Skip to main content

Advertisement

SpringerLink
Log in

Utility of Oncotype DX in Male Breast Cancer Patients and Impact on Chemotherapy Administration: A Comparative Study with Female Patients

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Use of the Oncotype DX recurrence score (RS) has been widely adopted in women with early-stage hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER−) breast cancer (BC). Validation studies on the use of RS in male BC (MBC) are lacking.

Objective

The aim of this study was to identify the utilization of RS and association with chemotherapy recommendations in early-stage MBC compared with female BC (FBC).

Methods

Using the National Cancer Database (NCDB), a retrospective review was performed for patients with T1/T2, node-negative, HR+/HER2− BC between 2010 and 2014. Patients were stratified by demographics, tumor characteristics, RS, and chemotherapy use comparing MBC with FBC over the allotted time period.

Results

A total of 358,497 patients—3068 (0.8%) males and 355,429 (99.1%) females—met the inclusion criteria. A smaller proportion of MBC patients received RS testing compared with FBC patients (32% vs. 35%, p < 0.001). Male patients who had RS were younger, had T2 tumors, lymphovascular invasion, and private insurance. The distribution of RS was similar in both groups. Only 4% of MBC patients with low RS received adjuvant chemotherapy, compared with 4.9% of FBC patients. Overall chemotherapy rates were similar in MBC and FBC patients.

Conclusions

Our results showed that RS has not been completely embraced in the management of MBC, although when performed in MBC, chemotherapy recommendations vary based on RS. Whether the use of RS affects the clinical outcomes of MBC is unknown. A prospective registry would help clarify and evaluate the impact of RS on clinical outcomes in MBC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Key Statistics for Breast Cancer in Men. https://www.cancer.org/cancer/breast-cancer-in-men/about/key-statistics.html. Accessed 21 Oct 2019.

  2. Gradishar WJ, Abraham J, Aft R, et al. NCCN breast cancer guidelines version 3.2019. 2019. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed 21 Oct 2019.

  3. Muir D, Kanthan R, Kanthan SC. Male versus female breast cancers: a population-based comparative immunohistochemical analysis. Arch Pathol Lab Med. 2003;127(1):36–41. https://doi.org/10.1043/0003-9985(2003)127%3c36:mvfb%3e2.0.co;2.

    Article  CAS  PubMed  Google Scholar 

  4. Shaaban AM, Ball GR, Brannan RA, et al. A comparative biomarker study of 514 matched cases of male and female breast cancer reveals gender-specific biological differences. Breast Cancer Res Treat. 2012;133(3):949–58. https://doi.org/10.1007/s10549-011-1856-9.

    Article  CAS  PubMed  Google Scholar 

  5. Fentiman IS. The biology of male breast cancer. Breast. 2018;38:132–5. https://doi.org/10.1016/j.breast.2018.01.001.

    Article  PubMed  Google Scholar 

  6. Paik S, Shak S, Tang G, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004;351(27):2817–26. https://doi.org/10.1056/nejmoa041588.

    Article  CAS  PubMed  Google Scholar 

  7. Paik S, Tang G, Shak S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24(23):3726–34. https://doi.org/10.1200/jco.2005.04.7985.

    Article  CAS  PubMed  Google Scholar 

  8. Albain KS, Barlow WE, Shak S, et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol. 2010;11(1):55–65. https://doi.org/10.1016/s1470-2045(09)70314-6.

    Article  CAS  PubMed  Google Scholar 

  9. Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med. 2018;379(2):111–21. https://doi.org/10.1056/nejmoa1804710.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Boffa DJ, Rosen JE, Mallin K, et al. Using the national cancer database for outcomes research: a review. JAMA Oncol. 2017;3(12):1722–8. https://doi.org/10.1001/jamaoncol.2016.6905.

    Article  PubMed  Google Scholar 

  11. Goss PE, Reid C, Pintilie M, Lim R, Miller N. Male breast carcinoma: a review of 229 patients who presented to the Princess Margaret Hospital during 40 years: 1955-1996. Cancer. 1999;85(3):629–39. https://doi.org/10.1002/(sici)1097-0142(19990201)85:3%3c629::aid-cncr13%3e3.0.co;2-v.

    Article  CAS  PubMed  Google Scholar 

  12. Cardoso F, Bartlett JMS, Slaets L, et al. Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Ann Oncol. 2018;29(2):405–17. https://doi.org/10.1093/annonc/mdx651.

    Article  CAS  PubMed  Google Scholar 

  13. Cronin PA, Romanoff A, Zabor EC, et al. Influence of age on the clinical outcome of breast cancer for men and the development of second primary cancers. Ann Surg Oncol. 2018;25(13):3858–66. https://doi.org/10.1245/s10434-018-6767-0.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Grenader T, Yerushalmi R, Tokar M, et al. The 21-gene recurrence score assay (Oncotype DX™) in estrogen receptor-positive male breast cancer: experience in an Israeli cohort. Oncology. 2014;87(1):1–6. https://doi.org/10.1159/000360793.

    Article  CAS  PubMed  Google Scholar 

  15. Speirs V, Shaaban AM. The rising incidence of male breast cancer. Breast Cancer Res Treat. 2009;115(2):429–30. https://doi.org/10.1007/s10549-008-0053-y.

    Article  PubMed  Google Scholar 

  16. Yadav S, Karam D, Bin Riaz I, et al. Male breast cancer in the United States: treatment patterns and prognostic factors in the 21st century. Cancer. 2020;126(1):26–36. https://doi.org/10.1002/cncr.32472.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Lankenau Medical Center, Wynnewood, PA, USA

    Austin D. Williams MD, MSEd

  2. Rena Rowan Breast Center, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Christopher M. McGreevy MD & Julia C. Tchou MD, FACS

  3. Department of Surgery, Inova Health System, Fairfax, VA, 22033, USA

    Lucy M. De La Cruz MD

Authors
  1. Austin D. Williams MD, MSEd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher M. McGreevy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julia C. Tchou MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lucy M. De La Cruz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LDLC conceptualized the study; LDLC, CM, and JT designed the study; LDLC drafted the initial manuscript; and AW performed the data collection and analysis. All authors reviewed, revised, and approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Lucy M. De La Cruz MD.

Ethics declarations

Disclosures

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 34 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Williams, A.D., McGreevy, C.M., Tchou, J.C. et al. Utility of Oncotype DX in Male Breast Cancer Patients and Impact on Chemotherapy Administration: A Comparative Study with Female Patients. Ann Surg Oncol 27, 3605–3611 (2020). https://doi.org/10.1245/s10434-020-08473-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-020-08473-y

Search

Navigation