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Treatment of Male Breast Cancer Has Evolved, Study Shows

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While there have been no clinical trials specifically focused on male breast cancer in the United States, treatment of this disease has evolved over the years and researchers now know factors linked to better survival, according to a study.

The research was published online on Oct. 7, 2019, in the journal Cancer. Read the abstract of “Male breast cancer in the United States: Treatment patterns and prognostic factors in the 21st century.”

Male breast cancer

While breast cancer in men is rare, it does happen. Fewer than 1% of all breast cancers are diagnosed in men. In 2019, about 2,670 new cases of invasive breast cancer will be diagnosed in men. For men, the lifetime risk of getting breast cancer is about 1 in 833.

Like breast cancer in women, breast cancer in men can be hormone-receptor-positive or hormone-receptor-negative, as well as HER2-positive or HER2-negative.

Because the number of cases of breast cancer in men is relatively small compared to the number of cases in women, there is a lack of information on male breast cancer in general and there have been no studies focused specifically on male breast cancer. Treatment decisions for male breast cancer are usually based on studies in women. In August 2019, the U.S. Food and Drug Administration issued a draft guidance saying that men should be included in breast cancer clinical trials.

About the study

For this study, the researchers wanted to look at how male breast cancer has been treated in the United States in recent years, as well as whether there were factors that could be linked to prognosis and survival.

The researchers looked at information on 10,873 men diagnosed with stage I to stage III breast cancer from 2004 to 2014. The information came from the National Cancer Database, a collection of information from more than 1,500 Commission on Cancer-accredited facilities in the United States. The database is sponsored by the American College of Surgeons and the American Cancer Society. The data represent more than 70% of newly diagnosed cancer cases in the country.

Characteristics of the men in the study:

  • about half were younger than 64 and about half were older
  • 24% of the men had lumpectomy
  • 70% of men who had lumpectomy also had radiation therapy
  • 44% of the men were treated with chemotherapy
  • 62% of the men diagnosed with estrogen-receptor-positive breast cancer were treated with hormonal therapy; the researchers weren’t able to determine which hormonal therapy medicine was used
  • 35% of the men diagnosed with estrogen-receptor-positive, HER2-negative breast cancer had an Oncotype DX test on the cancer tumor; this genomic test analyzes the activity of a group of genes in the cancer to figure out how likely the cancer is to come back (recur), as well as how likely it is that the cancer will respond to chemotherapy

During the time of the study, the researchers noted that there were increases in:

  • mastectomy
  • preventive removal of the other healthy breast, called contralateral prophylactic mastectomy
  • radiation after lumpectomy
  • hormonal therapy treatment
  • Oncotype DX testing

Factors linked to better overall survival were:

  • being diagnosed with progesterone-receptor-positive breast cancer
  • living in a higher income area
  • being treated with chemotherapy
  • being treated with radiation
  • being treated with hormonal therapy

Factors linked to worse overall survival were:

  • being older
  • being black
  • being diagnosed at a high cancer stage and grade
  • having several other medical issues
  • having mastectomy

"Our study highlights unique practice patterns and factors associated with prognosis in male breast cancer, furthering our understanding of the treatment and prognosis of male breast cancer," said study author Kathryn Ruddy, M.D., of the Mayo Clinic, in a statement. "The racial, economic, and age-related health disparities we found could inform future efforts to target interventions to optimize outcomes in men with breast cancer."

What this means for you

If you’re a man who has been diagnosed with breast cancer, this study is encouraging and emphasizes the importance of being your own best advocate to make sure that you get the treatments that are best for your unique situation.

It’s very important to talk to your doctor right away about any changes in your breasts, including:

  • nipple pain
  • inverted nipple
  • nipple discharge
  • sores on the nipple and/or areola area
  • enlarged lymph nodes under the arm

Because many men don’t consider the possibility that they may develop breast cancer, they may wait a year or longer to talk to their doctor after noticing a breast symptom. This means the cancer is diagnosed at a later stage, which contributes to higher mortality rates for men with breast cancer compared to women.

For more information, visit the Breastcancer.org pages on Male Breast Cancer.

To talk with others who have been diagnosed with male breast cancer, join the Breastcancer.org forum Male Breast Cancer.

Written by: Jamie DePolo, senior editor

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