1
|
Lim JSH, Sim Y, Ngeow J, Yuen J, Tan VKM, Tan BKT, Yong WS, Wong CY, Lim SZ, Hamzah JLB, Tan SY, Wong FY, Madhukumar P. Male breast cancer: a Singapore perspective. ANZ J Surg 2022; 92:1440-1446. [PMID: 35470542 DOI: 10.1111/ans.17737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Male breast cancer (MBC) is rare, representing <1% of all breast cancers. Treatment recommendations have been extrapolated from trial data of female breast cancer patients. This study aims to report our institutional experience of MBC across a 20 year period, analyse the survival outcome and prognosis of this group against female breast cancer patients treated at the same centre. METHODS Clinical, histopathological, treatment and survival data of male and female breast cancer patients treated between Jan 1999 and July 2019 at Singapore General Hospital and National Cancer Centre Singapore were identified and analysed. RESULTS Fifty-seven male patients were identified. The median age at diagnosis was 63 years. Majority had invasive ductal carcinoma (86%) and presented at an early disease stage: 70.2% presented as Tis/T1/T2 and 49.1% had no axillary nodal involvement. 84.2% had a simple mastectomy with either a sentinel lymph node biopsy or axillary clearance. The median follow up was 5.69 years for males and 5.83 years for females. The median survival was 11.86 years for males and 16.3 years for females. At 5 years, overall survival (OS) was 69.9% (52.3-82.1%) and disease free survival (DFS) was 62.9% (44.9-76.5%) for males compared with OS 83.8% (83.21-84.39%) and DFS 74.5% (73.91-75.09%) for females. CONCLUSION MBC remains understudied. Our institutional data indicates that good long term survival in South-East Asian patients can be achieved with treatment protocols that are similar to female breast cancer. More prospective studies are required.
Collapse
Affiliation(s)
- Joshua S H Lim
- Department of General Surgery, Singapore General Hospital, Singapore
| | - Yirong Sim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Joanne Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Jeanette Yuen
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Veronique K M Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Benita Kiat Tee Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore.,Department of General Surgery, Sengkang General Hospital, Singapore
| | - Wei-Sean Yong
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Chow Yin Wong
- Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Sue Zann Lim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Julie Liana B Hamzah
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Si Ying Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre, Singapore
| | - Preetha Madhukumar
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore
| |
Collapse
|
2
|
Pizzato M, Carioli G, Bertuccio P, Malvezzi M, Levi F, Boffetta P, Negri E, La Vecchia C. Trends in male breast cancer mortality: a global overview. Eur J Cancer Prev 2021; 30:472-479. [PMID: 33470692 DOI: 10.1097/cej.0000000000000651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Recent trends in male breast cancer have been inadequately studied. We updated mortality trends in selected countries and regions worldwide using most recent available data and we predicted figures for 2020. METHODS We extracted official death certification data for male breast cancer and population estimates from the WHO and the Pan American Health Organization databases, from 2000 to 2017. We computed age-standardized (world population) death rates for selected countries and regions worldwide. We used joinpoint regression analysis to identify significant changes in trends and to predict death numbers and rates for 2020. RESULTS In 2015-2017, Central-Eastern Europe had a rate of 2.85/1 000 000, and Russia of 2.22, ranking among the highest. North-Western and Southern Europe, the European Union as a whole and the USA showed rates ranging between 1.5 and 2.0. Lower rates were observed in most Latin American countries, with values below 1.35/1 000 000, in Australia, 1.22, and Japan, 0.58. Between 2000-2004 and 2015-2017, age-adjusted death rates decreased between 10 and 40% in North-Western Europe, Russia, and the USA, and between 1.5 and 25% in the other areas under study, except Latin America (+0.8%). Except for Central-Eastern Europe, predicted rates for 2020 were favourable. CONCLUSION Advancements in management are likely the main drivers of the favourable trends in male breast cancer death rates over the last decades. Delayed diagnosis and limited access to effective care explain the higher mortality in some areas.
Collapse
Affiliation(s)
| | - Greta Carioli
- Department of Clinical Sciences and Community Health
| | - Paola Bertuccio
- Department of Biomedical and Clinical Sciences L. Sacco, Università degli Studi di Milano, Milan, Italy
| | | | - Fabio Levi
- Department of Epidemiology and Health Services Research, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| | - Eva Negri
- Department of Biomedical and Clinical Sciences L. Sacco, Università degli Studi di Milano, Milan, Italy
| | | |
Collapse
|
3
|
Fentiman IS. Prognostic difficulties of men with breast cancer. Breast J 2021; 27:877-882. [PMID: 34652050 DOI: 10.1111/tbj.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
Most adequately powered studies confirm a worse prognosis for males versus matched females with breast cancer. There is in-stage migration for stage I cancers with a different ratio of tumor/normal breast tissue in males. Younger men have a better prognosis, largely the result of increased morbidity in the elderly, exacerbated by smoking, low socioeconomic differences, and ethnic disparity. BRCA2 carriers with MBC have a worse outcome than noncarriers as do men with amplification of EMSY. Men with tumors having a high cytosol level of plasminogen activator inhibitor 1 (PAI-1) may have more invasive cancers leading to earlier spread and hence a worse outcome. PREDICT+ is a useful prognostic model for MBC and multigene testing enables more specific systemic therapies to be used.
Collapse
Affiliation(s)
- Ian S Fentiman
- Professor of Surgical Oncology, Research Oncology, Guy's Hospital, London, UK
| |
Collapse
|
4
|
Adel A, Abdel-Halim MRE, Abdel-Galeil Y. Ulcerated Nipple Nodule, Clinicopathologic Challenge: Answer. Am J Dermatopathol 2021; 43:466-467. [PMID: 34006735 DOI: 10.1097/dad.0000000000001784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ahmad Adel
- Dermatology Department, El-Mataria Teaching Hospital, Cairo, Egypt ; and
| | - Mona R E Abdel-Halim
- Dermatopathology Unit, Dermatology Department, Cairo University, Kasr Al Aini Hospital, Cairo, Egypt
| | - Yosra Abdel-Galeil
- Dermatology Department, El-Mataria Teaching Hospital, Cairo, Egypt ; and
| |
Collapse
|
5
|
Abstract
Male breast cancer is a rarely encountered disease, when compared with female breast cancer, often detected in more advanced stage at the time of diagnosis, and associated with more lymph node metastasis rates, more estrogen receptors positivity, and less human epidermal growth factor receptor-2 expression (HER-2) rates. Surgical management also shows some difference, where the most common operative technique of male breast cancer patients is mastectomy and/or axillary surgery. Triple-negative breast cancer is less frequent than other subtypes and is associated with poorer prognosis. This is because of its association with higher histopathological grade than that in other types of breast cancer. Only fewer treatment options are available compared to hormone-positive, HER-2 positive breast cancer. We are present a case of 71-year-old gentleman with triple-negative breast cancer.
Collapse
Affiliation(s)
- Qasif Qavi
- Surgery, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Firas Alkistawi
- Surgery, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Shashi Kumar
- Surgery, Mid and South Essex NHS Foundation Trust, Basildon, GBR
| | - Rizwan Ahmed
- Surgery, Princess Royal University Hospital, Orpington, GBR
| | - Abdalla Saad Abdalla Al-Zawi
- Breast Surgery, Anglia Ruskin University, Chelmsford, GBR.,Breast Surgery, Basildon and Thurrock University Hospital, Basildon, GBR.,General Surgery, Mid and South Essex NHS Foundation Trust, Basildon, GBR
| |
Collapse
|
6
|
Lee YJ, Shin J, Jung JM, Kim EK, Jung J, Jeong JH, Gong G, Ko B. Bilateral Metachronous Paget's Disease of the Accessory Breasts in a Male. J Breast Cancer 2020; 23:665-671. [PMID: 33408892 PMCID: PMC7779722 DOI: 10.4048/jbc.2020.23.e38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022] Open
Abstract
Bilateral axillary Paget's disease in men is a rare occurrence with limited reports on its diagnosis, treatment, and prognosis. Here, we report the case of a 55-year-old Korean male, who presented with a palpable mass and eczematous skin lesion on the left axilla. An incisional biopsy and histopathologic examination indicated invasive ductal carcinoma with Paget's disease arising in the accessory breast. Magnetic resonance imaging and positron emission tomography revealed no malignancy in the normal breast and other organs. The patient was subjected to a wide excision, wherein the left axillary lymph node was dissected, followed by the administration of adjuvant chemotherapy and radiation therapy. After 17 months of disease-free survival, the patient was diagnosed with Paget's disease of the contralateral accessory breast. He underwent wide excision surgery along with radiation therapy. To the best of our knowledge, this is the first report of bilateral extramammary Paget's disease in a male.
Collapse
Affiliation(s)
- Young Joo Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Junyoung Shin
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jin-Min Jung
- Department Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Eun Key Kim
- Department of Plastic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jinhong Jung
- Department of Medical Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Ho Jeong
- Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Gyungyub Gong
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - BeomSeok Ko
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| |
Collapse
|
7
|
Park YH, Senkus-Konefka E, Im SA, Pentheroudakis G, Saji S, Gupta S, Iwata H, Mastura MY, Dent R, Lu YS, Yin Y, Smruti BK, Toyama T, Malwinder S, Lee SC, Tseng LM, Kim JH, Kim TY, Suh KJ, Cardoso F, Yoshino T, Douillard JY. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with early breast cancer: a KSMO-ESMO initiative endorsed by CSCO, ISMPO, JSMO, MOS, SSO and TOS. Ann Oncol 2020; 31:451-469. [PMID: 32081575 DOI: 10.1016/j.annonc.2020.01.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/20/2019] [Accepted: 01/04/2020] [Indexed: 12/27/2022] Open
Abstract
In view of the planned new edition of the most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of primary breast cancer published in 2015, it was decided at the ESMO Asia Meeting in November 2018, by both the ESMO and the Korean Society of Medical Oncology (KSMO), to convene a special face-to-face guidelines meeting in 2019 in Seoul. The aim was to adapt the latest ESMO 2019 guidelines to take into account the ethnic and geographical differences associated with the treatment of early breast cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with early breast cancer representing the oncology societies of Korea (KSMO), China (CSCO), India (ISMPO) Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and was independent of both the current treatment practices, and the drug availability and reimbursement situations, in the individual participating Asian countries.
Collapse
Affiliation(s)
- Y H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - E Senkus-Konefka
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - S-A Im
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - S Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - S Gupta
- Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Y Mastura
- Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - R Dent
- Medical Oncology, National Cancer Center Singapore, Singapore, Singapore
| | - Y-S Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Y Yin
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - B K Smruti
- Medical Oncology, Lilavati Hospital and Research Centre and Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - T Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - S Malwinder
- Sri Kota Specialist Medical Centre, Selangor, Malaysia
| | - S C Lee
- Department of Haematology-Oncology, National University, Cancer Institute, Singapore, (NCIS) National University Health System, Singapore, Singapore
| | - L-M Tseng
- Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
| | - J H Kim
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - T-Y Kim
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - K J Suh
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | |
Collapse
|
8
|
Lee EG, Jung SY, Lim MC, Lim J, Kang HS, Lee S, Han JH, Jo H, Won YJ, Lee ES. Comparing the Characteristics and Outcomes of Male and Female Breast Cancer Patients in Korea: Korea Central Cancer Registry. Cancer Res Treat 2020; 52:739-746. [PMID: 32054149 PMCID: PMC7373857 DOI: 10.4143/crt.2019.639] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/12/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE This study aimed to determine the incidence of male breast cancer (MBC) and its survival outcomes in Korea, and to compare these results to those for female breast cancer (FBC). Materials and Methods We searched the Korea Central Cancer Registry and identified 227,122 breast cancer cases that were diagnosed between 1999 and 2016. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to sex, age, histological type, and cancer stage. RESULTS The 227,122 patients included 1,094 MBC cases and 226,028 FBC cases. Based on the age-standardized rate, the male: female ratio was 0.0055:1. The most common ages at diagnosis were 60-69 years for MBC and 40-49 years for FBC (p < 0.001). Male patients were less likely than female patients to receive adjuvant radiotherapy (7.5% vs. 21.8%, p < 0.001) or adjuvant chemotherapy (40.1% vs. 55.4%, p < 0.001). The 5-year OS rates after diagnosis were 88.8% for all patients, although it was significantly lower for MBC than for FBC (76.2% vs. 88.9%, p < 0.001). In both groups, older age (≥ 60 years) was associated with shorter survival. The 5-year OS rates for the invasive histological types were 75.8% for men and 89.0% for women. The 5-year OS rates in both groups decreased with increasing cancer stage. CONCLUSION MBC was diagnosed at older ages than FBC, and male patients were less likely to receive radiotherapy and chemotherapy. The survival outcomes were worse for MBC than for FBC, with even poorer outcomes related to older age, the inflammatory histological types, and advanced stage. It is important that clinicians recognize the differences between FBC and MBC when treating these patients.
Collapse
Affiliation(s)
- Eun-Gyeong Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Goyang, Korea.,Cancer Healthcare Research Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Myong Cheol Lim
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jiwon Lim
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Han-Sung Kang
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Seeyoun Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Jai Hong Han
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Heein Jo
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea.,Immunotherapeutics Branch, Research Institute, National Cancer Center, Goyang, Korea.,National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| |
Collapse
|
9
|
Jung SY, Jung KW, Ha J, Won YJ, Kim YA, Kwon Y, Kong SY, Lee ES. Different Patterns of Conditional Survival of Breast Cancer Patients by Age and Histologic Types: Evidence from the Korean Nationwide Registry. Cancer Epidemiol Biomarkers Prev 2019; 28:1169-1176. [PMID: 31028082 DOI: 10.1158/1055-9965.epi-18-1072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/11/2018] [Accepted: 04/18/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Conditional relative survival (CRS), which is the survival estimate of patients who have already survived for a certain period of time after diagnosis, could provide more relevant information on the current prognosis of cancer survivors than the standard 5-year relative survival (RS). This study aimed to estimate the 5-year CRS of Korean breast cancer patients. METHODS We identified 145,083 breast cancer cases diagnosed between 2002 and 2013 in the Korea Central Cancer Registry. The CRS was estimated for every year after diagnosis, according to sex, age, histologic type, and stage. RESULTS The 5-year RS at diagnosis was 90.8%, and the 10-year RS was 85.7%. The 5-year CRS was 91.0% and 94.3% at 1 year and 5 years after diagnosis, respectively. Very young and very old patients had worse 5-year CRS after 5 years of survival than those of other age groups (92.2% in the <40-year and 92.6% in the ≥70-year groups vs. 95.4% in 40-49-year, 94.3% in 50-59-year, and 93.7% in 60-69-year groups). The 5-year CRS of metaplastic carcinoma increased from 82.0% at diagnosis to 95.2% at 5 years after diagnosis, compared with that of lobular carcinoma (from 93.1% to 92.5%). Hardly any excess mortality (5-year CRS ≥ 95%) was seen within 7 years after diagnosis. CONCLUSIONS This study shows that the CRS of breast cancer survivors in Korea has increased, but varies by sex, age, stage, and histologic type. IMPACT These findings provide more detailed information to breast cancer survivors and clinicians.
Collapse
Affiliation(s)
- So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Goyang, Korea.,Cancer Healthcare Research Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Kyu-Won Jung
- Cancer Registration and Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
| | - Johyun Ha
- Cancer Registration and Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Cancer Registration and Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Young Ae Kim
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Youngmee Kwon
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Sun-Young Kong
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy.,Translational Cancer Research Branch, Research Institute, National Cancer Center, Goyang, Korea.,Department of Laboratory Medicine, Center for Diagnostic Oncology, Hospital, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea.,Immunotherapeutics Branch, Research Institute, National Cancer Center, Goyang, Korea.,National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| |
Collapse
|
10
|
Wei JL, Zhang JX, Fu DY. Characterization and prognosis of estrogen receptor-positive/progesterone receptor-negative male breast cancer: a population-based study. World J Surg Oncol 2018; 16:236. [PMID: 30558615 PMCID: PMC6297954 DOI: 10.1186/s12957-018-1539-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 12/04/2018] [Indexed: 01/11/2023] Open
Abstract
Background The aim of this study was to explore the characteristics and prognostic information of estrogen receptor-positive/progesterone receptor-negative (ER+/PR−) male breast cancer. Methods Using the US National Cancer Institute’s Surveillance, Epidemiology, and End Results database, we compared the demographics, clinical characteristics, and outcome of estrogen receptor-positive/progesterone receptor-positive (ER+/PR+) patients with ER+/PR− male breast cancer patients from 1990 to 2010. Two thousand three hundred twenty-two patients with ER+/PR+ tumors and 355 patients with ER+/PR− tumors were included in our study. Results ER+/PR− patients were younger (P = 0.008) and more likely to be African American (P < 0.001) while presented with higher histological grade (P < 0.001), larger tumor size (P = 0.010), and more invasion to the lymph nodes (P = 0.034) and distant sites (P < 0.001), thus later stage (P = 0.001). Despite higher chance of receiving chemotherapy (51.0% vs 36.5%, P < 0.001), ER+/PR− patients experienced significantly worse breast cancer-specific survival (BSCC) (P < 0.001) and shorter overall survival (OS) (P = 0.003). Multivariate Cox model confirmed that tumor size, lymph node invasion, metastasis, and surgery were independent prognostic factors of both BSCC and OS for ER+/PR− male breast cancer. Age at diagnosis and chemotherapy were significantly associated with OS but not with BSCC. Conclusion ER+/PR− male breast cancer was more aggressive and experienced shorter survival than ER+/PR+ patients. The prognosis was mainly associated with tumor size, lymph node invasion, metastasis, and surgery.
Collapse
Affiliation(s)
- Jin-Li Wei
- Department of Thyroid and Breast Surgery, Clinical Medical College of Yangzhou University and Northern Jiangsu People's Hospital, Yangzhou, China.,Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jia-Xin Zhang
- Department of Thyroid and Breast Surgery, Clinical Medical College of Yangzhou University and Northern Jiangsu People's Hospital, Yangzhou, China
| | - De-Yuan Fu
- Department of Thyroid and Breast Surgery, Clinical Medical College of Yangzhou University and Northern Jiangsu People's Hospital, Yangzhou, China.
| |
Collapse
|
11
|
Özkurt E, Tükenmez M, Yılmaz R, Cabioğlu N, Müslümanoğlu M, Dinççağ AS, İğci A, Özmen V. Favorable Long-Term Outcome in Male Breast Cancer. Eur J Breast Health 2018; 14:180-185. [PMID: 30123885 DOI: 10.5152/ejbh.2018.3946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 03/03/2018] [Indexed: 11/22/2022]
Abstract
Objective Male breast cancer (MBC) is a rare type of cancer in the breast cancer series and in the male population. Data is usually extrapolated from female breast cancer (FBC) studies. We aim to study the clinicopathological characteristics and outcome of MBC patients at our institution and we aim to emphasize the differences compared with FBC. Materials and Methods Between January 1993 and April 2016, 56 male patients who were diagnosed as breast cancer and underwent surgical operation were retrospectively analyzed. Patients were evaluated for demographical characteristics, surgery type, clinicopathological characteristics, adjuvant and neoadjuvant treatments, follow-up time, overall survival (OS), disease free survival (DFS), and disease specific survival (DSS). Results The ratio of MBC among all breast cancers at our institution is 1%. The median age was 64 (34-85). Surgical procedures were modified radical mastectomy (MRM) in 41 patients (77%), simple mastectomy in 11 patients (21%), and lumpectomy in 1 patient (2%). Two patients were Stage 0 (4%), 7 were Stage 1 (13%), 12 were Stage 2 (22.6%), and 32 were Stage 3 (60.4%). Molecular subtypes of the invasive tumors were luminal A in 40 (80%), luminal B in 6 (12%), HER-2 type in 1 (2%), and basal-like in 3 (6%). Median follow-up time was 77 (3-287) months. 5-year and 10-year OS, DFS, and DSS rates were 80.7%, 96%, 95.6% and 71.6%, 81.9%, 91.7% respectively. Conclusion MBC presents different clinicopathological and prognostic factors when compared to FBC. Our survival rates are higher than the average presented in available literature. Because of the high rate of hormone receptor positivity, hormonal therapy is the mainstay for the treatment of estrogen receptor (ER)+ male breast cancer.
Collapse
Affiliation(s)
- Enver Özkurt
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey.,Department of Breast Surgical Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, USA
| | - Mustafa Tükenmez
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Ravza Yılmaz
- Department of Radiology, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Ahmet Said Dinççağ
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Abdullah İğci
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| |
Collapse
|
12
|
Kim BK, Oh SJ, Song JY, Lee HB, Park MH, Jung Y, Park WC, Lee J, Sun WY. Clinical Characteristics and Prognosis Associated with Multiple Primary Cancers in Breast Cancer Patients. J Breast Cancer 2018; 21:62-69. [PMID: 29628985 PMCID: PMC5880967 DOI: 10.4048/jbc.2018.21.1.62] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/15/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose Breast cancer is one of the most common malignancies worldwide and the second most common cancer among Korean women. The prognosis of breast cancer is poor in patients with other primary cancers. However, there have been few clinical studies regarding this issue. Therefore, we analyzed the characteristics and prognosis of patients with breast cancer with multiple primary cancers (MPCs). Methods Data from the Korean Breast Cancer Society Registry were analyzed. Data from enrolled patients who underwent surgery for breast cancer were analyzed for differences in prognosis dependent on the presence of MPCs, and which MPC characteristics affected their prognosis. Results Among the 41,841 patients analyzed, 913 patients were found to have MPCs, accounting for 950 total MPCs. There was a significant difference in survival rates between the breast cancer only group and the MPC group. The 5-year survival rates were 93.6% and 86.7% and the 10-year survival rates were 87.5% and 70.4%, respectively. Among the 913 patients with MPCs, patients with two or more MPCs had significantly worse prognoses than patients with a single MPC. With respect to the time interval between breast cancer and MPC occurrence, patients with a 5-year or greater interval had significantly better prognoses than patients with less than 1 year between occurrences. Among MPCs, thyroid cancer was the most common primary cancer. However, this type was not related to the prognosis of breast cancer. Gynecologic cancer, colorectal cancer, upper gastrointestinal cancer, and lung cancer were related to breast cancer prognosis. Conclusion MPCs were a poor prognostic factor for patients with breast cancer. Two or more MPCs and a shorter time interval between occurrences were worse prognostic factors. Although MPCs were a poor prognostic factor, thyroid cancer did not affect the prognosis of patients with breast cancer.
Collapse
Affiliation(s)
- Bong Kyun Kim
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jeong-Yoon Song
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Han-Byoel Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Min Ho Park
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Yongsik Jung
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Woo-Chan Park
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jina Lee
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Woo Young Sun
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | | |
Collapse
|
13
|
Rebaza LP, Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Calderon G, Dunstan J, la Cruz MD, Cotrina JM, Abugattas J, Guerra H, Villa-Robles MR, Poma N, Mejia O, Gomez HL. Androgen expression & clinicopathological features in male breast cancer. BREAST CANCER MANAGEMENT 2018. [DOI: 10.2217/bmt-2017-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To investigate prognostic features in male breast cancer (MBC). Methods: Clinicopathological information from 40 MBC patients was retrospectively reviewed. Androgen receptor (AR) and estrogen receptor (ER) were prospectively stained out in 22 cases and counted through software program analysis. Results: Median age was 65.5 years; most cases were Stage II (40%), Grade II (37.5%), ER ≥10% (72.5%) and PgR ≥10% (75%). AR >10% was found in 17 of 22 cases. Although AR expression was correlated with ER, there are some cells without coexpression. Axillary node involvement was associated with DFS (p = 0.001) and age (p = 0.002) was associated with overall survival. Conclusion: ER is expressed in most MBC cases and is correlated with AR. Axillary involvement and age were associated with survival.
Collapse
Affiliation(s)
- Lia P Rebaza
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
- Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima 15067, Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Luis A Bernabe
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Joselyn Sanchez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Gabriela Calderon
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Jorge Dunstan
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Miguel de la Cruz
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Jose M Cotrina
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Julio Abugattas
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Henry Guerra
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Maria R Villa-Robles
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Nathaly Poma
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Omar Mejia
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| |
Collapse
|
14
|
Epidemiology and survival outcome of breast cancer in a nationwide study. Oncotarget 2017; 8:16939-16950. [PMID: 28199975 PMCID: PMC5370012 DOI: 10.18632/oncotarget.15207] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/24/2017] [Indexed: 12/17/2022] Open
Abstract
Breast cancer is among the most prevalent cancers in Taiwan. The National Health Insurance database was used to identify patients with breast cancer and estimate the yearly prevalence and incidence of breast cancer between 1997 and 2013. Joinpoint regression analysis was used for the annual percentage change of incidence, prevalence, and survival outcome. Among 12,181,919 female beneficiaries in 2013, the prevalence was 834.37 per 100,000 persons (95% confidence interval, 829.28–839.45) and the incidence was 93.00 per 100,000 person-year (95% confidence interval, 91.27–94.73). The average annual percentage change of the age-standardized breast cancer incidence was 3.5 per 100,000 person-years (3.1–3.8; P < 0.05), suggesting an increase in breast cancer incidence over the study period. The 5-year mortality rate was 4.5% in 1997 and 4.4% in 2008. The 5-year mortality rate among patients with Charlson comorbidity index > 1 was 39.1% (19.2%–59.1%) in 1997 and 21.1% (15.7%-32.0%) in 2008, with an annual percentage change of –0.8 (–1.3 to 2.9), suggesting that the mortality rate was gradually decreasing in patients with comorbidities. In conclusion, 1 in 120 women in Taiwan has breast cancer and the incidence is rising, while the annual percentage change of breast cancer prevalence is decreasing. The mortality rate of breast cancer was essentially stable, but the 1-year, 2-year, and 5-year mortality rates in people with Charlson comorbidity index > 1 were declined.
Collapse
|
15
|
The Benefit of Pro Re Nata Antiemetics Provided With Guideline-Consistent Antiemetics in Delayed Nausea Control. Cancer Nurs 2017; 41:E49-E57. [PMID: 28418944 DOI: 10.1097/ncc.0000000000000484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Delayed nausea after chemotherapy remains a symptom of interest. Clinicians often provide additional and/or pro re nata (p.r.n.) antiemetics with guideline-consistent antiemetics in an attempt to achieve further symptom control. Whether the usage of additional and/or p.r.n. antiemetics provide added benefit remains as a question. OBJECTIVE The purpose of this study was to determine the benefit of providing additional antiemetics and/or p.r.n. antiemetics with guideline-consistent antiemetics in the control of nausea, functioning, and quality of life (QOL). METHODS A secondary data analysis of 143 breast cancer patients who received guideline-consistent antiemetics for anthracycline and cyclophosphamide chemotherapy was conducted. Instruments included vomiting frequency and nausea intensity items of the Multinational Association of Supportive Care in Cancer Antiemesis Tool and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. RESULTS Providing p.r.n. antiemetics alleviated the incidence of significant nausea (intensity, ≥3) in the delayed phase. The experience of nausea contributed to symptom incidence in the next phase and cycle. The intensity of delayed nausea demonstrated a moderate negative correlation with physical and role functioning and global health/QOL. CONCLUSION Providing patients with strategies to further control nausea (p.r.n. antiemetics) in addition to guideline-consistent antiemetics is recommended for practice. Because the nausea experience contributes to symptom incidence in the next phase and cycle and because the nausea intensity demonstrated a significant relationship with function and global health/QOL, proactive supportive approaches are strongly recommended. IMPLICATIONS FOR PRACTICE Delayed nausea control may be improved by adhering to guideline-consistent antiemetics and using p.r.n. antiemetics. Delayed nausea control would contribute to patients' functioning and QOL.
Collapse
|