title: Use of tamoxifen with postsurgical irradiation may improve survival in estrogen and progesterone receptor-positive male breast cancer.
abstract: BACKGROUND
  The purpose of this study is to assess the impact of adjuvant therapy on survival in males with non-metastatic breast cancer.
  
  
  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, 24-90 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiation Oncology, Boston University Medical Center, USA. shannonfogh@jeffersonhospital.org
authors.forename: Shannon
authors.initials: S
authors.lastname: Fogh
authors.forename: Ariel E
authors.initials: AE
authors.lastname: Hirsch
authors.forename: Jon P
authors.initials: JP
authors.lastname: Langmead
authors.forename: Saveli I
authors.initials: SI
authors.lastname: Goldberg
authors.forename: Carol L
authors.initials: CL
authors.lastname: Rosenberg
authors.forename: Alphonse G
authors.initials: AG
authors.lastname: Taghian
authors.forename: Simon N
authors.initials: SN
authors.lastname: Powell
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kachnic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D018567:Breast Neoplasms, Male / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011879:Radiotherapy Dosage; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D015996:Survival Rate; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013629:Tamoxifen