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 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, 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. 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.