[Role of percutaneous radiotherapy in male breast carcinoma]

Breast cancer in men is a very rare malignancy. Current knowledge about its natural history, diagnostic management and overall prognosis is poor and usually relies on reviews and a few retrospective studies. Herein we report about our past 20-year-clinical experience.

From 1972 to 1993, 21 men with histologically verified tumors were irradiated for operable primary (n = 17) or recurrent (n = 4) breast cancers at our institution. Patients received surgery and post-operative radiotherapy to the chest wall and ipsilateral lymph nodes. Additionally hormones and chemotherapy were applied in only a few cases (n = 5).

The follow-up ranged from 18 to 184 months (median 46 months). At last follow-up (11/94), 9 patients were alive and 8 without disease. The median overall survival of all patients was 69 (mean: 106) months and the 5-year survival rate 59%. In univariate analysis, a relapse- and disease-free survival advantage was observed for patients with stage I/II disease, with negative lymph nodes, central tumor location, patients younger than 60 years and short interval (less than 3 months) from first symptoms and diagnostic verification of the malignancy. None of these factors, however, was statistically significant due to the low case number.

Postoperative adjuvant radiotherapy is an essential part of the treatment strategy of advanced node-negative and node-positive cancer of the breast in men. With respect to locoregional tumor control it is a necessary treatment, while it does not influence the rate of distant metastases. The role of adjuvant hormones and chemotherapy management remains unclear from our scarce patient data.