Background

As a rare disease, knowledge about management of male breast cancer (male BC) is scarce but increasing in the last years. Still, according to RARECAREnet study, 5-year relative survival in Bulgarian male BC patients is 18% less than European mean. We look for potential reasons for this low survival rate; we also identify trends or gaps in the adjuvant (ADJ) management. Analysis of available data would lead to perception of the lack of knowledge about management of MBC and would identify areas for future improvement.

Methods

This is a retrospective population based study of all patients with male BC, diagnosed between 2002 and 2013 in Bulgaria. Clinicopathological features and treatment was obtained from the National Cancer Registry. We compare ADJ management in 2 time intervals: 2002-2007 and 2008-2013.

Results

Data about the clinicopathological features of the patients with male BC are shown in Table. Indications for ADJ endocrine treatment (ET), chemotherapy (CHT) or radiotherapy (RT) were considered as per extrapolation for females with BC (Table). Clinicopathological features of patients with male BC, divided in two time intervals. For 2002-2007: Of all 70 nonmetastatic HR+ patients, 10 (14.3%) had ADJ ET; For 2008-2013: Of all 96 nonmetastatic HR+ patients, 36 had ADJ ET (37.5%). For 2002-2007: ADJ RT was delivered to 12 patients of all 70 N+ nonmetastatic male BC (17.1%) For 2008-2013: ADJ RT was delivered to 63 patients of all 94 N+ nonmetastatic male BC (67%) We consider that at least patients with HER+ male BC as well as stages T2-4N+M0 would be indicated for ADJ CHT (73 and 123 for both periods) whereas ADJ CHT was administered to only 9 and 48 patients respectively (12.3 and 39% respectively).

Conclusions

Despite the recommendations to treat male BC as BC in females, use of ADJ modalities, incl. ET, CHT or RT are still largely underused in male BC. There is though a clear trend towards improvement with the years. Data quality of reported cases is improving over time, as well as the staging, diagnosis and ADJ treatment. Despite this, In Bulgaria they remain largely suboptimal and improvement is urgently needed.

Legal entity responsible for the study

Assia Konsoulova.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Table: 98P