Retrospective Male Breast Cancer study in the Czech Republic: Treatment and Prognosis Experience Over 11 Years in 256 Cases

Abstract

Abstract Purpose To analyze clinicopathologic characteristics, treatment procedures, and prognosis of men with breast cancer (MBC) in the Czech Republic and compare them with international data. Methods Men diagnosed with breast cancer in 2007–2017 were retrospectively identified from the databases of Complex Oncological Centers in the Czech Republic, and subsequently clinical, histopathological, and molecular-genetic characteristics, treatment procedures, and long-term treatment outcomes were evaluated. Prognostic factors of survival outcomes (overall survival, relapse-free survival, and breast cancer-specific mortality) were analyzed using Cox and the competing risks model. Results In this study, data from 256 patients with MBC at a median age of 66 years were analyzed. Of 201 patients with primary non-metastatic (M0) radically treated MBC, 6% were younger than 40 years, 29% had stage I, 55% were node-negative (cN0), and 54% were indicated to genetic testing. Estrogen receptor (ER) expression over 10% had 97% of tumors, 61% had high mitotic activity (Ki67), 40% high grade (G3), and 68% Luminal B-like (HER2- negative) subtype. Regarding the therapy, 97% of men underwent mastectomy (ME), 34% sentinel lymph node biopsy (SLNB), 48% adjuvant radiotherapy (RT), 13% neoadjuvant therapy, 44% adjuvant chemotherapy (CT), 90% adjuvant endocrine therapy (ET), of which 74% adjuvant tamoxifen (TMX). Patients treated with aromatase inhibitor (AI) alone had significantly shortened RFS (p < 0.001). There were also associations between OS/RFS/BCSM and disease stage, T, N, progesterone receptor (PR) expression, G and Ki67. Median OS reached 122 months in curatively treated M0 patients, 42 months in the de novo metastatic (M1) group (N = 30), and 39 months in the group of M0/X patients treated with palliative intention (N = 25). Conclusion Although the number of MBC cases with unfavorable features (young age, M1 cases, predominant Luminal B-like tumors) was higher in the Czech dataset compared to international studies, the prognosis of men remains consistent with the real-world published data.