The results of the just concluded EORTC10085/TBCRC/BIG/NABCG International Male Breast Cancer Program has shown that male breast cancer victims have a higher survival rate than women breast cancer victims. The program was held both in Europe and here in the United States with results announced at the 2014 San Antonio Breast Cancer Symposium. The research, which lasted for two decades, starting in 1990 and ending in 2010, included 1822 men cancer victims. They all received cancer treatment which furnished important data regarding the clinical components and biological attributes of breast cancer in men.
Dr. Fatima Cardoso of the Champalimaud Clinical Center in Lisbon was the coordinator of this project. She had this to say: “This study aims to characterize the biology of this rare disease; only with this crucial knowledge will men with breast cancer be properly treated in the future, which will definitely improve both their survival and quality of life”.
Breast cancer constitutes less than 1% of all cancers involving men. However, male breast cancer has a higher prevalence in Africa with both Zambia and Uganda at 15% and 5%, respectively. Breast cancer may not be as common in men as it is in women, but it is more fatal. In 2013 there were only 2,240 diagnosed male breast cancer patients in the United States but had 410 attributed deaths to it, which is a mortality rate of 18.30%. Quite high.
Male breast cancer remains an enigma even now. Male breast cancer treatment patterns are modeled after female treatments but the distinction between the two has yet to be differentiated. Large scale research is needed to separate the two. Even case studies for male breast cancer were done in small scales until this study took place. Clinical analysis was virtually nonexistent, the result of which was the discontinuation of all clinical activities due to inadequate results.
It’s highly fortunate that the Translational Breast Cancer Research Consortium or TBCRC, North American Breast Cancer Groups or NABCG, EORTC, and the Breast International Group or BIG made this International Program on Male Breast Cancer possible. The conclusion was that male breast cancer is different from women’s breast cancer with one of the findings being that male breast cancer patients lack the proper attention to properly deal with it compared to women cancer patients. It was discovered that out of 100 patients, only 77 received the required medicine Tamoxifen, the required medication for all estrogen receptor patients. Another finding which was the subjecting of male cancer patients to mastectomies, which should not be the case since cancer in men is usually detected much earlier. Instead of undergoing only breast-conserving surgery, 96% of the patients underwent mastectomies. This had a profound social and psychological effect on the patients.
Clinical studies showed that during this research study, male breast cancer is 99% ER or estrogen receptor positive. Only 7% were diagnosed with human epidermal growth factor receptor 2 or HER2 positive. To this end, only 1% do not manifest the genes for ER, progesterone receptor or PR, or HER-2. This is considered a triple negative and therefore does react to hormonal or anti-HER-2 treatments. In women, ER positives comprised about 70% of the cancer victims, HR-2 were 20%, and only about 10 to 15% percent were considered triple negative.
Other discoveries was the most common histological type carcinoma is the grade 2 invasive ductal carcinomas. Male breast cancers are mostly androgen receptor positive and belong to the subtype known as luminal A- like or 7% HER2 positive & 1% TNBC. Preferred medications are adjuvant radiotherapy, for adjuvant chemotherapy it should be anthracyclines, and after loco-regional therapy, Tamoxifen for hormonal therapy should come next.
The breast cancer program is now in its second phase. Male breast cancers participants from international origins will receive treatments from selected institutes for 30 months. Collection of clinical data is an integral part of the program. There are participants who will be included in the future clinical testing and evaluation, detailed care methods will be recorded, and sample collection will be a part of the program in countries to be chosen later. Utilizing the EORTC QLQ-30 questionnaire, including those from the BR-23 and PR-25, questionnaires will also be a component of the program.
The opening of the planned random clinical testing is now under discussion. It’s the initial program for the coming third segment of the International Male Breast Cancer Program.
The EORTC 10085 Male BC research was done in cooperation with the EORTC Breast Cancer Group, the Breast Cancer Research Foundation, the EBCC Council, the Swedish Breast Cancer Association (BRO), the Dutch Pink Ribbon, and the Susan G. Komen For the Cure.
This information was produced by the European Organization for Research and Treatment of Cancer.