PracticeUpdate: Oncology - Winter 2018

EDITOR’S PICKS 15

Male Breast Cancer: An Updated SEER Data Analysis Take-home message • This analysis of the SEER database was designed to report outcomes among male patients with breast cancer, diag- nosed between 2005 and 2010. The 5-year survival rate was inferior for male patients compared with that for female patients (82.8% vs 88.5%). • During the follow-up period, the risk of death was 43% higher for males than females (HR, 1.43). Neil Majithia MD Abstract BACKGROUND Male breast cancer is rare and under- studied when compared to female breast cancer. A current comparison with female breast cancer could assist in bridging this gap. While there is conflicting literature on male and female survival outcomes, data from 1973 through 2005 in the Surveillance, Epidemiology, and End Results (SEER) program demonstrates that the improvement of breast cancer survival in males has fallen behind that of females. As treatment for breast cancer has improved signif- icantly, an updated analysis using a contemporary population is necessary. MATERIALS AND METHODS Analysis of SEER data from patients diagnosed with primary breast can- cer between 2005 and 2010 were included. A Cox regression model was used to examine the asso- ciation between sex and breast cancer mortality after controlling for prognostic factors, including age, race, marital status, disease stage, estrogen and progesterone receptor status, lymph node involve- ment, grade, surgery, and geography. Subgroup analyses were performed by race and stage. RESULTS We included a total of 289,673 breast can- cer cases (2,054 males) diagnosed between 2005 and 2010. The 5-year survival rate for male patients was lower than that for female patients (82.8 vs. 88.5%). After controlling for other factors, the risk of death in males was 43% higher than females dur- ing the follow-up period (HR =1.43, 95% CI 1.26–1.61). Similar results were noted in race and stage sub- group analyses. CONCLUSION In recent years, male breast cancer patients have a worse survival outcome than female patients. Male Breast Cancer: An Updated SEER Data Anal- ysis. Clin Breast Cancer 2018 Jun 22;[EPub Ahead of Print], N Liu, KJ Johnson, CX Ma. www.practiceupdate.com/c/69956 Clinical Breast Cancer

METHODS A total of 5783 patients with intermediate-risk or high-risk localized prostate cancer who were diagnosed between 2000 and 2015 and treated with RT and androgen depriva- tion therapy were identified from Veterans Affairs data. Patients were divided into groups based on 3-month post-RT PSA values: <0.10ng/mL, 0.10 to 0.49ng/mL, and ≥0.50ng/mL. The effect of the 3-month PSA group on bPFS, PCSS, and OS was evaluated in multivaria- ble Cox models adjusting for potential confounders. RESULTS There were 2651 patients with intermediate-risk and 3132 with high-risk disease; approximately 11% had a 3-month PSA level of ≥0.50ng/mL. A higher 3-month PSA level was found to be strongly associated with each outcome; compared with patients in the group with a 3-month PSA value <0.10ng/mL, the authors noted greater hazards for the patients with a 3-month PSA value ≥0.50ng/mL (hazard ratio for bPFS: 5.23; PCSS: 3.97; and OS: 1.50 [P<.001 for all]) and the patients with a 3-month PSA value of 0.10 to 0.49ng/mL (haz- ard ratio for bPFS: 2.41 [P<.001]; PCSS: 2.29 [P<.001]; and OS: 1.21 [P= .003]). When analyzed separately, the 3-month PSA level was found to be predictive of OS in the high-risk group (P<.001) but not the intermediate-risk group (P= .21). CONCLUSIONS The 3-month post-RT PSA level appears to be a strong prognostic biomarker for bPFS, PCSS, and OS in patients with intermediate-risk and high-risk prostate cancer, particularly those with high-risk disease. The 3-month PSA measurement may augment clin- ical decision making and holds promise as a potential surrogate endpoint in clinical trials. Three-Month Posttreatment Prostate-Specific Antigen Level as a Biomarker of Treatment Response in Patients With Intermediate-Risk or High-Risk Prostate Cancer Treated With Androgen Deprivation Therapy and Radiotherapy. Cancer 2018 May 04;[EPub Ahead of Print], AK Bryant, AV D'Amico, PL Nguyen, et al. www.practiceupdate.com/c/68349

VOL. 2 • NO. 3 • 2018