Top

Annals of Surgical Oncology

Published in:

01-10-2020 | Breast Cancer | Breast Oncology

Utility of Oncotype DX in Male Breast Cancer Patients and Impact on Chemotherapy Administration: A Comparative Study with Female Patients

Authors: Austin D. Williams, MD, MSEd, Christopher M. McGreevy, MD, Julia C. Tchou, MD, FACS, Lucy M. De La Cruz, MD

Published in: Annals of Surgical Oncology | Issue 10/2020

Abstract

Background

Use of the Oncotype DX recurrence score (RS) has been widely adopted in women with early-stage hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER−) breast cancer (BC). Validation studies on the use of RS in male BC (MBC) are lacking.

Objective

The aim of this study was to identify the utilization of RS and association with chemotherapy recommendations in early-stage MBC compared with female BC (FBC).

Methods

Using the National Cancer Database (NCDB), a retrospective review was performed for patients with T1/T2, node-negative, HR+/HER2− BC between 2010 and 2014. Patients were stratified by demographics, tumor characteristics, RS, and chemotherapy use comparing MBC with FBC over the allotted time period.

Results

A total of 358,497 patients—3068 (0.8%) males and 355,429 (99.1%) females—met the inclusion criteria. A smaller proportion of MBC patients received RS testing compared with FBC patients (32% vs. 35%, p < 0.001). Male patients who had RS were younger, had T2 tumors, lymphovascular invasion, and private insurance. The distribution of RS was similar in both groups. Only 4% of MBC patients with low RS received adjuvant chemotherapy, compared with 4.9% of FBC patients. Overall chemotherapy rates were similar in MBC and FBC patients.

Conclusions

Our results showed that RS has not been completely embraced in the management of MBC, although when performed in MBC, chemotherapy recommendations vary based on RS. Whether the use of RS affects the clinical outcomes of MBC is unknown. A prospective registry would help clarify and evaluate the impact of RS on clinical outcomes in MBC.

Available only for authorised users

Key Statistics for Breast Cancer in Men. https://www.cancer.org/cancer/breast-cancer-in-men/about/key-statistics.html. Accessed 21 Oct 2019.

Gradishar WJ, Abraham J, Aft R, et al. NCCN breast cancer guidelines version 3.2019. 2019. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed 21 Oct 2019.

Muir D, Kanthan R, Kanthan SC. Male versus female breast cancers: a population-based comparative immunohistochemical analysis. Arch Pathol Lab Med. 2003;127(1):36–41. https://doi.org/10.1043/0003-9985(2003)127%3c36:mvfb%3e2.0.co;2.CrossRefPubMed

Shaaban AM, Ball GR, Brannan RA, et al. A comparative biomarker study of 514 matched cases of male and female breast cancer reveals gender-specific biological differences. Breast Cancer Res Treat. 2012;133(3):949–58. https://doi.org/10.1007/s10549-011-1856-9.CrossRefPubMed

Fentiman IS. The biology of male breast cancer. Breast. 2018;38:132–5. https://doi.org/10.1016/j.breast.2018.01.001.CrossRefPubMed

Paik S, Shak S, Tang G, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004;351(27):2817–26. https://doi.org/10.1056/nejmoa041588.CrossRefPubMed

Paik S, Tang G, Shak S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24(23):3726–34. https://doi.org/10.1200/jco.2005.04.7985.CrossRefPubMed

Albain KS, Barlow WE, Shak S, et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol. 2010;11(1):55–65. https://doi.org/10.1016/s1470-2045(09)70314-6.CrossRefPubMed

Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med. 2018;379(2):111–21. https://doi.org/10.1056/nejmoa1804710.CrossRefPubMedPubMedCentral

10.

Boffa DJ, Rosen JE, Mallin K, et al. Using the national cancer database for outcomes research: a review. JAMA Oncol. 2017;3(12):1722–8. https://doi.org/10.1001/jamaoncol.2016.6905.CrossRefPubMed

11.

Goss PE, Reid C, Pintilie M, Lim R, Miller N. Male breast carcinoma: a review of 229 patients who presented to the Princess Margaret Hospital during 40 years: 1955-1996. Cancer. 1999;85(3):629–39. https://doi.org/10.1002/(sici)1097-0142(19990201)85:3%3c629::aid-cncr13%3e3.0.co;2-v.CrossRefPubMed

12.

Cardoso F, Bartlett JMS, Slaets L, et al. Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Ann Oncol. 2018;29(2):405–17. https://doi.org/10.1093/annonc/mdx651.CrossRefPubMed

13.

Cronin PA, Romanoff A, Zabor EC, et al. Influence of age on the clinical outcome of breast cancer for men and the development of second primary cancers. Ann Surg Oncol. 2018;25(13):3858–66. https://doi.org/10.1245/s10434-018-6767-0.CrossRefPubMedPubMedCentral

14.

Grenader T, Yerushalmi R, Tokar M, et al. The 21-gene recurrence score assay (Oncotype DX™) in estrogen receptor-positive male breast cancer: experience in an Israeli cohort. Oncology. 2014;87(1):1–6. https://doi.org/10.1159/000360793.CrossRefPubMed

15.

Speirs V, Shaaban AM. The rising incidence of male breast cancer. Breast Cancer Res Treat. 2009;115(2):429–30. https://doi.org/10.1007/s10549-008-0053-y.CrossRefPubMed

16.

Yadav S, Karam D, Bin Riaz I, et al. Male breast cancer in the United States: treatment patterns and prognostic factors in the 21st century. Cancer. 2020;126(1):26–36. https://doi.org/10.1002/cncr.32472.CrossRefPubMed

Title: Utility of Oncotype DX in Male Breast Cancer Patients and Impact on Chemotherapy Administration: A Comparative Study with Female Patients
Authors: Austin D. Williams, MD, MSEd
Christopher M. McGreevy, MD
Julia C. Tchou, MD, FACS
Lucy M. De La Cruz, MD
Publication date: 01-10-2020
Publisher: Springer International Publishing
Keywords: Breast Cancer
Breast Cancer
Cytostatic Therapy
Published in: Annals of Surgical Oncology / Issue 10/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-020-08473-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Utility of Oncotype DX in Male Breast Cancer Patients and Impact on Chemotherapy Administration: A Comparative Study with Female Patients

Abstract

Background

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 10/2020

ASO Author Reflections: Elevated Preoperative Specific Growth Rate is Associated with Shortened Survival After Resection for Pancreatic Neuroendocrine Tumors

Indocyanine Green-Enhanced Fluorescence in Laparoscopic Duodenum-Preserving Pancreatic Head Resection: Technique with Video

Timing Is Everything: Could Surveillance Imaging Intensity Influence Survival in High-Risk Melanoma?

To Perform an Axillary Lymph Node Dissection or Not? That Is (Still) the Question

Circulating PD-1 mRNA in Peripheral Blood is a Potential Biomarker for Predicting Survival of Breast Cancer Patients

The Landmark Series: Multimodality Treatment of Extremity Sarcoma