Abstract 4172
Background
Breast Cancer (BC) in men accounts for 1% of all BC. Management is still based largely on BC management in women. Only small and selected retrospective series on metastatic cases have been reported so far. Based on a national database, we aimed at providing a large comprehensive analysis of metastatic BC (MBC) in men.
Methods
ESME MBC platform is a French multi-center retrospective real life database using a clinical trial-like methodology to collect data from 18 French Comprehensive Cancer Centers. It includes data from each newly diagnosed MBC patients having initiated at least one treatment between 01/2008 and 12/2014. Cases occurring in men were retrieved and compared to the overall female population (characteristics, Student T-test), and to a population of women matched (1/1) on age, histology, grade, adjuvant treatment and metastasis location, regarding treatment effects and survival.
Results
Of 16 701 evaluable patients, 149 (0.89%) men were identified. Main comparative characteristics are listed below.
| Men (n=149) | Women (n=16552) | p | |
| Mean age (SD) (years) Median age (range) (years) | 68.1y (11.2) 69y (44-90) | 60.6y (13.8) 61y (19-99) | <0.0001 . |
| Histological Subtypes : - HR+/HER2- - Triple Negative - HER2+ - missing |
105 (78.4%) 6 (4.5%) 23 (17.1%) 15 |
9815 (65.6%) 2315 (15.4%) 2840 (19%) 1582 |
p= 0.0019 p= 0.0005 p=0.62 . |
| Metastatic de novo | 49 (32.9%) | 4754 (28.7%) | p=0.26 |
In HR+/HER2- men, 45/105 (42.9%) received frontline hormonal therapy : tamoxifen (20/45), aromatase inhibitor (AI) ± LHRH analogs (18/45), others (7/45). Median PFS was 9.8 months (m) without evidence of statistically difference between HT types. Compared with a matched cohort of women , median PFS was similar : 9.8m versus 13.0m (p=0.8). For HR+/HER2- men receiving front line CT (29/105 (27.6%)), median PFS was 6.9m and was similar to the 6.3m PFS in matched women (HR=1.24, [0.69-2.23]). The overall survival in men was 41.8m versus 34.9m in matched women (p=0.745).
Conclusions
We report on one of the largest series of MBC in men. Compared with women, prognosis and treatment effects look the same. More biological information is needed to improve the customized management of MBC in men.