Background

Breast cancer (BC) in men is treated as per the recommendations for menopausal women with BC. Despite the favorable tumor biology in men, survival outcomes are worse as compared to women. We aimed to study the tumor biology and stage at diagnosis of men with BC in Bulgaria, Romania and Serbia.

Methods

This is a retrospective study of men with invasive BC, diagnosed at Medical University Pleven, Bulgaria (2002-2020), Institute of Oncology Cluj-Napoca, Romania (2000-2020) and Institute of Radiology and Oncology in Belgrade, Serbia (2000-2018).

Results

A total of 318 men with BC were included. Mean age and stage distribution at diagnosis are shown in the table. The mean age at diagnosis was significantly lower in Romania, compared to Serbia. About 80% of patients from each country had invasive ductal cancer. The rate of invasive lobular cancer ranged from 0.6% in Romania to 8.9% in Serbia. The receptor status subtype was unknown in almost half of the patients from each country. Among patients with known receptor status, over 93% were positive for at least one of the hormonal receptors. None of the patients had a HER2-overexpressing tumor subtype. Table: 172P

Number of patients included per country, age and stage at diagnosis

Conclusions

As a rare disease, BC in men is a difficult and uncommon diagnosis. This is why, not only in Eastern Europe, it is diagnosed at a later stage, compared to women. In our study more than 80% of patients have regional lymph node metastases at diagnosis. Similarly to other reports, the vast majority of our patients had invasive ductal histology and hormone receptors expressing tumors. Raising the awareness of male BC, closer follow up and optimized registration could improve the outcomes of this disease.

Editorial acknowledgement

Minka Yordanova - expert systemic software for databases, Bulgarian National Cancer Registry; Prof. Zdravka Valerianova Chief of Bulgarian National Cancer Registry.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Bulgaria is one of the countries with the lowest breast cancer (BC) survival in Europe. We investigated the impact of the adherence to EUSOMA recommendations for diagnosis and treatment of breast diseases on treatment outcomes.

Methods

This retrospective study includes 6699 women with single-sided invasive BC, who lived longer than 1 month after diagnosis. All patients were diagnosed with a single primary tumor and were registered at the Bulgarian National Cancer Registry (BNCR) in 2012 and 2013. We investigated the distribution of the EUSOMA quality indicators (QI) among patients; the median overall survival (OS) in subgroups according to the status of those QI and the difference in OS between the subgroups. Patients were followed up until November 2020. The Kaplan Meier method and log rank test were applied. Information for tumor size was available only according to T category of TNM.

Results

Analysis could be performed for only four QI. Their distribution among patients (pts) and the significance of the survival differences between subgroups is shown in the table. The median OS in most of the subgroups was not reached. The observed 5-year survival rate among all included patients was 74.2%. There was a significant difference in OS between all pairs of subgroups in favor of patients who received the required treatment and had known tumor characteristics, except between HER2+ (T > 2 cm or N+) women who received chemotherapy and were treated or not with adjuvant trastuzumab. Table: 173P

Distribution of EUSOMA QI and significance of the survival difference between the patients' subgroups

Conclusions

The low adherence to EUSOMA recommendations, according to data from BNCR, the observed low overall survival outcomes and the significant differences in survival between investigated subgroups raise the question of whether the patient’s registration process is insufficient or diagnostic procedures and treatments are suboptimal. Wider implementation of the international standards of diagnosis and treatment of BC on a national level is needed.

Legal entity responsible for the study

Mariela Vasileva-Slaveva.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Breast cancer (BC) in men is treated as per the recommendations for menopausal women with BC. Despite the favorable tumor biology in men, survival outcomes are worse as compared to women. We aimed to study the tumor biology and stage at diagnosis of men with BC in Bulgaria, Romania and Serbia.

Methods

This is a retrospective study of men with invasive BC, diagnosed at Medical University Pleven, Bulgaria (2002-2020), Institute of Oncology Cluj-Napoca, Romania (2000-2020) and Institute of Radiology and Oncology in Belgrade, Serbia (2000-2018).

Results

A total of 318 men with BC were included. Mean age and stage distribution at diagnosis are shown in the table. The mean age at diagnosis was significantly lower in Romania, compared to Serbia. About 80% of patients from each country had invasive ductal cancer. The rate of invasive lobular cancer ranged from 0.6% in Romania to 8.9% in Serbia. The receptor status subtype was unknown in almost half of the patients from each country. Among patients with known receptor status, over 93% were positive for at least one of the hormonal receptors. None of the patients had a HER2-overexpressing tumor subtype. Table: 172P

Number of patients included per country, age and stage at diagnosis

Conclusions

As a rare disease, BC in men is a difficult and uncommon diagnosis. This is why, not only in Eastern Europe, it is diagnosed at a later stage, compared to women. In our study more than 80% of patients have regional lymph node metastases at diagnosis. Similarly to other reports, the vast majority of our patients had invasive ductal histology and hormone receptors expressing tumors. Raising the awareness of male BC, closer follow up and optimized registration could improve the outcomes of this disease.

Editorial acknowledgement

Minka Yordanova - expert systemic software for databases, Bulgarian National Cancer Registry; Prof. Zdravka Valerianova Chief of Bulgarian National Cancer Registry.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Bulgaria is one of the countries with the lowest breast cancer (BC) survival in Europe. We investigated the impact of the adherence to EUSOMA recommendations for diagnosis and treatment of breast diseases on treatment outcomes.

Methods

This retrospective study includes 6699 women with single-sided invasive BC, who lived longer than 1 month after diagnosis. All patients were diagnosed with a single primary tumor and were registered at the Bulgarian National Cancer Registry (BNCR) in 2012 and 2013. We investigated the distribution of the EUSOMA quality indicators (QI) among patients; the median overall survival (OS) in subgroups according to the status of those QI and the difference in OS between the subgroups. Patients were followed up until November 2020. The Kaplan Meier method and log rank test were applied. Information for tumor size was available only according to T category of TNM.

Results

Analysis could be performed for only four QI. Their distribution among patients (pts) and the significance of the survival differences between subgroups is shown in the table. The median OS in most of the subgroups was not reached. The observed 5-year survival rate among all included patients was 74.2%. There was a significant difference in OS between all pairs of subgroups in favor of patients who received the required treatment and had known tumor characteristics, except between HER2+ (T > 2 cm or N+) women who received chemotherapy and were treated or not with adjuvant trastuzumab. Table: 173P

Distribution of EUSOMA QI and significance of the survival difference between the patients' subgroups

Conclusions

The low adherence to EUSOMA recommendations, according to data from BNCR, the observed low overall survival outcomes and the significant differences in survival between investigated subgroups raise the question of whether the patient’s registration process is insufficient or diagnostic procedures and treatments are suboptimal. Wider implementation of the international standards of diagnosis and treatment of BC on a national level is needed.

Legal entity responsible for the study

Mariela Vasileva-Slaveva.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.