Geburtshilfe Frauenheilkd 2011; 71 - M_34
DOI: 10.1055/s-0031-1286451

Postmastectomy radiotherapy in male breast cancer –20 Years follow-up data

H Eggemann 1, A Ignatov 1, R Stabenow 2, G von Minkwitz 3, FW Röhl 4, G Hildebrandt 5, P Hass 6, SD Costa 1
  • 1Department of Obstetrics and Gynecology, Otto-von-Guericke University, Magdeburg, Germany
  • 2Register of Cancer, Berlin, Germany
  • 3German Breast Group, Neu-Isenburg, Germany
  • 4Institut of Medical Informatics, Otto-von-Guericke University, Magdeburg, Germany
  • 5Department of Radiation Therapy, University, Rostock, Germany
  • 6Department of Radiation Therapy, Otto-von-Guericke University, Magdeburg, Germany

Purpose: The goal of this population-based, retrospective study was to determine the impact of post-mastectomy radiation therapy on long-term overall survival (OS) of male patients with breast cancer.

Patients and Methods: We investigated 20 year OS rates of 664 male patients diagnosed with primary stage I-III breast cancer in the former German Democratic Republic between 1970 and 1989. Patients have been treated by radical mastectomy with axillary lymph node dissection with or without postoperative megavoltage irradiation using Cobalt-60 y-radiation but without any systemic adjuvant therapy.

Results: Median follow-up time was 26.2 years (range 19–38 years). 52.4% (348/664) of patients received post-mastectomy radiotherapy. Cox regression analysis revealed a significant, 20% benefit for patients treated by radiotherapy after 10 years (HR 0.80 (95%CI 0.66–0.98), p=0.031). Patients <75 years with stage I disease showed a trend towards a lower OS when receiving radiotherapy compared to those not receiving radiotherapy (HR 1.45, 95%CI 0.98–2.15, p=0.065). Patients with stage II disease receiving or not receiving radiotherapy showed no difference in OS (HR 0.82, 95%CI 0.62–1.1, p=0.15). In patients with stage III breast cancer radiotherapy led to a significant better OS (HR 0.60, 95%CI 0.41–0.88, p=0.008).

Conclusion: Male patients with stage III breast cancer show a survival benefit from post-mastectomy radiotherapy. Male breast cancer patients at earlier stages do not seem to benefit from radiotherapy, but obsolete irradiation techniques might explain adverse long-term effects in earlier stages.