RSNA 2005 

Abstract Archives of the RSNA, 2005


Localized Therapy for Male Breast Cancer: Functional Advantages and Comparable Outcomes with Breast Conservation

Scientific Papers

Presented on November 30, 2005
Presented as part of SSK25: Radiation Oncology and Radiobiology (Breast Cancer)

 Trainee Research Prize - Medical Student


Shannon Fogh, Presenter: Nothing to Disclose


Purpose/Objective: Male breast cancer (MBC) accounts for approximately 1% of all breast cancers. Given the rarity of this disease, treatment of male breast cancer generally follows the same principles as treatment of female breast cancer. However, the traditional surgical approach for male breast cancer is modified radical mastectomy (MRM) instead of breast conservation surgery, given the relative lack of breast tissue and the central location of most male breast tumors. The purpose of this study was to examine the feasibility of breast conservation therapy as an alternative to MRM for male breast cancer, with respect to musculoskeletal functionality and treatment outcome. Materials/Methods: A retrospective analysis was undertaken of all male patients with breast cancer who presented to Massachusetts General Hospital or Boston University Medical Center for localized therapy from 1990 to 2003. Musculoskeletal functionality (tissue fibrosis, arm edema and range of motion) and treatment outcome (local-regional control and disease-free survival) were evaluated. Functional outcomes were assessed via multidisciplinary review of patient follow-up visits, and were scored as either 'good-excellent' or 'fair-poor' to account for subjectivity among different clinicians. Results: Forty-five patients with MBC who underwent surgery were identified; 6 of these patients also presented with distant metastatic disease and were excluded from this analysis. Of the 39 patients with localized breast cancer, 31 underwent MRM (1 Stage 0, 8 stage I, 19 stage II, 3 stage III) and 8 underwent lumpectomy (1 Stage 0, 3 stage I, 4 stage II, 0 stage III). Adjuvant radiation therapy (RT) was administered in 12/31 MRM patients (chest wall and axilla in 8; chest wall alone in 4), and in 3/8 lumpectomy patients (breast RT alone). Median follow-up from the time of surgery was 48 months in the mastectomy group and 36 months in the lumpectomy group (overall range: 12 to 144 months). Actuarial overall 1-year 'fair-poor' documented tissue fibrosis, arm edema and decreased range of motion rates were 13% (4 patients), 19% (6 patients) and 26% (8 patients) for MRM patients vs. 13% (1 patient), 0% and 0% for all patients receiving lumpectomy, with 3-year rates of 3% (1 patient), 6% (2 patients) and 6% (2 patients) for MRM vs. 0%, 0% and 0% for lumpectomy. Of the patients that had 5 or more years of follow-up, the actuarial 5-year LC and DFS was 95.5% and 80.4% for MRM vs. 100% and 100% for lumpectomy. Conclusions: These data suggest that breast conservation therapy with lumpectomy followed by radiation therapy may be considered a reasonable local treatment option for male patients presenting with breast cancer. Breast conservation therapy in this setting may offer cosmetic and functional advantages over mastectomy, with comparable rates of local control and disease-free survival.

Cite This Abstract

Fogh, S, Localized Therapy for Male Breast Cancer: Functional Advantages and Comparable Outcomes with Breast Conservation.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL.