Male Breast Cancer Patients Research Articles

Stage and Type of Male Breast Cancer Presented at Mankweng Academic Hospital from 2015-2023

Background: Male breast cancer (MBC) is very uncommon, occurring less than 1% of all breast cancers, and has a worse survival rate compared with that of female patients. Clinical studies on male breast cancer have not been done frequently because of the rarity of the condition. The main aim of this study is to understand the profile of male breast cancer patients treated at Mankweng Hospital. Methods: A retrospective cross-sectional descriptive quantitative design was adopted to analyze the profile of all patients with histologically confirmed male breast cancer from March 2015 to May 2023 in the Mankweng Breast Oncology clinic. Results: A total of 17 patients with confirmed MBC were evaluated. Age range 23–80 years. The mean age is 62.5 years, with the majority (76%, 5%) being above the age of 50 years. Early-stage (0, I & II) comprised 6 (35%) and late-stage (III & IV) consisted of 11 (65%) patients. Invasive ductal carcinoma was 14 (82%), Colloid carcinoma 1, Papillary carcinoma 1 and Metastatic Adenocarcinoma 1. Molecular subtype: Luminal A: 7 (43.8%), Luminal B: 8 (50%) & Triple-negative: 1 (6.2%). ER Positive: 15 (93.7%), ER Negative: 1 (6.3%). Conclusions: The majority (65%) of male breast cancer were diagnosed at an advanced stage, and 76.5% were over the age of 50 years. Invasive ductal carcinoma was the most (82%) common histological type of breast cancer, and the majority (93%) are oestrogen receptor positive in this study. There is a gap that needs to be filled in terms of public knowledge about male breast cancer. Breast cancer awareness campaigns are also important for men to prevent delayed presentation. Men over 50 years old who notice a change in their breasts should report promptly to a health facility for further assessment.

Genome Sequencing Enhances the Diagnostic Yield and Expands the Genetic Landscape of Male Breast Cancer

PurposeTo understand the broader genetic landscape of Male Breast Cancer (MBC), focusing on the utility of genome sequencing (GS) beyond BRCA1/2 (HGNC: 1100, 1101) variants. Methods24 MBC patients underwent a multi-step genetic analysis. Initial screening targeted BRCA1/2 variants followed by GS to identify pathogenic/likely pathogenic (P/LP) germline variants through a three-tiered classification. Polygenic risk score (PRS) analysis was further incorporated using a model for female breast cancer with 2666 non-cancer controls. Exome sequencing (ES) was employed to transition from germline to somatic investigations, assessing second-hit variant and mutational signatures. ResultsThe GS analysis unveiled previously unrecognized P/LP germline variants in BARD1, ATR, BRIP1, and CHEK2 (HGNC: 952, 882, 20473, 16627) among 21 BRCA1/2-negative MBC patients, elevating the diagnostic yield from 12.5% to 33.0% in all MBC. Elevated average PRS was noted compared to controls, with a significant correlation to early-onset MBC when combined with high-penetrance germline pathogenic variants (P = 1.10×10-4). ES analysis further identified significant somatic oncogenic drivers and revealed a dominant mutational signature SBS3 across BRCA1/2-negative samples, reinforcing the contribution of HRD underlying the MBC development. ConclusionOur findings extended the MBC genetic spectrum beyond BRCA1/2 and highlighted the intricate interplay of monogenic and polygenic predispositions, presenting a comprehensive MBC genomic profile.

Unveiling the comorbidity burden of male breast cancer

Male breast cancer (MBC) is a rare condition with unique characteristics compared to female breast cancer (FBC). Despite its scarceness, there is growing evidence that MBC should not be studied and treated as FBC due to factors like later diagnosis stage and distinct genetic makeup. Retrospective observational study in the EpiChron Cohort, selecting all the prevalent patients with breast cancer between 2010 and 2019. Logistic models were used to determine associated comorbidities. Between 2010 and 2019, 105 MBC and 11,657 FBC patients were found in the EpiChron Cohort. MBC patients had a high mean age at diagnosis and number of comorbidities. Paying attention to comorbidity prevalences in breast cancer patients, it was clear that MBC patients tended to be prone to cardio-metabolic coexisting diseases, while FBC patients were more prone to hormone-, bone- and mental diseases. There were nine chronic conditions associated to MBC patients, but after a year-by-birth matching only four associations remained. Two of them were associated previously [odds ratio (95% confidence interval)]: “Disorder of lipid metabolism” [1.65 (1.03–2.64)] and “Genitourinary symptoms and ill-defined conditions” [2.03 (1.07–3.87)]; and the other two were new, “Anxiety disorders” [2.05 (1.09–3.87)] and “Osteoporosis” [3.58 (1.26–10.14)]. After comparing associated comorbidities in FBC with those in MBC, it seems MBC patients share some of them, but they have their own particular set of coexisting diseases. In fact, once a year-by-birth matching was performed in MBC patient cohort, it was more obvious MBC comorbidities behave more similar to none-Breast-Cancer male population than to FBC patients. These findings highlight the distinct characteristics of the MBC patient population and the need for a tailored approach of managing MBC.

Trends and efficacy of omitting axillary lymph node dissection in early-stage male breast cancer with limited nodal involvement: A population-based cohort study.

The effectiveness of sentinel lymph node biopsy (SLNB) versus axillary lymph node dissection (ALND) in managing early-stage male breast cancer (MBC) patients with T1-2 tumors and limited lymph node metastasis, all receiving radiotherapy, remains uncertain. This study examines trends and survival outcomes for SLNB and ALND in the United States. We conducted a retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) data from 2010 to 2020 for MBC patients with T1-2 tumors and 1-2 positive lymph nodes undergoing radiotherapy. Patients were classified by nodes removed (SLNB ≤5, ALND ≥10), comparing overall survival (OS) and breast cancer-specific survival (BCSS) between the groups before and after propensity score matching. Of 299 MBC patients analyzed, SLNB usage increased from 18.8% in 2010 to 61.0% in 2020. Multivariable logistic regression highlighted significant associations of SLNB use with diagnosis year, race, surgery type, positive lymph node count, and metastasis size. No significant differences in 5-year OS (77.98% SLNB vs. 85.85% ALND, p = 0.337) or BCSS (91.54% SLNB vs. 94.97% ALND, p = 0.214) were observed. Propensity score matching (96 patients per group) confirmed similar 5-year OS (83.9% for SLNB vs. 82.0% for ALND, p = 0.925) and BCSS (90.1% for SLNB vs. 96.9% for ALND, p = 0.167). SLNB and ALND provide comparable survival outcomes in early-stage MBC patients with limited lymph node metastasis undergoing radiotherapy. The increased utilization of SLNB supports its consideration to reduce surgical morbidity in selected MBC patients despite limited direct evidence.

Characteristics and Survival Outcomes of Male Breast Cancer in Brazil: A Large Population-Based Study

AimsThis study evaluated the clinicopathological characteristics, treatment trends, and overall survival (OS) in male breast cancer (BC) in Sao Paulo State of Brazil. Materials and methodsMen diagnosed with invasive breast cancer between January 2000 and June 2020 were identified from Fundação Oncocentro de Sao Paulo database encompasses data pertinent to 46 million residents of the Sao Paulo State of Brazil. Patients were described according to age, education level, clinical stage, treatment modalities, and medical practice. Categorical variables were described as percentages and frequencies. Demographic, treatment factors, and OS were associated using a Cox proportional hazard regression model while accounting for different lengths of participant follow-up. The Kaplan-Meier curves were used to display survival curves. ResultsA total of 907 male BC patients were included. The age distribution at diagnosis was <51 years, 51–70 years, and >70 years in 21.5%, 51.5% and 27.0% of patients, respectively. The proportions of stages I, II, III, and IV were 19.5%, 36.6%, 31.5%, and 12.3%. For each stage I, II, III, and IV, 5- and 10-years OS were 87.9% and 77.8%, 79.9% and 58.9%, 51.6% and 24.5%, 20.0% and 5.6%, respectively. Patients who received postoperative radiotherapy experienced a significant improvement in OS (HR 0.67; 95% CI 0.53–0.84; p < 0.001). In the multivariable analysis adjusted for practice (public or private), education (low or medium/high), age, stage at diagnosis, and treatment modalities, the significant independent predictor for OS was stage at diagnosis. ConclusionMale BC tends to be diagnosed at a more advanced stage and older age at the time of diagnosis. Age and educational level did not influence survival outcomes. Stage at diagnosis and the use of postoperative radiotherapy were factors associated with improved OS.

Impact of adding preoperative magnetic resonance imaging to ultrasonography on male breast cancer survival: a matched analysis with female breast cancer.

The study investigated whether incorporating magnetic resonance imaging (MRI) alongside ultrasonography (US) in the preoperative evaluation is associated with differing survival outcomes between male and female breast cancer patients in a matched analysis. Additionally, clinicopathological prognostic factors were analyzed. Between January 2005 and December 2020, 93 male and 28,191 female patients who underwent breast surgery were screened. Exact matching analysis was conducted for age, pathologic T and N stages, and molecular subtypes. The clinicopathological characteristics and preoperative imaging methods of the matched cohorts were reviewed. Disease-free survival (DFS) and overall survival (OS) were assessed using Kaplan-Meier analysis, and Cox proportional hazards regression analysis was used to identify prognostic factors. A total of 328 breast cancer patients (61 men and 267 women) were included in the matched analysis. Male patients had worse DFS (10-year DFS, 70.6% vs. 89.2%; P=0.001) and OS (10-year OS, 64.4% vs. 96.3%; P&lt;0.001) than female patients. The pathologic index cancer size (hazard ratio [HR], 2.013; 95% confidence interval [CI], 1.063 to 3.810; P=0.032) was associated with worse DFS, whereas there were no significant factors associated with OS. Adding MRI to US for preoperative evaluation was not associated with DFS (HR, 1.117; 95% CI, 0.223 to 5.583; P=0.893) or OS (HR, 1.529; 95% CI, 0.300 to 7.781; P=0.609) in male patients. Adding breast MRI to US in the preoperative evaluation was not associated with survival outcomes in male breast cancer patients, and the pathologic index cancer size was associated with worse DFS.

ThP1.10 - Expression Pattern of Arginase In Tumour Tissue In Male Breast Cancer

Abstract Aim To study the expression pattern of arginase in tumor tissue of male breast cancer (MBC) by immunohistochemistry (IHC). Methods We retrospectively analysed the data of 21 MBC patients who were treated in our centre from January 2018 to March 2022. Immunohistochemical analysis of arginase expression was performed in tumor and lymph node tissue with primary arginase-1 antibody (1:300 dilution). Results The mean patient age was 57 years (33–81 years). 10 patients (48%) had metastatic disease at presentation, while early breast cancer (EBC) and locally advanced breast cancer (LABC) constituted 19% and 33%, respectively. Invasive ductal carcinoma was the predominant histology, with luminal being the major subtype. Modified radical mastectomy was done in 9 patients (43%), and palliative chemotherapy was given to all metastatic patients. IHC analysis revealed a lack of arginase expression in the tumor tissue even though it was expressed in the surrounding neutrophils. Conclusion Contrary to the majority of existing literature, ours was an IHC-based study, which provides a more accurate estimation of arginase expression at the cellular level. The lack of arginase expression obtained in our study may point towards the non-expression of the enzyme in MBC. This suggests that arginase is not a tissue biomarker in MBC. Taking other studies with protein expression into account, arginase should be treated, if necessary, only as a blood biomarker.

Examining stigma in experiences of male breast cancer patients and its impact as a barrier to care: a narrative review.

Male breast cancer (MBC) accounts for nearly one percent of all diagnosed breast cancer (BC). In the United States alone, there were 2,670 MBC reported cases and 500 fatalities in 2019. In addition to the general challenges faced by patients to diagnose and treat cancer, MBC patients experience stigma from the medical community and their own feelings of embarrassment. The presence of stigma has a negative impact on the quality of life and psychological outcomes of MBC patients. This narrative review investigates current research on the presence of stigma in the diagnosis and care of MBC patients, and the role of stigma as a barrier to care. Current literature on MBC and stigma was found through a search of PubMed and Google Scholar. The search strategy consisted of keywords related to "male breast cancer, stigma, awareness, experiences, and social support". Studies published from January 2005 to April 2024, that were retrievable and written in English, were included in this review. Several studies have supported that MBC patients experience stigma due to the lack of awareness in the medical community, and feelings of embarrassment felt by the patients. This stigma is seen through insufficient guidelines on MBC diagnosis and treatment and a lack of male-specific information for BC. These topics of stigma act as barriers to care, as they lead to psychological distress (e.g., anxiety and depression) and delayed diagnoses. Current studies suggest addressing the lack of information and awareness of MBC and implementing screening procedures to mitigate the negative impact of stigma. This review highlights the presence of stigma in the care of MBC patients and its distressing effects on patients. There is a need for increased awareness among the medical community to improve diagnosis and treatment of MBC patients, to allow for more equitable care. Future therapies should focus on the viability of routine screening programs for male patients and addressing the gap of male-specific information.

Development and Validation of a Prognostic Nomogram Model for HER2-Positive Male Breast Cancer Patients.

HER2-positive male breast cancer (MBC) is a rare condition that has a poor prognosis. The purpose of this study was to establish a nomogram model for predicting the prognosis of HER2-positive MBC patients. 240 HER2-positive MBC patients from 2004 to 2015 were retrieved from the surveillance, epidemiology, and end results (SEER) database. All HER2-positive MBC patients were divided randomly into training (n = 144) and validation cohorts (n = 96) according to a ratio of 6:4. Univariate and multivariate Cox regression analyses were used to determine the prognostic factors associated with HER2-positive MBC patients. A clinical prediction model was constructed to predict the overall survival of these patients. The nomogram model was assessed by using receiver operating characteristics (ROC) curves, calibration plots and decision curve analysis (DCA). The Cox regression analysis showed that T-stage, M-stage, surgery and chemotherapy were independent risk factors for the prognosis of HER2-positive MBC patients. The model could also accurately predict the Overall survival (OS) of the patients. In the training and validation cohorts, the C indexes of the OS nomograms were 0.746 (0.677-0.815) and 0.754 (0.679-0.829), respectively. Calibration curves and DCA verified the reliability and accuracy of the clinical prediction model. In conclusion, the predictive model constructed had good clinical utility and can help the clinician to select appropriate treatment strategies for HER2-positive MBC patients.

Male breast cancer and sexual aspects research and analysis (MASARA study): preliminary results

PurposeTo evaluate the impact of male breast cancer and its treatment on patient’s sexual function, including changes in sexual desire, performance, and satisfaction. To investigate changes in the body image experienced by male breast cancer patients and their perception in accessing healthcare in hospital facilities.MethodsWe administered three online questionnaires using Google Forms (Google LLC) to male breast cancer patients treated at our Institution from 2015 to 2023. The surveys were provided in Italian and distributed from March 1st to April 1st, 2024. A panel of one breast radiologist, one oncologist and one clinical psychologist designed a 22-item tailored survey to investigate imaging follow-up routine, sexual habits before and after treatment and perceived male breast cancer stigma. The International Index of Erectile Function and Italian version of the Body Image Scale were also administered. Replies to the three questionnaires were analyzed using descriptive statistical analysis.ResultsAlmost half of the patients completed the three questionnaires (33/70, 47%). The median age was 62 (IR 56–72). Only 27.8% were aware of male breast cancer prior to diagnosis. 86.1% (31/36) underwent regular breast imaging follow-up, with sexual activity declining during treatment. Endocrine treatment was reported by 63.9%. Discomfort was experienced, notably during interactions and communication about their condition. Erectile dysfunction was prevalent, with 18.2% reporting severe dysfunction. The average body image score was 9.1.ConclusionsOur findings emphasize the importance of comprehensive care that attends to the full spectrum of emotional and social well-being beyond medical requirements in male breast cancer patients.

Trends in incidence, prevalence, and survival of breast cancer in the United Kingdom from 2000 to 2021

Breast cancer is the most frequently diagnosed cancer in females globally. However, we know relatively little about trends in males. This study describes United Kingdom (UK) secular trends in breast cancer from 2000 to 2021 for both sexes. We describe a population-based cohort study using UK primary care Clinical Practice Research Datalink (CPRD) GOLD and Aurum databases. There were 5,848,436 eligible females and 5,539,681 males aged 18+ years, with ≥ one year of prior data availability in the study period. We estimated crude breast cancer incidence rates (IR), prevalence and survival probability at one-, five- and 10-years after diagnosis using the Kaplan–Meier method. Analyses were further stratified by age. Crude IR of breast cancer from 2000 to 2021 was 194.4 per 100,000 person-years for females and 1.16 for males. Crude prevalence in 2021 was 2.1% for females and 0.009% for males. Both sexes have seen around a 2.5-fold increase in prevalence across time. Incidence increased with age for both sexes, peaking in females aged 60–69 years and males 90+ . There was a drop in incidence for females aged 70–79 years. From 2003–2019, incidence increased > twofold in younger females (aged 18–29: IR 2.12 in 2003 vs. 4.58 in 2018); decreased in females aged 50–69 years; and further declined from 2015 onwards in females aged 70–89 years. Survival probability for females after one-, five-, and ten-years after diagnosis was 95.1%, 80.2%, and 68.4%, and for males 92.9%, 69.0%, and 51.3%. Survival probability at one-year increased by 2.08% points, and survival at five years increased by 5.39% from 2000–2004 to 2015–2019 for females, particularly those aged 50–70 years. For males, there were no clear time-trends for short-term and long-term survival probability. Changes in incidence of breast cancer in females largely reflect the success of screening programmes, as rates rise and fall in synchronicity with ages of eligibility for such programmes. Overall survival from breast cancer for females has improved from 2000 to 2021, again reflecting the success of screening programmes, early diagnosis, and improvements in treatments. Male breast cancer patients have worse survival outcomes compared to females, highlighting the need to develop male-specific diagnosis and treatment strategies to improve long-term survival in line with females.

Long-term clinical outcomes of male breast cancer patients treated with curative intent by trimodality therapy at an academic university hospital in India.

Male breast cancer is rare and accounts for less than 1% of all breast cancer cases worldwide. This retrospective cohort study included all patients of invasive male breast cancer treated with curative intent by a trimodality approach via a multidisciplinary team at an academic university hospital in India between 2009 and 2023. Records were identified from a prospectively maintained database. Clinicopathological parameters, treatment details and survival were recorded and analysed. Thirty-four patients were included. The median (IQR) age was 55(44-63) years. Most patients were overall stage III (74%) and node positive (79%) with Scarff-Bloom-Richardson grade II (50%). Twenty-five patients (73%) were oestrogen receptor (ER) positive. Lymphovascular space invasion (LVSI) and perineural invasion (PNI) were present in 62% and 21% of patients, respectively. The most common chemotherapy timing was adjuvant (53%) followed by neoadjuvant (41%), and the most commonly used regimen consisted of a combination of doxorubicin-cyclophosphamide followed by a taxane (53%). Most (85%) patients underwent a mastectomy, five patients underwent breast conservation. All patients received radiotherapy to a dose of 42.6 Gy in 16 fractions, followed by a tumour bed boost for those undergoing breast conservation. At a median follow-up of 70 months (range 10-159 months), the five and ten-year overall survival was 91% and 58%, and the five-year disease-free survival (DFS) was 67%. The median DFS was 72 months. On univariate analysis, the tumour sub-type (Luminal versus TNBC) significantly predicted DFS (P = 0.03 log-rank). Breast cancer in males has a high incidence of node positivity, ER positivity and LVSI. Even with advanced stages at presentation, trimodality therapy in a multidisciplinary setting offers good long-term outcomes.

Demographics and survival outcomes of stage IV male breast cancer: A retrospective analysis of SEER database.

11142 Background: Male Breast Cancer (MBC) is a rare malignancy accounting for &lt;1% of all breast cancer cases in the United States. It is often lately diagnosed due to lack of awareness leading to substantial morbidity and mortality. Previous studies revealed higher risk of death among males compared to females across all stages, but little known about the impact of Hormone Receptor (HR) and Human Epidermal growth factor Receptor 2(HER 2) statuses on prognosis and survival among MBC patients. So, we aim to study the survival outcomes of stage IV MBC patients using SEER (Surveillance, Epidemiology, and End Results) data. Methods: A retrospective analysis was conducted using a SEER database and identified stage IV MBC cases (Any T, Any N, M1) diagnosed between 2010-2015. The selection of these years is based on the reporting of HER2 status on SEER database starting from 2010 and to ensure a current period and a minimum of 5 years of follow-up. Patient demographics, tumor HR/HER 2 status and survival data were extracted and analyzed. Subgroup analyses were performed to show the correlation between HR/HER 2 status and survival. Results: The study included 144 patients. 59.7%(86/144) were above 60 years of age. Majority were Caucasians up to 68.1%(98/144) followed by African Americans 18.7% (27/144), Hispanics 6.9%(10/144) and Asians/Pacific Islanders 6.2%(9/144). Among the subtypes, the most common was HR+/HER2- consisting of 69.4%(100/144) followed by HR+/HER2+ 19.4%(28/144), HR-/HER2- 9.7%(14/144), HR-/HER2+ 1.4%(2/144). The median overall survival varied among different subtypes of breast cancer and was noted to be 31.5 months, 25 months, 4.5 months and 10 months among HR+/HER2-, HR+/HER2+, HR-/HER2- and HR-/HER2+ respectively (Table). In the comparison between HR+/HER2+ and HR-/HER2-, the risk of death differed significantly, as indicated by a hazard ratio of 0.26 (95% CI 0.12-0.56, p = 0.001), highlighting a poor survival of HR-/HER2-. Conclusions: This retrospective analysis provides valuable insights into the demographics and survival outcomes of stage IV MBC patients. Triple negative (HR-/HER2-) subtype continues to have poor outcomes in males as well, emphasizing the need to explore novel treatment strategies to improve outcomes for this unique patient population. Although, treatment regimens for MBC are extrapolated from women, the disparity in survival across all subtypes requires the need to get more men on breast cancer clinical trials when feasible. [Table: see text]

Germline sequence variation in Rwandan patients with breast and prostate cancer.

10591 Background: Clinically relevant cancer genetic data from Sub-Saharan Africa (SSA) are limited, despite the observation that cancers in this region are frequently diagnosed at an early age and follow an aggressive course. A prospective pilot study was undertaken to explore the feasibility of implementing germline genetic testing (GGT) and counseling in breast and prostate cancer patients in Rwanda. Methods: Consecutive female breast (FBC), male breast (MBC) and prostate (PC) cancer patients from hospitals in Rwanda underwent GGT. Demographic, disease, and treatment information were collected. A commercial 84-gene multi-cancer panel (Invitae Corp.) was used to identify pathogenic variants (PV) and variants of uncertain significance (VUS). Descriptive statistics were utilized. Results: 342 total patients underwent GGT: PV were observed in 32/175 (18.3%) FBC, 7/161 (4.3%) PC, and 1/6 (16.7%) MBC patients. PV were most frequently identified in BRCA2: FBC (n=14), MBC (n=1), PC (n=2). BRCA1 was almost common in FBC (n=11). The majority of PV in FBC cases were in established breast cancer susceptibility genes (94%), while 43% of PV in PC involved PC susceptibility genes. Notably, of 40 total PV identified, 35 (88%) were in DNA damage repair (DDR) genes. 224 patients (65%) had &gt; 1 VUS in the absence of a PV finding, including 109 (68%) in PC and 115 (64%) in FBC/MBC combined. Recurrent PV were observed in BRCA1, BRCA2, or ATM in apparently unrelated FBC cases. Conclusions: The high proportion of PV, observed in these Rwandan breast and prostate cancer cases, particularly in DDR genes, suggest that GGT should be more routinely implemented into cancer care and prevention strategies in this population. More widespread GGT may also help to resolve the high VUS rates. The recurrent variants identified warrant further investigation into founder effects. [Table: see text]

Gender disparities in incidence of psychological disorder among patients with breast cancer: A national cohort study.

e23285 Background: Male breast cancer (MBC) is rare. The features of MBC shares similar characteristics with female breast cancer, often resembling postmenopausal breast cancer. However, there are notable differences between male and female breast cancer, especially regarding gender and age, which can have distinct psychological impacts on male patients. In this study, we investigated whether the psychological distress experienced upon a diagnosis of breast cancer differs according to gender. Methods: Data were obtained from the National Health Insurance claims database of the Health Insurance Review and Assessment Service in South Korea. This study focused on the three most common psychological disorders: sleep disorders, anxiety disorders, and depression. Diagnosis confirmation relied on diagnostic codes based on the International Code of Disease, 10th revision, alongside breast cancer diagnoses. Propensity score matching was used in a 1:5 ratio, and adjustment variables included age, endocrine therapy, chemotherapy, HER2-targeted treatment, and Charlson Comorbidity Index score. Results: After excluding patients with previous psychological disorder, there were a total of 75,936 patients, and 281 (0.4%) male patients. Male patients were diagnosed at an older age, had a higher prevalence of hormone receptor-positive status, higher comorbidities, and lower rates of anxiety disorders, while sleep disorders and depressive disorders showed similar incidences. The Cox proportional hazard regression model exhibited that being female was a risk factor for anxiety disorder (after matching, multivariable, HR 1.498, 95% CI 1.057-2.123, p = 0.023). However, gender did not significantly influence the development of sleep or depressive disorders, despite these conditions typically having a higher incidence in females. During the acute phase shortly after diagnosis, women tend to have more distress, as seen on the cumulative incidence curves. Conclusions: MBC patients experienced similar levels of psychological distress related to sleep and depression disorders as female patients. These results suggested that both genders require an equal support system and psychological care to maintain mental well-being after a breast cancer diagnosis.

Conditional survival of male breast cancer

Background The incidence of male breast cancer has been increasing in recent years; however, the long-term survival outcomes of diagnosed patients remain uncertain. This study was designed to evaluate the conditional survival of male breast cancer patients and to predict the future survival of patients through the conditional nomogram, to provide important suggestions for clinical decision-making. Methods Retrospective data from the SEER database included 3600 male breast cancer patients, divided into training and validation groups (7 : 3 ratio). Overall survival rates were calculated using Kaplan–Meier analysis. Conditional survival analysis described survival at specific years. Time-dependent multivariate Cox analysis identified prognostic factors’ impact. The conditional survival nomogram model predicted real-time survival rates. Results Over time, the 5-year real-time survival rate of patients gradually improved, increasing from 70.5 to 74.8, 79.4, 85.8, and 92.9% (respectively, representing 5-year survival rates of 1–4 years after diagnosis). In addition, the improvement in conditional survival rate CS5 showed a nonlinear trend. After 5 years of diagnosis, age, tumor size, and tumor stage had a sustained impact on patient prognosis. Finally, a conditional survival nomogram was constructed to predict the 10-year survival rate in real time. Conclusion Five years after diagnosis, the conditional survival rate of male patients with breast cancer has improved, but it is not nonlinear. In the first 5 years after diagnosis, patients with older age, larger tumor size, poorer tumor stage, and distant metastasis should be actively followed up and treated to improve their long-term survival.

Abstract PO1-08-05: Using the CTS5 Score to Predict Late Recurrence in Male and Female Estrogen Receptor-Positive Breast Cancer Patients: a SEER database analysis of 65,729 cases

Abstract Purpose: The Clinical Treatment Score post-5 years (CTS5) score is a prognostic prediction tool to predict the risk of late distant recurrence in postmenopausal women with estrogen receptor-positive (ER+) breast cancer. Here we aimed to evaluate the prediction role of CTS5 in male breast cancer patients using the Surveillance, Epidemiology, and End Results (SEER) database. Methods: ER+ early male and female breast cancer patients from the SEER database 2010-2013 were included. Clinicopathological features and the CTS5 score between the gender groups were compared using chi-square test. Overall survival (OS) and breast cancer-specific survival (BCSS) were estimated by Kaplan-Meier plots and compared between the groups with Log-rank test and multivariate cox proportional hazard regression models was used to determine the relationship between the CTS5 score and breast cancer survival outcomes in different gender cohorts. Results: A total of 65,729 ER+ breast cancer patients were included in the study and 611 were men. Male breast cancer was more likely to be diagnosed later in life (&amp;gt;50 years old, 87.1% vs 73.6%, p &amp;lt; 0.001), with more aggressive biological features (grade Ⅱ 51.6% vs 47.2%, p &amp;lt; 0.001; grade Ⅲ 37.8% vs 28.3%, p &amp;lt; 0.001) , and higher tumor burden (stage Ⅱ 45.8% vs 32.9%, p &amp;lt; 0.001, stage Ⅲ 17.5% vs 10.5%, p &amp;lt; 0.001) when compared to female counterparts. More male patients were CTS5 intermediate- or high-risk than female patients (high 7.9% vs 6.3%, intermediate 41.1% vs 24.6%, low 51.1% vs 69.1%, p &amp;lt; 0.001). Patients were divided into 0-5 year and &amp;gt;5 year cohorts based on whether they had a BCSS event within 5 years. In the &amp;gt;5 year cohort, patients with CTS5 high- or intermediate- risk had worse survival outcomes compared with low-risk cases in male and postmenopausal female patients but not in premenopausal female patients. In the 0-5 year cohort, the CTS5 score was not predictive for disease recurrence in male or postmenopausal patients. Conclusion: Male breast cancer patients were more likely to have aggressive tumors and worse survival outcomes. The CTS5 score could be applied to predict breast cancer-specific mortality risk beyond 5 years in male ER+ breast cancer patients. Citation Format: Fenhua Wang, Fang Ren, Jian Qian, Yunxia Xu, Jiayi Wu, Yu Zong, Xidong Gu. Using the CTS5 Score to Predict Late Recurrence in Male and Female Estrogen Receptor-Positive Breast Cancer Patients: a SEER database analysis of 65,729 cases [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-08-05.

Abstract PO1-16-10: BRCA mutated Male Breast Cancer, hallmarks of a distinct disease. Data from the Spanish Male Breast Cancer Registry (GEICAM/2016-04)

Abstract Background: Male breast cancer (MBC) accounts for approximately 0.25% of all male cancers and &amp;lt; 1% of all BCs. Its incidence is increasing by 1.1% per year. Most population studies indicate that 10-15% of MBC patients (pts) have a germline BRCA2 mutation (BRCA2 mut). Around 5-10% of BRCA2mut male carriers will develop BC at their lives. Preliminary evidence suggests that BRCA2mut MBC pts tend to have a more aggressive disease. Here we present comparative series of MBC with and without BRCA to gain insight on differences between both groups. Methods: GEICAM/2016-04 (NCT03800355) is a retrospective, observational study which includes data from MBC pts diagnosed between 2000 and 2019 throughout Spain. This analysis includes the 1st unselected 186 pts included in the study, who had BRCA1/2 genes mutational status assessed within clinical practice. BC clinical subtypes are defined: luminal (HR+, HER2-), Triple Negative (TN) (HR-, HER2-), and HER2+ (HR+ or HR-); subtype is unknown in 6% pts. Results: 186 validated pts with BRCA1/2 testing were identified, representing the 24% of pts available in the database at the cut-off date (6-Mar-2023). 36 (19%) pts had germline BRCA1/2 mut (4 pts in BRCA1, 31 pts in BRCA 2 and 1 pt in both BRCA1 and BRCA2), and 150 (81%) pts had BRCA1/2 wild type (wt) or a variant of uncertain significance (VUS)/unknown (UK). Median age at BC diagnosis was 62 (34-87) years, 98% pts were Caucasian, and the median body mass index was 27 (18-46) Kg/m2 (overweight). Prior cancer history was reported in 6% BRCA1/2mut BC pts and 11% BRCA1/2wt or vus/uk, and family history included: 56% BC, 8% ovarian cancer, and 14% prostate cancer (PC). PC as part of prior medical history, cancer family history, and 2nd non-breast primary malignancy, was most frequent in BRCA1/2wt or vus/uk pts, with no statistical differences. At first diagnosis, stages III-IV were higher in BRCA1/2mut pts (28% vs. 17%, p=0.0093). Morphologically, invasive carcinoma of no special type (NST) was the most common pattern (92% in BRCA1/2mut vs. 86% in BRCA1/2wt or vus/uk), and lobular invasive carcinoma was not reported up-to-date. Histological grade 2 was the most frequent (54%), but grade 3 was present in 17/36 BRCA1/2mut pts. 88% pts received adjuvant treatment, 7% (neo-)adjuvant, 2% neoadjuvant and 3% did not receive any systemic therapy. Breast conserving surgery was performed in 4% (5/140) BRCA1/2wt or vus/uk EBC pts, and mastectomy was performed in 55% (n=6/11) de novo metastatic pts. In the advanced setting (n=38), visceral lesions were more frequent in BRCA1/2mut pts. Additionally, 92% BRCA1/2mut pts had ≤ 3 organs involved while one third of BRCA1/2wt or vus/uk pts had ≥ 4 metastatic locations. With a median follow-up of 64 months (mo.), median iDFS and DDFS were higher, but not statistically significant, in BRCA1/2wt or vus/uk pts vs. BRCA1/2mut pts. In advanced setting, median PFS to 1L-3L do not show statistically significant differences between both groups. Regarding OS, no differences were also observed, but the median values were not reached. Further detailed information according to BRCA1/2 mutational status and BC subtypes is included in the table below. Conclusions: In this subset analysis of GEICAM/2016-04, BRCA1/2mut pts had some features of worse prognosis, with a more prevalent de novo metastatic disease. No statistically significant differences were observed in outcomes in both early-stage and advanced setting vs. BRCA1/2wt or vus/uk pts. &amp;lt;graphic&amp;gt; Citation Format: Noelia Martínez-Jáñez, Purificación Martínez, Cristina Hernando, Sabela Recalde, Alfonso Sánchez, David Morales, Marta Santisteban, Isaura Fernández, Sonia Del Barco, Esther Zamora, Vega Iranzo, Tamara Martos, Eduardo Martínez-de Dueñas, Silvia Antolin Novoa, Severina Domínguez, Paula Domínguez, Mª José Echarri, Ana Santaballa Bertrán, Xavier Mira, Andrea Blasco, Susana Bezares, Ander Urriticoechea. BRCA mutated Male Breast Cancer, hallmarks of a distinct disease. Data from the Spanish Male Breast Cancer Registry (GEICAM/2016-04) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-16-10.

Adjuvant chemotherapy and survival in males aged 70 years or older with breast cancer: a population-based retrospective study

BackgroundMale breast cancer constitutes a minority of breast cancer diagnoses, yet its incidence has been on the rise in recent decades. However, elderly male breast cancer patients have been inadequately represented in clinical trials, posing challenges in treatment decisions. This study seeks to clarify the efficacy of chemotherapy in this demographic and identify the population most likely to benefit from such intervention.MethodsWe conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database, encompassing a total of 1900 male breast cancer patients aged 70 years or older. Among them, 1652 were categorized in the no-chemotherapy group, while 248 were in the chemotherapy group. A multifactorial logistic regression model was employed to investigate the determinants influencing the administration of chemotherapy in elderly male breast cancer patients. Additionally, the multivariate Cox proportional hazards regression model was applied to identify factors associated with outcomes, with overall survival (OS) as the primary endpoint.ResultsMultivariate logistic regression analysis revealed that grade, tumor size, and nodal status were robust predictors for elderly male breast cancer patients receiving chemotherapy. Furthermore, the multivariate analysis demonstrated that chemotherapy conferred benefits compared to the no-chemotherapy group (HR = 0.822, 95% CI: 0.682–0.991, p = 0.040). Stratified analyses indicated that individuals with N+, poorly/undifferentiated grade, and stage II/III disease could derive benefits from chemotherapy. Upon further investigation of progesterone receptor (PR) positive patients, it was found that only stage III patients experienced significant benefits from chemotherapy (HR = 0.571, 95% CI: 0.372–0.875, p = 0.010). Conversely, in PR negative patients, both stage II (HR = 0.201, 95% CI: 0.051–0.792, p = 0.022) and stage III patients (HR = 0.242, 95% CI: 0.060–0.972, p = 0.046) derived benefits from chemotherapy.ConclusionAdjuvant chemotherapy may benefit certain elderly male breast cancer patients, specifically those with positive lymph node status, poorly/undifferentiated grade, and PR-positive in stage III, as well as PR-negative expression in stage II/III. Given favorable physical tolerance, it is advisable not to hastily dismiss chemotherapy for these elderly male breast cancer patients.

Clinical characteristics and prognostic factors of male breast cancer in China.

This study aimed to explore the clinical characteristics of male breast cancer (MBC) patients and the factors influencing their prognosis. We conducted a retrospective case series analysis of 117 MBC cases who were treated at Zhejiang Cancer Hospital from 2009 to 2022. Cox proportional hazard model was used to identify prognostic factors of MBC. Nomogram was constructed based on these factors, which was further evaluated by C-index and calibration curves. A total of 115 MBC cases were finally included in our analyses, with median diagnosis age of 59 years. Of these cases, 80.0% were estrogen receptor (ER) positive, 79.2% were progesterone receptor (PR) positive, 48.7% were human epidermal growth factor receptor 2 (HER2) negative, and 42.6% had Ki67 levels higher than 15%. 108 (93.9%) cases underwent radical mastectomy, while only 3 (2.6%) received breast-conserving surgery. The Logrank test suggested that lymphocyte-to-monocyte ratio (LMR) was negatively associated with both overall survival (OS) and disease-free survival (DFS) of MBC, while platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were only positively associated with OS (all P-values < 0.05). Multivariate regression analysis showed that age (HR 1.08, 95% CI 1.03-1.13) was significant prognostic factors for OS. Meanwhile, age (HR 1.06, 95% CI 1.02-1.10), histological differentiation grade (poorly differentiated/undifferentiated vs. well-differentiated: HR 2.55, 95% CI 1.05-6.17), and TNM stage (IV vs. I: HR 31.59, 95% CI 6.01-165.93) were also significant prognostic factors for DFS. Nomograms were developed for DFS, with C-indexes of 0.782, indicating good predictive performance. Increased age, bigger tumor size, higher TNM stage, and lower histological differentiation grade were associated with poor MBC prognosis, and LMR, PLR, and NLR might be potential predictors for MBC prognosis.