Abstract P3-12-31: A 10 year retrospective study of male breast cancer patients within central Scotland

Abstract

Abstract Background. This study is a retrospective review of all of the male breast cancer patients treated within NHS Tayside, Scotland, over a 10 year period. The trust’s catchment area covers a population of 550,000 people. It evaluates several different important factors including epidemiology, patient presentation, pathology results, and treatment interventions. It also explores how choice of hormonal therapy influences patients’ overall outcomes. Materials And Methods. 33 patients in total were identified from the NHS breast cancer database. These results were then statistically analysed in order to determine overall trends within the data. Results. Patients’ ages ranged from 48 to 87 years old, with a mean age at 71 years. 94% of these patients had a palpable lump at presentation, with 42% having at least one palpable axillary node. 18% of patients experienced nipple discharge and 33% experienced some form of nipple distortion, confirming the fact that involvement of the nipple-areolar complex in males occurs early on and in a significant number of cases. 42% of patients experienced associated breast pain, a significantly higher rate than female breast cancer patients. The most common tumour grade was stage T2, highlighting the fact that males tend to be diagnosed on average 6-9 months later than females, who most commonly present at stage T1. The most common histological type was invasive ductal carcinoma (76% of cases). 66% of patients were ER+, PR+, HER2-. 61% of patients received surgical intervention. 33% underwent a sentinel lymph node biopsy (SLNB) and of these, 46% had node involvement. 27% of patients had axillary node clearance as part of their surgical intervention. 21% of patients had a synchronous malignancy at the time of diagnosis. This highlights that the majority of patients were elderly and as a result had other diseases of old age. The overall survival rate for our patient cohort was 55%, with a cancer specific survival rate of 88%. 33% of patients have completed 5 or more years of follow up. 30% are still within their 5 years of follow up, and 36% died within their 5 years of follow up, either as a result of their malignancy or for unrelated causes. Only 30% of patients were referred for genetic testing, with zero BRCA mutations identified, supporting the fact that contrary to popular belief, BRCA mutations occur in male breast cancer no more commonly than in female patients. The recurrence rate of the 11 patients receiving adjuvant Tamoxifen was 0, as was the recurrence rate of the 15 patients receiving adjuvant Letrozole. The similarities here can likely be attributed to the small sample size of this study, however it is now recognised that Tamoxifen should be the drug of choice. Letrozole has no effect on aromatase within the testes, which is responsible for 20% of oestrogen production. Conclusions. Male breast cancer is an important but often overlooked topic. Cases occur sporadically and are associated with old age, however there are a number of recognised risk factors including lifestyle and hormonal influences. A high proportion of patients will experience associated pain and early involvement of the nipple-areolar complex. A delay in diagnosis also means that many patients present at a higher stage of the disease, with more nodal involvement. Tamoxifen is the hormonal therapy of choice in these patients. Citation Format: Rachel EL Morris, Vasileios Pitsinis. A 10 year retrospective study of male breast cancer patients within central Scotland [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-31.