ABSTRACT
INTRODUCTION: Prospective data about quality of life (QoL) in men with breast cancer (BC) are lacking. A prospective registry (EORTC10085) of men with all BC stages, including a QoL correlative study, was performed as part of the International Male Breast Cancer Program. METHODS: Questionnaires at BC diagnosis included the EORTC QLQ-C30 and BR23 (BC specific module), adapted for men. High functioning and global health/QoL scores indicate high functioning levels/high QoL; high symptom-focused measures scores indicate high symptoms/problems levels. EORTC reference data for healthy men and women with BC were used for comparisons. RESULTS: Of 422 men consenting to participate, 363 were evaluable. Median age was 67 years, and median time between diagnosis and survey was 1.1 months. A total of 114 men (45%) had node-positive early disease, and 28 (8%) had advanced disease. Baseline mean global health status score was 73 (SD: 21), better than in female BC reference data (62, SD: 25). Common symptoms in male BC were fatigue (22, SD: 24), insomnia (21, SD: 28), and pain (16, SD: 23), for which women's mean scores indicated more burdensome symptoms at 33 (SD: 26), 30 (SD: 32), and 29 (SD: 29). Men's mean sexual activity score was 31 (SD: 26), with less sexual activity in older patients or advanced disease. CONCLUSIONS: QoL and symptom burden in male BC patients appears no worse (and possibly better) than that in female patients. Future analyses on impact of treatment on symptoms and QoL over time, may support tailoring of male BC management.
Subject(s)
Breast Neoplasms, Male , Breast Neoplasms , Female , Humans , Male , Aged , Child, Preschool , Quality of Life , Breast Neoplasms, Male/therapy , Prospective Studies , Health Status , Breast Neoplasms/therapy , Surveys and QuestionnairesSubject(s)
Breast Neoplasms/surgery , Carcinoma, Intraductal, Noninfiltrating/surgery , Mastectomy, Segmental/psychology , Patient Preference , Adult , Age Factors , Aged , Aged, 80 and over , Breast Neoplasms/psychology , Carcinoma, Intraductal, Noninfiltrating/psychology , Decision Making , Female , Humans , Mammaplasty/psychology , Mammaplasty/statistics & numerical data , Mastectomy, Segmental/statistics & numerical data , Middle Aged , Prospective StudiesABSTRACT
BACKGROUND: It is unknown what minimal benefit in disease-free survival older patients with breast cancer require from adjuvant systemic therapy, and if this differs from that required by younger patients. We prospectively examined patients' preferences for adjuvant chemotherapy (aCT) and adjuvant hormonal therapy (aHT), factors related to minimally-required benefit, and patients' self-reported motivations. PATIENTS AND METHODS: Fifty-two younger (40-64 years) and 29 older (≥ 65 years) women with a first primary, invasive tumor were interviewed post-surgery, prior to receiving aCT/aHT recommendation. RESULTS: The proportions of younger versus older participants who would accept, refuse, or were undecided about therapy were 92% versus 62%, 4% versus 24%, and 4% versus 14% for aCT, and 92% versus 59%, 8% versus 17%, and 0% versus 24% for aHT. The proportion of older participants who would refuse rather than accept aCT was larger than that of younger participants (P = .005). No significant difference was found for aHT (P = .12). Younger and older participants' minimally-required benefit, in terms of additional 10-year disease-free survival, to accept aCT (median, 5% vs. 4%; P = .13) or aHT (median, 10% vs. 8%; P = .15) did not differ. Being single/divorced/widowed (odds ratio [OR], 0.16; P = .005), presence of geriatric condition (inability to perform daily activities, incontinence, severe sensory impairment, depression, polypharmacy, difficulties with walking; OR, 0.27; P = .047), and having a preference to make the treatment decision either alone or after considering the clinician's opinion (active role; OR, 0.15; P = .012) were independently related to requiring larger benefits from aCT. The most frequent motivations for/against therapy included the wish to survive/avoid recurrence, clinician's recommendation, side effects, and treatment duration (only aHT). CONCLUSION: Whereas older participants were less willing to accept aCT than younger participants, no significant difference was found for aHT. However, a majority of older participants would still accept both therapies. Adjuvant systemic therapy should be discussed with eligible patients regardless of age.
Subject(s)
Antineoplastic Agents, Hormonal/therapeutic use , Breast Neoplasms/drug therapy , Chemotherapy, Adjuvant/methods , Neoplasm Recurrence, Local/drug therapy , Patient Preference/statistics & numerical data , Adult , Age Factors , Aged , Aged, 80 and over , Antineoplastic Agents, Hormonal/adverse effects , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Decision Making , Disease-Free Survival , Female , Humans , Middle Aged , Motivation , Neoplasm Recurrence, Local/mortality , Neoplasm Staging , Prospective Studies , Risk Assessment , Self ReportABSTRACT
Primary angiosarcoma of the spleen is rare and the prognosis is very poor. The authors present a 2-year-old girl with spontaneous rupture of splenic angiosarcoma. At diagnosis there were liver metastases. After splenectomy she received chemotherapy with ifosfamide, vincristine, and actinomycine D combined with a partial liver resection. She remained in complete remission over 2 years from diagnosis.
