invasion and blood vessel invasion were the significant prognostic factors for overall survival. In absence of prospective randomised trials, retrospective review data from multi-centre approaches are necessary and this can provide useful guidelines for understanding the biology of breast cancer in males. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4132.