Austin D Williams1, Christopher M McGreevy2, Julia C Tchou2, Lucy M De La Cruz3. 1. Department of Surgery, Lankenau Medical Center, Wynnewood, PA, USA. 2. Rena Rowan Breast Center, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 3. Department of Surgery, Inova Health System, Fairfax, VA, 22033, USA. lcruzclaver@gmail.com.
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.
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.
Authors: Soonmyung Paik; Gong Tang; Steven Shak; Chungyeul Kim; Joffre Baker; Wanseop Kim; Maureen Cronin; Frederick L Baehner; Drew Watson; John Bryant; Joseph P Costantino; Charles E Geyer; D Lawrence Wickerham; Norman Wolmark Journal: J Clin Oncol Date: 2006-05-23 Impact factor: 44.544
Authors: Soonmyung Paik; Steven Shak; Gong Tang; Chungyeul Kim; Joffre Baker; Maureen Cronin; Frederick L Baehner; Michael G Walker; Drew Watson; Taesung Park; William Hiller; Edwin R Fisher; D Lawrence Wickerham; John Bryant; Norman Wolmark Journal: N Engl J Med Date: 2004-12-10 Impact factor: 91.245
Authors: Daniel J Boffa; Joshua E Rosen; Katherine Mallin; Ashley Loomis; Greer Gay; Bryan Palis; Kathleen Thoburn; Donna Gress; Daniel P McKellar; Lawrence N Shulman; Matthew A Facktor; David P Winchester Journal: JAMA Oncol Date: 2017-12-01 Impact factor: 31.777
Authors: F Cardoso; J M S Bartlett; L Slaets; C H M van Deurzen; E van Leeuwen-Stok; P Porter; B Linderholm; I Hedenfalk; C Schröder; J Martens; J Bayani; C van Asperen; M Murray; C Hudis; L Middleton; J Vermeij; K Punie; J Fraser; M Nowaczyk; I T Rubio; S Aebi; C Kelly; K J Ruddy; E Winer; C Nilsson; L Dal Lago; L Korde; K Benstead; O Bogler; T Goulioti; A Peric; S Litière; K C Aalders; C Poncet; K Tryfonidis; S H Giordano Journal: Ann Oncol Date: 2018-02-01 Impact factor: 32.976
Authors: Abeer M Shaaban; Graham R Ball; Rebecca A Brannan; Gabor Cserni; Anna Di Benedetto; Jo Dent; Laura Fulford; Helen Honarpisheh; Lee Jordan; J Louise Jones; Rani Kanthan; Loaie Maraqa; Maria Litwiniuk; Marcella Mottolese; Steven Pollock; Elena Provenzano; Philip R Quinlan; Georgina Reall; Sami Shousha; Mark Stephens; Eldo T Verghese; Rosemary A Walker; Andrew M Hanby; Valerie Speirs Journal: Breast Cancer Res Treat Date: 2011-11-18 Impact factor: 4.872
Authors: Kathy S Albain; William E Barlow; Steven Shak; Gabriel N Hortobagyi; Robert B Livingston; I-Tien Yeh; Peter Ravdin; Roberto Bugarini; Frederick L Baehner; Nancy E Davidson; George W Sledge; Eric P Winer; Clifford Hudis; James N Ingle; Edith A Perez; Kathleen I Pritchard; Lois Shepherd; Julie R Gralow; Carl Yoshizawa; D Craig Allred; C Kent Osborne; Daniel F Hayes Journal: Lancet Oncol Date: 2009-12-10 Impact factor: 41.316
Authors: Joseph A Sparano; Robert J Gray; Della F Makower; Kathleen I Pritchard; Kathy S Albain; Daniel F Hayes; Charles E Geyer; Elizabeth C Dees; Matthew P Goetz; John A Olson; Tracy Lively; Sunil S Badve; Thomas J Saphner; Lynne I Wagner; Timothy J Whelan; Matthew J Ellis; Soonmyung Paik; William C Wood; Peter M Ravdin; Maccon M Keane; Henry L Gomez Moreno; Pavan S Reddy; Timothy F Goggins; Ingrid A Mayer; Adam M Brufsky; Deborah L Toppmeyer; Virginia G Kaklamani; Jeffrey L Berenberg; Jeffrey Abrams; George W Sledge Journal: N Engl J Med Date: 2018-06-03 Impact factor: 91.245
Authors: Jennifer K Plichta; Yi Ren; Caitlin E Marks; Samantha M Thomas; Rachel A Greenup; Laura H Rosenberger; Oluwadamilola M Fayanju; Susan G R McDuff; E Shelley Hwang; Jeremy Force Journal: Ann Surg Oncol Date: 2020-07-23 Impact factor: 5.344
Authors: Mariam F Eskander; Yaming Li; Oindrila Bhattacharyya; Allan Tsung; Bridget A Oppong; Ahmad Hamad; Margaret Gatti-Mays; Samilia Obeng-Gyasi Journal: Breast Cancer Res Treat Date: 2021-08-12 Impact factor: 4.624
Authors: Matthew G Davey; Ciara M Davey; Luis Bouz; Eoin Kerin; Carson McFeetors; Aoife J Lowery; Michael J Kerin Journal: Breast Date: 2022-04-28 Impact factor: 4.254