Journal Article
. 2020 Oct;12().
doi: 10.1177/1758835920958358.

The role of adjuvant chemotherapy in stage I-III male breast cancer: a SEER-based analysis

Wei-Ping Li 1 Hong-Fei Gao 2 Fei Ji 2 Teng Zhu 2 Min-Yi Cheng 2 Mei Yang 2 Ci-Qiu Yang 2 Liu-Lu Zhang 2 Jie-Qing Li 2 Jun-Sheng Zhang 2 Kun Wang 3 
Affiliations
  • PMID: 33014148
  •     23 References

Abstract

Background And Aims: Male breast cancer is an uncommon disease. The benefit of adjuvant chemotherapy in the treatment of male breast cancer patients has not been determined. The aim of this study was to explore the value of adjuvant chemotherapy in men with stage I-III breast cancer, and we hypothesized that some male patients may safely skip adjuvant chemotherapy.

Methods: Male breast cancer patients between 2010 and 2015 from the Surveillance Epidemiology and End Results database were included. Univariate and multivariate Cox analyses were used to analyse the factors associated with survival. The propensity score matching method was adopted to balance baseline characteristics. Kaplan-Meier curves were used to evaluate the impacts of adjuvant chemotherapy on survival. The primary endpoint was survival.

Results: We enrolled 514 patients for this study, including 257 patients treated with chemotherapy and 257 patients without. There was a significant difference in overall survival (OS) but not in breast cancer-specific survival (BCSS) between the two groups (p < 0.001 for OS and p = 0.128 for BCSS, respectively). Compared with the non-chemotherapy group, the chemotherapy group had a higher 4-year OS rate (97.5% versus 95.2%, p < 0.001), while 4-year BCSS was similar (98% versus 98.8%, p = 0.128). The chemotherapy group had longer OS than the non-chemotherapy group among HR+, HER2-, tumour size >2 cm, lymph node-positive male breast cancer patients (p < 0.05). Regardless of tumour size, there were no differences in OS or BCSS between the chemotherapy and non-chemotherapy cohorts for lymph node-negative patients (OS: p > 0.05, BCSS: p > 0.05). Adjuvant chemotherapy showed no significant effects on both OS and BCSS in patients with stage I (OS: p = 0.100, BCSS: p = 0.858) and stage IIA breast cancer (OS: p > 0.05, BCSS: p > 0.05).

Conclusion: For stage I and stage IIA patients, adjuvant chemotherapy could not improve OS and BCSS. Therefore, adjuvant chemotherapy might be skipped for stage I and stage IIA male breast cancer patients.

Keywords: SEER; chemotherapy; male breast cancer; prognosis; stage I–III.

Breast carcinoma in men: a population-based study.
Sharon H Giordano, Deborah S Cohen, +2 authors, Gabriel N Hortobagyi.
Cancer, 2004 Jun 29; 101(1). PMID: 15221988
Highly Cited.
The biological markers and results of treatment in male breast cancer patients. The Cracow experience.
B Sas-Korczynska, J Niemiec, +4 authors, A Sokolowski.
Neoplasma, 2014 May 16; 61(3). PMID: 24824936
Decline in breast cancer incidence in the United States: what about male breast cancer?
Andreas Stang, Christoph Thomssen.
Breast Cancer Res Treat, 2008 Jan 08; 112(3). PMID: 18176840
Multidisciplinary meeting on male breast cancer: summary and research recommendations.
Larissa A Korde, Jo Anne Zujewski, +13 authors, Fatima Cardoso.
J Clin Oncol, 2010 Mar 24; 28(12). PMID: 20308661    Free PMC article.
Highly Cited.
Male breast cancer: is the incidence increasing?
Nicole C F Hodgson, Jaclyn H Button, +2 authors, Alan S Livingstone.
Ann Surg Oncol, 2004 Aug 04; 11(8). PMID: 15289238
How representative are the surveillance, epidemiology, and end results (SEER) program cancer data of the United States?
Ray M Merrill, Kirk A Dearden.
Cancer Causes Control, 2005 Apr 02; 15(10). PMID: 15801487
Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer.
Joseph A Sparano, Robert J Gray, +27 authors, George W Sledge.
N Engl J Med, 2018 Jun 05; 379(2). PMID: 29860917    Free PMC article.
Highly Cited.
Application of a carbon nanoparticle suspension for sentinel lymph node mapping in patients with early breast cancer: a retrospective cohort study.
Liulu Zhang, Yijie Huang, +6 authors, Kun Wang.
World J Surg Oncol, 2018 Jun 20; 16(1). PMID: 29914538    Free PMC article.
Cancer statistics in China, 2015.
Wanqing Chen, Rongshou Zheng, +6 authors, Jie He.
CA Cancer J Clin, 2016 Jan 26; 66(2). PMID: 26808342
Highly Cited.
Breast-Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness.
H Gilbert Welch, Philip C Prorok, A James O'Malley, Barnett S Kramer.
N Engl J Med, 2016 Oct 13; 375(15). PMID: 27732805
Highly Cited.
Male breast cancer: risk factors, biology, diagnosis, treatment, and survivorship.
K J Ruddy, E P Winer.
Ann Oncol, 2013 Feb 22; 24(6). PMID: 23425944
Systematic Review.
Tumor location of the central and nipple portion is associated with impaired survival for women with breast cancer.
Fei Ji, Wei-Kai Xiao, +10 authors, Kun Wang.
Cancer Manag Res, 2019 May 02; 11. PMID: 31040717    Free PMC article.
Clinical practice guidelines in breast cancer.
N Kumar Tyagi, S Dhesy-Thind.
Curr Oncol, 2018 Jun 19; 25(Suppl 1). PMID: 29910658    Free PMC article.
Review.
Cancer Statistics, 2017.
Rebecca L Siegel, Kimberly D Miller, Ahmedin Jemal.
CA Cancer J Clin, 2017 Jan 06; 67(1). PMID: 28055103
Highly Cited.
Characterization and prognosis of estrogen receptor-positive/progesterone receptor-negative male breast cancer: a population-based study.
Jin-Li Wei, Jia-Xin Zhang, De-Yuan Fu.
World J Surg Oncol, 2018 Dec 19; 16(1). PMID: 30558615    Free PMC article.
The effect of adjuvant chemotherapy in male breast cancer: 134 cases from a retrospective study.
Xing-Fei Yu, Chen Wang, +4 authors, Hong-Jian Yang.
ESMO Open, 2017 Aug 02; 2(2). PMID: 28761739    Free PMC article.
Male Breast Cancer: Epidemiology and Risk Factors.
Ali Jad Abdelwahab Yousef.
Semin Oncol, 2018 Mar 13; 44(4). PMID: 29526255
Review.
Male breast cancer.
César Gómez-Raposo, Francisco Zambrana Tévar, +2 authors, Enrique Casado.
Cancer Treat Rev, 2010 Mar 03; 36(6). PMID: 20193984
Review.
Female breast cancers (T1-2, N0, M0, HR+, HER2-) with an intermediate genetic-based recurrence risk: a real-world estimate in Italy.
Emanuele Crocetti, Alessandra Ravaioli, +5 authors, Fabio Falcini.
Tumori, 2019 May 16; 105(6). PMID: 31088341
Male breast cancer in a multi-gene panel testing cohort: insights and unexpected results.
Mary Pritzlaff, Pia Summerour, +8 authors, Holly LaDuca.
Breast Cancer Res Treat, 2016 Dec 23; 161(3). PMID: 28008555    Free PMC article.
Survival analysis for male ductal and lobular breast cancer patients with different stages.
Jizhao Wang, Yuchen Sun, +6 authors, Guangjian Zhang.
Future Oncol, 2018 Aug 09; 15(2). PMID: 30088776
Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program.
F Cardoso, J M S Bartlett, +33 authors, S H Giordano.
Ann Oncol, 2017 Nov 02; 29(2). PMID: 29092024    Free PMC article.
Highly Cited.
Clinical and Genomic Risk to Guide the Use of Adjuvant Therapy for Breast Cancer.
Joseph A Sparano, Robert J Gray, +27 authors, George W Sledge.
N Engl J Med, 2019 Jun 04; 380(25). PMID: 31157962    Free PMC article.
Highly Cited.