Contemporary systemic therapy for male breast cancer.
BACKGROUND
The use, effectiveness, and tolerability of tamoxifen, aromatase inhibitors, and trastuzumab in early and advanced male breast cancer were examined at a population level.


METHODS
A total of 158 consecutively referred men with invasive breast cancer diagnosed between 2000 and 2010 were identified. Stage and prognostic factors were compared with a random sample of contemporary female patients. Survival outcomes were compared with a separate female cohort matched 2:1 by prognostic and treatment factors.


RESULTS
Men were older (median 69.5 years) than women (median 60 years) and presented with more advanced stage disease. Estrogen receptor was positive in 96% (n = 152) of cases. Tamoxifen was more commonly used than aromatase inhibitors in the curative and metastatic settings. Adherence to adjuvant tamoxifen therapy was generally adequate with estimated actuarial rates of persistence at 1 year and 3.5 years of 89% and 70%, respectively. For the 146 men treated with curative intent, 5-year overall survival, breast cancer-specific survival and progression-free survival were 72%, 86%, and 62%, respectively. Outcomes were similar to matched female patients in univariate and multivariate analyses.


CONCLUSIONS
In this large population-based study, outcomes appear similar between male and risk-matched female patients with breast cancer. Side effect profiles, tolerance, adherence, and outcomes after tamoxifen, aromatase inhibitors, and trastuzumab in men appear comparable with those described in the literature for women.
Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Katherine L
KL
Bradley
Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Scott
S
Tyldesley
Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Cancer Surveillance and Outcomes, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Caroline H
CH
Speers
Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Cancer Surveillance and Outcomes, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Ryan
R
Woods
Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. Electronic address: dvilla@bccancer.bc.ca.
Diego
D
Villa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D018567:Breast Neoplasms, Male / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011960:Receptors, Estrogen / Q000032:analysis; D013629:Tamoxifen / Q000627:therapeutic use; D000068878:Trastuzumab
D061067:Antibodies, Monoclonal, Humanized; D047072:Aromatase Inhibitors; D011960:Receptors, Estrogen; D013629:Tamoxifen; D000068878:Trastuzumab
Adherence; Aromatase inhibitors; Tamoxifen; Toxicity; Trastuzumab