Male breast cancer in Australia (2020)

Male breast cancer is rare, less than 1% of cases submitted to the BreastSurgANZ Quality Audit (BQA). Recommendations on how to treat breast cancer are based on female breast cancer patients. This study found that treatment received by male patients was different than that received by female patients despite the recommendations being the same.

Male patients in this study were:

• older at diagnosis
• more likely to have hormone-receptor positive tumours (able to be treated with hormonal therapy)
• more likely to be lymph node-positive (cancer cells in the lymph nodes)
• more likely to have a mastectomy (removal of whole breast) over breast conserving surgery (removal of tumour and small amount of tissue around tumour)

These results are similar to results from studies in other countries.

Treatment for males followed five of the six BQA key performance indicator (KPI) recommendations for treatment, falling short on KPI 1 regarding referral for radiotherapy following breast conserving surgery.

The low number of male patients made it difficult to compare treatment with National Comprehensive Cancer Network (NCCN) guidelines. The only group large enough for comparison was male patients with hormone receptor positive, HER-2 negative (HER2 is a protein which promotes growth of cancer cells), lymph node-positive disease. These patients were less likely to be referred for treatment in line with the NCCN guidelines than females in the same grouping.

The authors of this study recommend:

• male patients be discussed in multidisciplinary meetings (where a range of health professionals discuss treatment plans)
• the risks and benefits of treatment options be discussed, specific to the individual patient
• referral to medical centres that treat higher numbers of breast cancer cases be considered if the patient is diagnosed at a centre which treats comparatively low numbers