by Peiwen Wu, Dongjie He, Shuchai Zhu, Hao Chang, Qiming
Wang, Qiuju Shao, Gaiyan Li
The Breast: Published: June 22, 2022
Background
This study aimed to investigate the role of adjuvant radiation
therapy in a large population-based cohort of patients with stage I–III male
breast cancer (MaBC).
Methods
Patients with stage I–III breast cancer treated with surgery
were selected from the Surveillance, Epidemiology, and End Results cancer
database from 2010 to 2015. Multivariate logistic regression identified the
predictors of receiving radiation therapy. Multivariate Cox regression model
were used to evaluate the predictors of survival.
Results
We identified 1321 patients. Age, stage, positive regional
nodes, surgical procedure, and HER2 status were strong predictors of radiation
therapy administration. There was no difference between patients who received
radiation therapy and those who did not (P = 0.46); however, after propensity
score matching, it was associated with improved OS (P = 0.04). In the
multivariate analysis, the factors associated with better OS were
administration of radiation therapy and chemotherapy. In the subset analysis,
adjuvant radiation therapy was associated with improved OS in men undergoing
breast-conserving surgery (BCS), with four or more node-positive or larger
primary tumours (T3/T4). Furthermore, we found no benefit of radiation therapy,
regardless of the type of axillary surgery in mastectomy (MS). In older MaBC
patients with T1-2N1 who underwent MS, radiation therapy showed no significant
effects, regardless of chemotherapy.
Conclusion
Adjuvant radiation therapy could improve the survival of
MaBC patients undergoing BCS, with four or more node-positive or larger primary
tumours. Moreover, it should be carefully considered in patients undergoing MS
and older T1-2N1 patients.
