Pattern of care of adjuvant radiotherapy in male breast cancer patients in clinical practice: an observational study

Background and purposeDue to the rarity of male breast cancer (male BC), no consensus has been reached regarding the most appropriate curative treatment strategy. The objective of the present observational study was to identify patient and tumor characteristics and assess the role of radiotherapy (RT) in clinical practice.MethodsBetween 1998 and 2014, data of male BC patients treated at two breast centers were consecutively collected and retrospectively analyzed. Patients were stratified based on the addition of adjuvant RT. Data on overall survival (OS) and local recurrence-free survival (LRFS) were estimated with the Kaplan-Meier method and compared by the log-rank test.ResultsAconsecutive cohort of 58male BC patients was evaluated. Median follow-up was 56months. Twenty-one patients (36.2%) received adjuvant RT. Overall, patients undergoing postoperative RT were characterized by more high-risk features. Patients receiving postoperative RT had significantly more frequently ahigh UICC stage (50 vs. 9.7% UICCIII, p=0.018) and positive lymph nodes as compared to patients undergoing surgery alone (65 vs. 34.4% pN+, p=0.046). Accordingly, there was ahigher proportion of patients receiving axillary lymph node dissection in the RT group (71.4 vs. 35.6%). Mastectomy was performed in 31/37 (86.1%) in the surgery group as compared to 14/21 (66.7%) in patients receiving postoperative RT. In addition, RT patients were more likely to receive endocrine therapy (78.9 vs. 39.3%, p=0.016). Outcome was not significantly different between the groups (5-year LRFS: 89.8 vs. 80.0%, p=0.471 and 5-year OS 88.4 vs. 88.9%, p=0.819).ConclusionThe present observational study evaluated the pattern of care in male BC patients treated in clinical practice. Due to its rarity, randomized clinical trials are unlikely and male BC remains an entity with apoor evidence base. Nevertheless, RT remains acrucial component of the multidisciplinary treatment strategy in male BC.