Characterization of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program

F. Cardoso, J. M.S. Bartlett, L. Slaets, C. H.M. van Deurzen, E. van Leeuwen-Stok, P. Porter, B. Linderholm, I. Hedenfalk, C. Schröder, J. Martens, J. Bayani, C. van Asperen, M. Murray, C. Hudis, L. Middleton, J. Vermeij, K. Punie, J. Fraser, M. Nowaczyk, I. T. RubioS. Aebi, C. Kelly, Kathryn J Ruddy, E. Winer, C. Nilsson, L. Dal Lago, L. Korde, K. Benstead, O. Bogler, T. Goulioti, A. Peric, S. Litière, K. C. Aalders, C. Poncet, K. Tryfonidis, S. H. Giordano

Research output: Contribution to journalArticle

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Abstract

Background: Male breast cancer (BC) is rare, managed by extrapolation from female BC. The International Male BC Program aims to better characterize and manage this disease. We report the results of part I, a retrospective joint analysis of cases diagnosed during a 20-year period. Methods: Patients with follow-up and tumor samples, treated between 1990 and 2010, in 93 centers/9 countries. Samples were centrally analyzed in three laboratories (the United Kingdom, the Netherlands and the United States). Results: Of 1822 patients enrolled, 1483 were analyzed; 63.5% were diagnosed between 2001 and 2010, 57 (5.1%) had metastatic disease (M1). Median age at diagnosis: 68.4 years. Of 1054 M0 cases, 56.2% were node-negative (N0) and 48.5% had T1 tumors; 4% had breast conserving surgery (BCS), 18% sentinel lymph-node biopsy; half received adjuvant radiotherapy; 29.8% (neo)adjuvant chemotherapy and 76.8% adjuvant endocrine therapy (ET), mostly tamoxifen (88.4%). Per central pathology, for M0 tumors: 84.8% ductal invasive carcinomas, 51.5% grade 2; 99.3% estrogen receptor (ER)-positive; 81.9% progesterone receptor (PR)-positive; 96.9% androgen receptor (AR)-positive [ER, PR or AR Allred score ≥ 3]; 61.1% Ki67 expression low (<14% positive cells); using immunohistochemistry (IHC) surrogates, 41.9% were Luminal-A-like, 48.6% Luminal-B-like/HER-2-negative, 8.7% HER-2-positive, 0.3% triple negative. Median follow-up: 8.2 years (0.0-23.8) for all, 7.2 years (0.0-23.2), for M0, 2.6 years (0.0-12.7) for M1 patients. A significant improvement over time was observed in age-corrected BC mortality. BC-specific-mortality was higher for men younger than 50 years. Better overall (OS) and recurrence-free survival (RFS) were observed for highly ER+(P=0.001), highly PR+(P=0.002), highly AR+ disease (P=0.019). There was no association between OS/RFS and HER-2 status, Ki67, IHC subtypes nor grade. Conclusions: Male BC is usually ER, PR and AR-positive, Luminal B-like/HER2-negative. Of note, 56% patients had T1 tumors but only 4% had BCS. ER was highly positive in > 90% of cases but only 77% received adjuvant ET. ER, PR and AR were associated with OS and RFS, whereas grade, Ki67 and IHC surrogates were not. Significant improvement in survival over time was observed.

Original languageEnglish (US)
Pages (from-to)405-417
Number of pages13
JournalAnnals of Oncology
Volume29
Issue number2
DOIs
StatePublished - Feb 1 2018

Fingerprint

Male Breast Neoplasms
Androgen Receptors
Progesterone Receptors
Estrogen Receptors
Sentinel Lymph Node Biopsy
Neoplasms
Ductal Carcinoma
Adjuvant Radiotherapy
Segmental Mastectomy
Tamoxifen
Adjuvant Chemotherapy
Netherlands
Pathology
Breast Neoplasms
Survival
Therapeutics

Keywords

  • Clinical and biological characteristics
  • Consortium
  • Male breast cancer
  • Retrospective analysis

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Cardoso, F., Bartlett, J. M. S., Slaets, L., van Deurzen, C. H. M., van Leeuwen-Stok, E., Porter, P., ... Giordano, S. H. (2018). Characterization of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Annals of Oncology, 29(2), 405-417. https://doi.org/10.1093/annonc/mdx651

Characterization of male breast cancer : Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. / Cardoso, F.; Bartlett, J. M.S.; Slaets, L.; van Deurzen, C. H.M.; van Leeuwen-Stok, E.; Porter, P.; Linderholm, B.; Hedenfalk, I.; Schröder, C.; Martens, J.; Bayani, J.; van Asperen, C.; Murray, M.; Hudis, C.; Middleton, L.; Vermeij, J.; Punie, K.; Fraser, J.; Nowaczyk, M.; Rubio, I. T.; Aebi, S.; Kelly, C.; Ruddy, Kathryn J; Winer, E.; Nilsson, C.; Dal Lago, L.; Korde, L.; Benstead, K.; Bogler, O.; Goulioti, T.; Peric, A.; Litière, S.; Aalders, K. C.; Poncet, C.; Tryfonidis, K.; Giordano, S. H.

In: Annals of Oncology, Vol. 29, No. 2, 01.02.2018, p. 405-417.

Research output: Contribution to journalArticle

Cardoso, F, Bartlett, JMS, Slaets, L, van Deurzen, CHM, van Leeuwen-Stok, E, Porter, P, Linderholm, B, Hedenfalk, I, Schröder, C, Martens, J, Bayani, J, van Asperen, C, Murray, M, Hudis, C, Middleton, L, Vermeij, J, Punie, K, Fraser, J, Nowaczyk, M, Rubio, IT, Aebi, S, Kelly, C, Ruddy, KJ, Winer, E, Nilsson, C, Dal Lago, L, Korde, L, Benstead, K, Bogler, O, Goulioti, T, Peric, A, Litière, S, Aalders, KC, Poncet, C, Tryfonidis, K & Giordano, SH 2018, 'Characterization of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program', Annals of Oncology, vol. 29, no. 2, pp. 405-417. https://doi.org/10.1093/annonc/mdx651
Cardoso, F. ; Bartlett, J. M.S. ; Slaets, L. ; van Deurzen, C. H.M. ; van Leeuwen-Stok, E. ; Porter, P. ; Linderholm, B. ; Hedenfalk, I. ; Schröder, C. ; Martens, J. ; Bayani, J. ; van Asperen, C. ; Murray, M. ; Hudis, C. ; Middleton, L. ; Vermeij, J. ; Punie, K. ; Fraser, J. ; Nowaczyk, M. ; Rubio, I. T. ; Aebi, S. ; Kelly, C. ; Ruddy, Kathryn J ; Winer, E. ; Nilsson, C. ; Dal Lago, L. ; Korde, L. ; Benstead, K. ; Bogler, O. ; Goulioti, T. ; Peric, A. ; Litière, S. ; Aalders, K. C. ; Poncet, C. ; Tryfonidis, K. ; Giordano, S. H. / Characterization of male breast cancer : Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. In: Annals of Oncology. 2018 ; Vol. 29, No. 2. pp. 405-417.
@article{248a2d4f46ed49959aa4b269d8db7bb5,
title = "Characterization of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program",
abstract = "Background: Male breast cancer (BC) is rare, managed by extrapolation from female BC. The International Male BC Program aims to better characterize and manage this disease. We report the results of part I, a retrospective joint analysis of cases diagnosed during a 20-year period. Methods: Patients with follow-up and tumor samples, treated between 1990 and 2010, in 93 centers/9 countries. Samples were centrally analyzed in three laboratories (the United Kingdom, the Netherlands and the United States). Results: Of 1822 patients enrolled, 1483 were analyzed; 63.5{\%} were diagnosed between 2001 and 2010, 57 (5.1{\%}) had metastatic disease (M1). Median age at diagnosis: 68.4 years. Of 1054 M0 cases, 56.2{\%} were node-negative (N0) and 48.5{\%} had T1 tumors; 4{\%} had breast conserving surgery (BCS), 18{\%} sentinel lymph-node biopsy; half received adjuvant radiotherapy; 29.8{\%} (neo)adjuvant chemotherapy and 76.8{\%} adjuvant endocrine therapy (ET), mostly tamoxifen (88.4{\%}). Per central pathology, for M0 tumors: 84.8{\%} ductal invasive carcinomas, 51.5{\%} grade 2; 99.3{\%} estrogen receptor (ER)-positive; 81.9{\%} progesterone receptor (PR)-positive; 96.9{\%} androgen receptor (AR)-positive [ER, PR or AR Allred score ≥ 3]; 61.1{\%} Ki67 expression low (<14{\%} positive cells); using immunohistochemistry (IHC) surrogates, 41.9{\%} were Luminal-A-like, 48.6{\%} Luminal-B-like/HER-2-negative, 8.7{\%} HER-2-positive, 0.3{\%} triple negative. Median follow-up: 8.2 years (0.0-23.8) for all, 7.2 years (0.0-23.2), for M0, 2.6 years (0.0-12.7) for M1 patients. A significant improvement over time was observed in age-corrected BC mortality. BC-specific-mortality was higher for men younger than 50 years. Better overall (OS) and recurrence-free survival (RFS) were observed for highly ER+(P=0.001), highly PR+(P=0.002), highly AR+ disease (P=0.019). There was no association between OS/RFS and HER-2 status, Ki67, IHC subtypes nor grade. Conclusions: Male BC is usually ER, PR and AR-positive, Luminal B-like/HER2-negative. Of note, 56{\%} patients had T1 tumors but only 4{\%} had BCS. ER was highly positive in > 90{\%} of cases but only 77{\%} received adjuvant ET. ER, PR and AR were associated with OS and RFS, whereas grade, Ki67 and IHC surrogates were not. Significant improvement in survival over time was observed.",
keywords = "Clinical and biological characteristics, Consortium, Male breast cancer, Retrospective analysis",
author = "F. Cardoso and Bartlett, {J. M.S.} and L. Slaets and {van Deurzen}, {C. H.M.} and {van Leeuwen-Stok}, E. and P. Porter and B. Linderholm and I. Hedenfalk and C. Schr{\"o}der and J. Martens and J. Bayani and {van Asperen}, C. and M. Murray and C. Hudis and L. Middleton and J. Vermeij and K. Punie and J. Fraser and M. Nowaczyk and Rubio, {I. T.} and S. Aebi and C. Kelly and Ruddy, {Kathryn J} and E. Winer and C. Nilsson and {Dal Lago}, L. and L. Korde and K. Benstead and O. Bogler and T. Goulioti and A. Peric and S. Liti{\`e}re and Aalders, {K. C.} and C. Poncet and K. Tryfonidis and Giordano, {S. H.}",
year = "2018",
month = "2",
day = "1",
doi = "10.1093/annonc/mdx651",
language = "English (US)",
volume = "29",
pages = "405--417",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Characterization of male breast cancer

T2 - Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program

AU - Cardoso, F.

AU - Bartlett, J. M.S.

AU - Slaets, L.

AU - van Deurzen, C. H.M.

AU - van Leeuwen-Stok, E.

AU - Porter, P.

AU - Linderholm, B.

AU - Hedenfalk, I.

AU - Schröder, C.

AU - Martens, J.

AU - Bayani, J.

AU - van Asperen, C.

AU - Murray, M.

AU - Hudis, C.

AU - Middleton, L.

AU - Vermeij, J.

AU - Punie, K.

AU - Fraser, J.

AU - Nowaczyk, M.

AU - Rubio, I. T.

AU - Aebi, S.

AU - Kelly, C.

AU - Ruddy, Kathryn J

AU - Winer, E.

AU - Nilsson, C.

AU - Dal Lago, L.

AU - Korde, L.

AU - Benstead, K.

AU - Bogler, O.

AU - Goulioti, T.

AU - Peric, A.

AU - Litière, S.

AU - Aalders, K. C.

AU - Poncet, C.

AU - Tryfonidis, K.

AU - Giordano, S. H.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: Male breast cancer (BC) is rare, managed by extrapolation from female BC. The International Male BC Program aims to better characterize and manage this disease. We report the results of part I, a retrospective joint analysis of cases diagnosed during a 20-year period. Methods: Patients with follow-up and tumor samples, treated between 1990 and 2010, in 93 centers/9 countries. Samples were centrally analyzed in three laboratories (the United Kingdom, the Netherlands and the United States). Results: Of 1822 patients enrolled, 1483 were analyzed; 63.5% were diagnosed between 2001 and 2010, 57 (5.1%) had metastatic disease (M1). Median age at diagnosis: 68.4 years. Of 1054 M0 cases, 56.2% were node-negative (N0) and 48.5% had T1 tumors; 4% had breast conserving surgery (BCS), 18% sentinel lymph-node biopsy; half received adjuvant radiotherapy; 29.8% (neo)adjuvant chemotherapy and 76.8% adjuvant endocrine therapy (ET), mostly tamoxifen (88.4%). Per central pathology, for M0 tumors: 84.8% ductal invasive carcinomas, 51.5% grade 2; 99.3% estrogen receptor (ER)-positive; 81.9% progesterone receptor (PR)-positive; 96.9% androgen receptor (AR)-positive [ER, PR or AR Allred score ≥ 3]; 61.1% Ki67 expression low (<14% positive cells); using immunohistochemistry (IHC) surrogates, 41.9% were Luminal-A-like, 48.6% Luminal-B-like/HER-2-negative, 8.7% HER-2-positive, 0.3% triple negative. Median follow-up: 8.2 years (0.0-23.8) for all, 7.2 years (0.0-23.2), for M0, 2.6 years (0.0-12.7) for M1 patients. A significant improvement over time was observed in age-corrected BC mortality. BC-specific-mortality was higher for men younger than 50 years. Better overall (OS) and recurrence-free survival (RFS) were observed for highly ER+(P=0.001), highly PR+(P=0.002), highly AR+ disease (P=0.019). There was no association between OS/RFS and HER-2 status, Ki67, IHC subtypes nor grade. Conclusions: Male BC is usually ER, PR and AR-positive, Luminal B-like/HER2-negative. Of note, 56% patients had T1 tumors but only 4% had BCS. ER was highly positive in > 90% of cases but only 77% received adjuvant ET. ER, PR and AR were associated with OS and RFS, whereas grade, Ki67 and IHC surrogates were not. Significant improvement in survival over time was observed.

AB - Background: Male breast cancer (BC) is rare, managed by extrapolation from female BC. The International Male BC Program aims to better characterize and manage this disease. We report the results of part I, a retrospective joint analysis of cases diagnosed during a 20-year period. Methods: Patients with follow-up and tumor samples, treated between 1990 and 2010, in 93 centers/9 countries. Samples were centrally analyzed in three laboratories (the United Kingdom, the Netherlands and the United States). Results: Of 1822 patients enrolled, 1483 were analyzed; 63.5% were diagnosed between 2001 and 2010, 57 (5.1%) had metastatic disease (M1). Median age at diagnosis: 68.4 years. Of 1054 M0 cases, 56.2% were node-negative (N0) and 48.5% had T1 tumors; 4% had breast conserving surgery (BCS), 18% sentinel lymph-node biopsy; half received adjuvant radiotherapy; 29.8% (neo)adjuvant chemotherapy and 76.8% adjuvant endocrine therapy (ET), mostly tamoxifen (88.4%). Per central pathology, for M0 tumors: 84.8% ductal invasive carcinomas, 51.5% grade 2; 99.3% estrogen receptor (ER)-positive; 81.9% progesterone receptor (PR)-positive; 96.9% androgen receptor (AR)-positive [ER, PR or AR Allred score ≥ 3]; 61.1% Ki67 expression low (<14% positive cells); using immunohistochemistry (IHC) surrogates, 41.9% were Luminal-A-like, 48.6% Luminal-B-like/HER-2-negative, 8.7% HER-2-positive, 0.3% triple negative. Median follow-up: 8.2 years (0.0-23.8) for all, 7.2 years (0.0-23.2), for M0, 2.6 years (0.0-12.7) for M1 patients. A significant improvement over time was observed in age-corrected BC mortality. BC-specific-mortality was higher for men younger than 50 years. Better overall (OS) and recurrence-free survival (RFS) were observed for highly ER+(P=0.001), highly PR+(P=0.002), highly AR+ disease (P=0.019). There was no association between OS/RFS and HER-2 status, Ki67, IHC subtypes nor grade. Conclusions: Male BC is usually ER, PR and AR-positive, Luminal B-like/HER2-negative. Of note, 56% patients had T1 tumors but only 4% had BCS. ER was highly positive in > 90% of cases but only 77% received adjuvant ET. ER, PR and AR were associated with OS and RFS, whereas grade, Ki67 and IHC surrogates were not. Significant improvement in survival over time was observed.

KW - Clinical and biological characteristics

KW - Consortium

KW - Male breast cancer

KW - Retrospective analysis

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