Breast cancer recurrence proves common in uncommon male patients

Men treated for breast cancer face a significantly high risk of future cancers, according to a study published online in the January issue of Breast Cancer Research. The data validate previous findings and suggest a role for screening in these patients.

"Male breast cancer patients need to be primary candidates for active cancer screening, early detection, and cancer prevention counseling," said senior investigator Hoda Anton-Culver, Ph.D., chief of epidemiology at the University of California, Irvine School of Medicine.

Male breast cancer affects about 1700 men in the U.S. each year. Risk factors include obesity, aging, liver disease, genetic conditions, and family history. Because the condition is so rare, however, studying recurrence offers a way to provide clues about its origin and prevention. Three earlier studies - including patients from Sweden and the U.S. and a pool of 13 cancer registries from around the world - had surveyed the excess risk of recurrence. But they had overlooked variables such as race, which were included in the UCI study.

Anton-Culver and colleagues retrospectively reviewed data from the California Cancer Registry on 1926 men aged 85 or younger who had been diagnosed with primary breast cancer between 1988 and 2003. They found that more than 10% of these men had suffered a recurrence or developed other primary cancers, particularly those affecting the breast, stomach, and skin.

The investigators found that men diagnosed with a first primary breast cancer have a 16% increased risk in developing a second breast, colorectal, bladder, stomach, or skin malignancy compared with men in the general population. They also found that almost 12% of patients in their population sample developed a new malignancy within two months of the original breast cancer diagnosis.

"Even more disturbing, we found that men with breast cancer are diagnosed with later-stage disease and that patients with onset of the disease at a young age are even more likely to develop a second cancer," Anton-Culver said.

The study has some limitations. Researchers lacked data on challenging factors such as family history, genetic predisposition, and environmental exposures. About one-third of patients diagnosed after 1998 were followed for an insufficient amount of time. The cohort, comprising only cancer patients, bears a high likelihood of bias.

Future studies should explore the role of adjuvant hormonal, radiation, and chemotherapy with a longer follow-up period and a larger male patient population, the researchers said. Other areas of future insight might include the risk of breast cancer recurrence after first primary melanoma and stomach cancer.

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