Adjuvant radiotherapy in male breast cancer

Propose: To determine retrospectively the outcome of postoperative radiatio n therapy in male breast cancer. Local/distant control was assessed with at tention to age, stage, lymph node involvement, histopathological differenti ation and hormone receptor status. Materials and methods: Thirty-one male patients were irradiated postoperati vely at the chest wall (mean dose 50 Gy) and 16 patients received radiation to regional lymph nodes. Tumour distribution by stage was: stage 0 (9.7%), stage I (22.6%), stage II (32.2%) and stage III (35.5%). Nine patients wer e subjected to additional hormone therapy and three patients to chemotherap y. Results: Local control was achieved in 30/31 (96.8%) patients. Kaplan-Meier estimates of overall survival (OS), disease specific (DSS) and disease fre e survival (DFS) at 5 years were 77% (95% confidence interval (CI), 0.61-0. 93), 84% (CI, 0.69-0.98) and 73% (CI, 0.57-0.91), respectively. Five-year D FS for stage 0 + I, II and III was 100, 56.3 and 67.3%, respectively. Favou rable results were observed in patients with negative axillary nodes with 5 -year OS/DFS of 90.9% (CI, 0.74-1.0). For lymph node positive patients DFS was 71% (CI, 0.4- 1.0). Patients who presented lymph node metastases with e xtracapsular extension the 5-year OS was 80% (CI, 0.45-1.00), but the DFS w as 0%. Stage of disease, lymph node involvement and histological differenti ation were found to have statistically significant influence on DFS, but no t on OS. Conclusion: Application of postoperative radiotherapy approved in females r esulted in one local relapse in our study population. Other treatment modal ities (hormone therapy/chemotherapy) should continue to be considered a nec essary treatment option for appropriately selected patients. (C) 1999 Elsev ier Science Ireland Ltd. All rights reserved.