The Study: Male breast cancer isn’t that rare. At around 2500 cases per year, it's about twice as common as gastric MALT in men. This study draws from a 21-gene recurrence score (RS) registry to compare outcomes with estrogen-receptor (ER)+ breast cancers among women and men. Overall, patterns of disease were largely similar. While the majority of both groups had low RS, the rate of a high RS was greater among men (12%) than women (7%). Survival among those with a low/intermediate RS was similar, but men with a high RS had significantly worse breast cancer specific survival (81%) than women (95%) at 5 years. This brings up an interesting question raised by the authors: are we inappropriately extrapolating from the plethora of data we have on women rather than utilizing the teeny bit of data we have on men? For example, men of all ages have gonadal physiology that is most similar to premenopausal women making tamoxifen the endocrine therapy of choice.
Bottom Line: The 21-gene recurrence score is useful in men, and a high risk score in a man may portend a higher risk than we thought. | Massarweh, J Clin Oncol 2018