Adjuvant radiotherapy in male breast cancer

Stranzl, Heidi; Mayer, Ramona; Quehenberger, Franz; Prettenhofer, Ulrike; Willfurth, Peter; Stöger, Herbert; Hackl, A.

doi:10.1016/s0167-8140(99)00122-x

Cited by 40 publications

(23 citation statements)

References 20 publications

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“…The retrospective data presented in this review suggests that adjuvant RT in MBC provides a LRC benefit, [34][35][36][37][40][41][42][43] as has been shown in women. Survival data in men are limited due to the small numbers and lack of long-term follow up.…”

Section: Discussionmentioning

confidence: 95%

“…40 In addition, an Austrian cohort of 31 men with stage I-III disease treated with adjuvant RT showed only a 3.2 % LF rate. 41 Data from Stanford also shows excellent control rates, with no isolated LF at 23 month in 22 men treated with adjuvant RT from 1960 to 2011. 42 Despite strong associations between PMRT and LRC, there remains a lack of evidence demonstrating survival benefit in men.…”

Section: Radiation Therapy In Male Breast Cancermentioning

confidence: 87%

“…An Austrian review of men who received adjuvant RT reported no cases of a second malignancy in the irradiated field, a maximum of grade II skin toxicity scored by the Radiation Therapy Oncology Group (RTOG)/EORTC grading system and no severe late complications. 41 Bratman et al 42 reported low toxicity rates with grade 1-2 dermatitis and fatigue, and Schuchardt et al 40 reported similar acute and late toxicity with a maximum of grade II dermatitis. 19,20 Both trials demonstrated equivalent LRC and lower patient-reported toxicity rates in the hypofractionated arms.…”

Section: Complicationsmentioning

confidence: 98%

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Radiation Therapy in Male Breast Cancer

Bagshaw¹,

Cloyd²,

Poppe³

et al. 2013

European Oncology &Amp; Haematology

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Male breast cancer (MBC) is a relatively rare disease and because the dedicated literature on MBC is limited, management typically follows guidelines established for female breast cancer (FBC). Although radiation therapy (RT) comprises a critical role in the treatment of MBC, several unique challenges influence its use. Most men with breast cancer present at an older age with more extensive and advanced stage disease than women. In contrast to the predominance of breast conservation therapy in women with breast cancer, the majority of men are treated with mastectomy, with or without post-mastectomy radiation. Although no prospective or randomised trials are available, retrospective data suggests that surgery followed by adjuvant RT significantly improves locoregional control (LRC) in men. This article reviews the utilisation, efficacy and complications associated with adjuvant RT in MBC. KeywordsMale breast cancer, radiotherapy, adjuvant, outcomes, locoregional control, survival cancer that influence the role of adjuvant radiotherapy (RT). Men are not screened for breast cancer and commonly present at an older age and higher stage than women, and are more likely to present with a palpable mass that is centrally located.2,3 Due to the location and the low volume of normal breast tissue in men, there is a high propensity for nipple, chest wall and nodal involvement 3,4 resulting in more advanced stage at diagnosis and possibly greater need for post-mastectomy radiation (PMRT).2 Based on data from randomised clinical trials, adjuvant RT improves locoregional control (LRC) following lumpectomy and radiation in many circumstances. [5][6][7][8] In this article, we review the literature associated with the role of adjuvant RT in MBC. Role of Radiation Therapy in Locoregional Control Post-mastectomy RadiotherapyIn the US, PMRT has traditionally been indicated in women with four or more positive lymph nodes, T3 tumours or stage III disease.9,10 Multiple randomised trials have demonstrated improvement in LRC and overall survival (OS) with the addition of PMRT (see Table 1 Breast Conservation TherapyBreast conservation therapy (BCT) is defined as partial mastectomy (e.g. lumpectomy, segmentectomy, quandrectomy) followed by RT with or without adjuvant hormonal or systemic chemotherapy. Since the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-04 trial demonstrated equivalent survival outcomes among women with breast cancer undergoing radical mastectomy, total mastectomy with PMRT or simple mastectomy with axillary node dissection (ALND), there has been a shift to less extensive surgery.6 NSABP B-06 compared

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Section: Discussionmentioning

confidence: 95%

Section: Radiation Therapy In Male Breast Cancermentioning

confidence: 87%

Section: Complicationsmentioning

confidence: 98%

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Radiation Therapy in Male Breast Cancer

Bagshaw¹,

Cloyd²,

Poppe³

et al. 2013

European Oncology &Amp; Haematology

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“…In the literature the size of the analysed groups ranges from 31 to 118 patients, studied over a periods from 14 to 47 years [15,16,20,21,27,28,29,31,33]. The number of male patients treated for breast carcinoma at the Institute of Oncology in Cracow is similar.…”

Section: Discussionmentioning

confidence: 99%

“…According to Nilsson et al, mastectomy is performed in 92% of male patients and 44% of female patients [28]. The adjuvant treatment employed in such cases (radiotherapy, chemotherapy, hormone therapy) depends on the presence of prognostic and predictive features, which are indications for this type of treatment [5,6,12,15,16,23,25,26,28,29,30,31].…”

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confidence: 99%

The biological markers and results of treatment in male breast cancer patients. The Cracow experience.

Sas-Korczyńska¹,

Niemiec²,

Harazin-Lechowska³

et al. 2014

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Male breast cancer is a rare form of carcinoma with an incidence rate of approximately 0.5-1% compared with cases of breast carcinoma as a whole. Male breast cancer reacts effectively to endocrine therapy because of a high frequency of hormone receptor expression.The aim of the present study was the assessment of correlations between stage, grade, expression of steroid receptors, basal/mesenchymal markers and proliferation index, as well as analysis of the impact of the above-mentioned parameters on overall (OS) and disease-free survival (DFS) in the group of 32 male breast cancer patients, treated at the Centre of Oncology in Cracow.We showed the significant positive correlation between MIB-1 LI and tumor stage, and hormone receptors (ER or PgR) immunonegativity, and expression of EGFR, vimentin (p<0.05) and P-cadherin (the last at statistical border). The presence of any of basal or masenchymal markers correlated with a more advanced tumor stage. Moreover tumors without vimentin expression were characterised by lower MIB-1 LI and were more frequently EGFR immunonegative.We found that hormone receptor negativity, vimentin immunopositivity and high MIB-1 LI are significant independent indicators of poor OS and DFS for male breast cancer patients (p<0.05). Key words: male breast cancer, basal markers, mesenchymal markers, nodal status, hormonal receptorsMale breast cancer is a rare form of carcinoma with an incidence rate of approximately 0.5-1% compared with cases of breast carcinoma as a whole [1,2,3,4]. Its peak incidence is noted in the seventh decade of life [5,6,7]. The most significant risk factors are an increased concentration of estrogen and obesity, that are a result of estrogen overproduction, impaired metabolism, and disturbances in the concentration of estrogen and androgen (i.e. in Klinefelter's syndrome) as well as the use of estrogenes in prostate cancer treatment [6,8,9,10,11]. Other factors include alcoholism, liver cirrhosis, the presence of hereditary BRCA1 and BRCA2 gene mutations and exposure to ionizing radiation, the electromagnetic field and increased temperature [6,8,9,12,13,14,15,16,17].According to Anderson et al., male breast cancer is characterised by similar biological factors to those present in the female variant of the cancer [18]. However, these tumors are diagnosed in more advanced stages of the disease, are characterised by higher degree of differentiation (more frequently G1, G2 grade) and a lower mitotic index in comparison to female breast cancer [5,19]. There are also differences in the frequency of the expression of hormone receptors and growth factor receptors [19,20]. Besides, the prognosis for male breast cancer is worse [5,18,20,21]. A study by Baojiang et al. of 5-year survival rates of patients suffering from male breast carcinoma and female breast carcinoma produced the following results: 61.2% and 68.7% (DFS), and 75.% and 82.9% (OS), respectively [20].Male breast cancer has a higher (over 90%) hormone receptor expression and, as a consequence, reacts more effect...

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Non-homogeneous Markov Processes for Biomedical Data Analysis

Ocañ-Riola

2005

Biom. J.

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Some time ago, the Markov processes were introduced in biomedical sciences in order to study disease history events. Homogeneous and Non-homogeneous Markov processes are an important field of research into stochastic processes, especially when exact transition times are unknown and interval-censored observations are present in the analysis. Non-homogeneous Markov process should be used when the homogeneous assumption is too strong. However these sorts of models increase the complexity of the analysis and standard software is limited. In this paper, some methods for fitting non-homogeneous Markov models are reviewed and an algorithm is proposed for biomedical data analysis. The method has been applied to analyse breast cancer data. Specific software for this purpose has been implemented.

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Adjuvant radiotherapy in male breast cancer

Cited by 40 publications

References 20 publications

Radiation Therapy in Male Breast Cancer

Radiation Therapy in Male Breast Cancer

The biological markers and results of treatment in male breast cancer patients. The Cracow experience.

Non-homogeneous Markov Processes for Biomedical Data Analysis

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