LOCAL RECURRENCE AFTER NEO-ADJUVANT CHEMOTHERAPY AND BREAST CONSERVING SURGERY

This study describes our experience with adjuvant chemo-hormonal therapy in male breast cancer (MBC). A retrospective review of all MBC patients referred to our institution between 1991 and 2003 was conducted. Twenty-four men were diagnosed with a breast ductal carcinoma; 20/24 pts had invasive carcinoma; 2/24 were metastatic (lung metastasis; supraclavicular lymph node involvement). All pts underwent radical mastectomy with axillary lymph node dissection. Twelve pts (10 adjuvant, two metastatic) were treated with chemotherapy (seven with anthracycline, five with CMF) and 18 pts received adjuvant hormonal therapy (17 tamoxifen, one anastrozole). Ten pts received postoperative radiotherapy to chest wall and axilla and/or supraclavicular site according to the guidelines of our institution. Median age was 59 years; median tumor size was 1.5 cm (0.5–3.5 cm). Tumors were ER positive in 20 pts and PgR positive in 17 samples. Pathological node involvement was seen in 10 pts and 50% of tumors were high grade. To date, 6/18 pts with early disease relapsed. Four of six pts who relapsed had received chemotherapy and radiotherapy; all tumors that recurred were >1 cm diameter at diagnosis (2/6 >2 cm). The ER and PgR were positive in 4/6 and 3/6 of pts, respectively. About 50% of cancers that recurred had a high proliferation rate. At relapse, patients received chemotherapy with anthracycline or navelbine or taxotere in addition totrastuzumab for 1 pt with erbB2 overexpression, plus hormonal therapy. One patient died from metastatic disease, 2 pts with metastatic disease are still alive. Phenotypic characteristics of MBC are more similar to those of menopausal women. Our results demonstrated a balance in the biological characterization of relapses so we cannot draw conclusions on the benefit from different adjuvant treatments.