Male breast Cancer (MBC) is a rare disease accounting for about 1% of all malignancies in men and 1% of all breast cancers. These patients(pts) are managed like female breast cancers. There is limited literature available defining the role of radiotherapy(RT) in management of MBC. We conducted a retrospective analysis to study the impact of adjuvant RT on outcome of MBC pts treated at our centre.
Review of MBC pts presenting to our centre from 2005 to 2015 was done. All underwent pre-treatment evaluation in a combined tumor clinic comprising radiation, surgical and medical oncologist. Most pts were treated with surgery followed by adjuvant therapy and kept on regular follow up. Overall survival (OS) was defined as time from pathologic diagnosis to last follow up or death. Disease free survival (DFS) was defined as time from diagnosis to first relapse.
96 pts of MBC were identified. Median age was 58 years (range 28-83). Clinical stage I, II, III and IV were 8, 27, 39 and 22 respectively. Of 66 pts with known receptor status, 83% were ER positive, 82% PR positive, 20% Her-2/neu positive and 7.5% triple negative. 69 pts underwent modified radical mastectomy or wide local excision. 54% were pathologically node positive. Adjuvant RT was delivered to 34% pts at 1.8-2 Gy per fraction to a median dose of 50 Gy (range 45-60 Gy). Radiation field comprised of chest wall with (75%) or without regional nodes (25%). Median follow up was 24 months (range 9-132). 16 pts had relapse out of which 4 had local and 13 had distant (most common site bone) metastases after a median duration of 19 mnths. 2 yr estimated DFS for the entire cohort was 79.2% and 2 yr OS was 85.7%. The 2 yr DFS in pts undergoing surgery was 86.4% vs 29.2% in those who did not(p = 0.001). Pts who received adjuvant RT had better 2 yr DFS (92.4% vs 52.9%, p = 0.002). Adjuvant chemotherapy did not significantly affect the 2 yr DFS (93.1% vs 73%, p = 0.123).
MBC mostly present in advance stages at our centre and harbor HR positive disease with low HER-2 overexpression. Adjuvant RT provided a statistically significant improvement in outcome. Longer follow up of these cohort of pts is required for accurate evaluation of role of RT in MBC.
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All India Institute of Medical Sciences
All authors have declared no conflicts of interest.