MALE BREAST-CANCER - RESULTS OF THE TREATMENTS AND PROGNOSTIC FACTORSIN 397 CASES

From 1960 to 1986, 397 cases of non-metastatic male breast cancer (MBC ) treated in 14 French regional cancer centres were reviewed. The medi an age was 64 years (range 25-93). TNM classification (UICC, 1978) sho wed seven T0, 79 T1, 162 T2, 31 T3, 74 T4 and 44 unclassified tumours (Tx). Clinical positive lymph nodes were found in 31% of the patients. 24 patients received radiotherapy only, and 373 underwent surgery, 24 7 of these with postoperative irradiation. Adjuvant chemotherapy and h ormonal therapy were used in 71 and 68 patients, respectively. There w ere 382 infiltrating carcinomas and 15 pure ductal carcinoma in situ. Lymph node involvement was found in 56% of infiltrating carcinoma. The oestregen (ER) and progesterone (PgR) receptors were positive in 79% and 77%, respectively, of examined cases. Isolated local and regional recurrence were observed in 8.8% and 4.5% of cases, respectively and 4 0% of patients developed metastases. The crude survival rates by Kapla n-Meier method were 65% and 38% at 5 and 10 years, respectively, and t he disease-specific survival rates (without death due to intercurrent disease or second cancer) was 74% at 5 years and 51% at 10 years. The disease-specific survival rate for pN- and pN+ groups were 77% and 39% at 10 years. The prognostic factors were clinical size (T) and histol ogical axillary status (pN-/pN+). The relative risk of death for pN- w as 1.0, 2.0 and 3.2 in the T0-T1, T2 and T3-T4 groups, respectively. F or pN+, these relative risks increased 1.9, 3.9 and 6.0 in the same gr oups. The optimal treatment include modified radical mastectomy and ir radiation for cases with risk factors of local relapse (nodal invasion , large tumour with cutaneous or muscular involvement). Locoregional f ailure had unfavourable prognosis. First-line adjuvant treatment seems to be tamoxifen, due to the very high rate of positive hormonal recep tors and the old age of the patients, which contraindicate chemotherap y in many cases. The prognosis of patients with breast cancer is the s ame in male and female patients when disease-specific survival rate, t umour size and axillary involvement ate compared.