Key takeaways
- Men with Stage IV breast most cancers who’re receptive to systemic remedy profit from surgical intervention.
- Patients additionally benefitted who acquired trimodal remedy consisting of systemic remedy, surgical procedure, and radiation in comparison with simply receiving systemic remedy.
- The authors hope their findings immediate reconsideration of National Comprehensive Cancer Network tips for this group of male breast most cancers sufferers, which now recommends systemic remedy with surgical intervention solely for use as a palliative measure.
CHICAGO: Men with Stage IV breast most cancers and recognized estrogen (ER) and progesterone receptor (PR) standing profit from surgical intervention and from trimodal remedy (systemic remedy, surgical procedure, and radiation), in response to a examine offered on the digital American College of Surgeons (ACS) Clinical Congress 2021.
The National Comprehensive Cancer Network tips to deal with males with Stage IV breast most cancers advocate systemic remedy, with surgical procedure for use to reduce signs akin to ulcerations, ache, or bleeding, mentioned first writer Kelly A. Stahl, MD, a surgical resident at Penn State College of Medicine, Hershey. However, new examine findings, present that surgical procedure does have survival advantages for males with Stage IV breast most cancers, she mentioned.
“We need to re-examine the notion that Stage IV breast cancer in men is so dire that there is no survival benefit to surgical intervention,” mentioned Daleela G. Dodge, MD, FACS, a common surgeon at Penn State Health Milton S. Hershey Medical Center in Hershey, PA, and a co-author of the examine.
“For this subgroup of patients who are responsive to systemic therapy and do not have a lot of metastatic burden, we’d like there to be a reconsideration of best practices.”
Breast most cancers in males accounts for lower than 1 p.c of all breast most cancers instances, whereas one in eight girls get breast most cancers in comparison with one in 1,000 males, Dr. Dodge mentioned. As a outcome, public consciousness of breast most cancers in males is low.
“We have a whole month devoted to breast cancer awareness for women, but it’s not well known that men can get it, too, and that some men even have a genetic predisposition to getting it,” Dr. Stahl mentioned.
Unfortunately, low public consciousness has contributed to the truth that 6 p.c of girls in contrast with 10 p.c of males should not recognized till they’ve Stage IV most cancers. In addition, 40 p.c of male breast most cancers sufferers don’t get recognized till Stages III or IV though breast most cancers is simpler for male sufferers to detect on their very own, mentioned Dr. Dodge. She added, “Men have a worse prognosis based on late diagnosis, so awareness is important.”
About the examine
The authors have been shocked at what number of sufferers they have been capable of finding that match the parameters of their examine, crediting the in depth dataset within the National Cancer Database (NCDB). The researchers recognized 539 Stage IV breast most cancers sufferers with recognized ER/PR standing from 2004-2017 within the NCDB. Chi-square checks examined subgroup variations between the therapy modalities acquired. Overall survival was assessed utilizing the Kaplan-Meier methodology. Multivariate Cox proportional hazard fashions examined components related to survival.
A famous survival benefit
The researchers discovered a survival benefit famous in sufferers who acquired trimodal remedy in contrast with sufferers who acquired systemic remedy alone. ER optimistic sufferers who acquired trimodal remedy or systemic remedy and surgical procedure had an improved 5-year total survival price when put next with systemic remedy. PR optimistic sufferers who acquired trimodal remedy or systemic remedy and surgical procedure had an improved 5-year total survival price when put next with systemic remedy. The sequence of therapy was important, with the best survival benefit famous in ER optimistic sufferers who acquired neoadjuvant chemotherapy in contrast with those that acquired adjuvant chemotherapy.
“We’re trying to catch up to better tailor our treatment of men with breast cancer and this study shows how treatment can be tailored in Stage IV disease,” Dr. Dodge mentioned.
Other examine authors are Rolfy Perez Holguin, MD; William Wong, DO; Christopher McLaughlin, MD; Elizabeth J. Olecki, MD; Chan Shen, PhD.
There are not any writer disclosures to report.
“FACS” designates {that a} surgeon is a Fellow of the American College of Surgeons.
Citation: Stahl KA, et al. Benefits of Surgical Treatment in Stage IV Male Breast Cancer Patients with Known Hormone Receptor Status. Scientific Forum Presentation. American College of Surgeons Clinical Congress 2021.
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About the American College of Surgeons
The American College of Surgeons is a scientific and academic affiliation of surgeons that was based in 1913 to boost the requirements of surgical training and apply and to enhance the standard of take care of surgical sufferers. Its achievements have positioned it on the forefront of American surgical procedure and have made the College an necessary advocate for all surgical sufferers. The College has greater than 84,000 members and is the most important group of surgeons on the earth. For extra info, go to www.facs.org.
