Use of Tamoxifen With Postsurgical Irradiation May Improve Survival in Estrogen and Progesterone Receptor-Positive Male Breast Cancer

Background: The purpose of this study is to assess the impact of adjuvant therapy on survival in males with nonmetastatic breast cancer. Materials and Methods: A retrospective analysis of male breast cancers treated between 1990 and 2003 was performed. Age, estrogen and progesterone receptor (ER/PgR) status, tumor histology and stage, and details of surgical and adjuvant therapy were recorded. Five and ten-year overall survival (OS) and disease-free survival (DFS) were calculated using the actuarial Kaplan-Meier method with comparisons made using the log-rank test. Results: Forty-two men received treatment for nonmetastatic breast cancer; median age, 62 years (range, 2490 years). All tumors were ER and PgR positive. Twenty-one received tamoxifen (50%), 18 chemotherapy (43%), and 11 radiation (26%). Median follow-up was 8 years (range, 3-18 years). Five and ten-year OS in patients who received tamoxifen and radiation was 100%, compared with 81% and 65%, respectively, with tamoxifen alone (P = .06), 92% and 83% radiation alone (P = .05), and 85% and 65% without adjuvant therapy (P = .03). Five- and 10-year DFS was 100% and 83.3% with tamoxifen and radiation, 90% and 70% with tamoxifen alone (P = .45), 50% and 50% with radiation alone (P = .05), and 80.8% and 67.9% without adjuvant therapy (P = .27). Adjuvant chemotherapy, either alone or in combination with Tamoxifen and/or radiation, did not significantly improve OS or DFS. Conclusion: This series suggests an important role for adjuvant tamoxifen and radiation in the management of ER- and PgR-positive nonmetastatic male breast cancer. Larger, multicenter datasets are warranted for this rare disease to validate these results.