The 1%: Unraveling What Drives Breast Cancer in Males
While research on breast cancer in men is growing, more is needed to offer the best treatment options to this subset of patients.
A pink ribbon with a blue dot—the last ribbon issued by the Breast Cancer Research Foundation (BCRF) before founder Evelyn Lauder died in 2011—was significant to Fatima Cardoso, MD, who has been working tirelessly since 2006 to bring awareness of breast cancer in males.
The blue dot represents the 1% of breast cancer that occurs in males. The American Cancer Society estimates that in 2015 in the United States, about 2,350 new cases of invasive breast cancer will be diagnosed and 440 men will die.1
What happened in 2006, Dr. Cardoso, Director of the Breast Cancer Unit at Champalimaud Cancer Center in Lisbon, Portugal, told Cancer Therapy Advisor, was that she had several male patients with metastatic breast cancer and turned to the literature to determine how best to treat them.
“Nothing existed to help me,” she said, so she had to treat them as if they were females with breast cancer. However, she couldn't help but believe there were differences, so she decided to raise interest in breast cancer in males.
Today, a search on ClinicalTrials.gov using the search terms “male” and “breast” and “cancer” returns a list of 130 studies that are currently recruiting men, with interventions ranging from chemotherapy, small molecule inhibitors, and vaccines to radiation therapy.
This delights Dr. Cardoso, who has pushed for protocols to include men, despite the limited number of patients available to recruit: breast cancer in men is rare, about 100 times less common than among women.1 In 2010, the incidence rate was 1.2 cases per 100,000 men.2
Dr. Cardoso, who is also Secretary General of the European Organisation for Research and Treatment of Cancer (EORTC), is leading the International Male Breast Cancer Program3 with Sharon H. Giordano, MD, MPH, Professor, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center in Houston, Texas. Coordinated by EORTC, with support from 10 collaborators worldwide (Table), the three-part program was created to characterize breast cancer in males as well as to develop specific treatments and improve outcomes.
|Table. International Male Breast Cancer Program Collaborators|
|Breast International Group|
|The North American Breast Cancer Group|
|Swiss Group for Clinical Cancer Research|
|ICORG – All Ireland Cooperative Oncology Research Group|
|Borstkanker Onderzoek Groep|
|Swedish Association of Breast Oncologists|
|Hellenic Cooperative Oncology Group|
|Hellenic Oncology Research Group|
|Latin American Cooperative Oncology Group|
|Translational Breast Cancer Research Consortium|
In part one, the program analyzed more than 1,800 cases of male breast cancer treated from 1990-2010 within the network of 23 centers in nine countries, the largest group ever studied.
Part two, which is now open, is creating a prospective registry of all male patients with breast cancer treated at the network centers over a period of 30 months. Dr. Cardoso told Cancer Therapy Advisor that the rapid accrual to this registry, primarily from the Netherlands, is demonstrating the feasibility of moving quickly to part three of the program, prospective clinical trials.