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Erschienen in:
01.12.2012 | Original Research
A population-based study of the impact of post-mastectomy radiation on survival for male breast cancer
Erschienen in: Journal of Radiation Oncology | Ausgabe 4/2012
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Objective
The role of post-mastectomy radiation therapy (PMRT) for male breast cancer (MBC) is not well defined. Because of the rarity of male breast cancer, large randomized clinical trials are not possible.
Methods
Using the Surveillance Epidemiology and End Results database, we identified MBC patients diagnosed between 1988 and 2007 and treated with mastectomy and axillary lymph node dissection. Risk groups were broadly assigned based on the female breast cancer literature: low risk (LR; T1-2N0), intermediate risk (IR; T1-2N1), and high risk (HR; T3-4N0-3, T1-2N2-3). Kaplan–Meier and Cox regression analyses were used to compare overall survival (OS) and breast-cancer-specific survival (BCSS) for all patients.
Results
We identified 2,382 patients who met the selection criteria, of whom 1,888 (79.3 %) received mastectomy alone and 494 (20.7 %) received mastectomy followed by PMRT. For patients with LR disease there were no differences in OS or BCSS. For IR disease, there were no differences in OS but BCSS was worse for those who received PMRT (p = 0.008). For the HR group, median survival and 5-year OS was 72 months and 56.3 % for those who underwent surgery alone and 99 months and 67.4 % for those receiving PMRT respectively (p = 0.002). However, there was no difference in BCSS between the two groups (p = 0.52).
Conclusion
In this large population-based study, there is a significant OS benefit without any change in BCSS associated with PMRT for MBC patients with HR disease. Further prospective studies are needed to confirm and validate these findings.