Treatment and Prognosis of Male Breast Cancer: A Multicentric, Retrospective Study Over 11 Years in the Czech Republic.

PURPOSE: Male breast cancer (MBC) is a rare, but increasingly common disease, and lacks prospective studies. Collaborative efforts are needed to understand and address MBC, including its prognosis, in different countries. METHODS: We retrospectively reviewed the clinical, histopathological, and molecular-genetic characteristics, treatments, and survival outcomes of MBC diagnosed between 2007 and 2017 in the Czech Republic. Prognostic factors of overall survival (OS), recurrence-free interval (RFi), and breast cancer-specific mortality (BCSM) were analyzed and indirectly compared to international data. RESULTS: We analyzed 256 patients with MBC (median age 66 years), including 12% with de novo metastatic (M1). Of 201 non-metastatic (M0) patients, 6% were <40 years old, 29% had stage I, 55% were cN0, and 54% underwent genetic testing. Overall, 97% of tumors had estrogen receptor expression ≥10%, 61% had high Ki67 index, 40% were high-grade (G3), and 68% were luminal B-like (HER2-negative). Systemic therapies included endocrine therapy (90%) and chemotherapy (53%). Few (5%) patients discontinued adjuvant endocrine therapy for reasons other than disease relapse or death. Patients treated with aromatase inhibitors alone had significantly shorter RFi (P < .001). OS, RFi, and BCSM were associated with disease stage, T stage, N stage, progesterone receptor expression, grade, and Ki67 index. Median OS reached 122 and 42 months in M0 and de novo M1 patients, respectively. CONCLUSION: Due to the rarity of MBC, this study highlights important findings from real clinical practice. Although the number of patients with MBC with unfavorable features was higher in this Czech dataset than in international studies, the prognosis remains consistent with real-world evidence.

BMI and Odds of Endometrial Adenocarcinoma in Czech Women - a Case Control Study.

INTRODUCTION: The incidence of malignant tumors of the uterine body is increasing in the Czech Republic. Endometrial adenocarcinoma is one of the most frequent morphological types. Obesity or even overweight is a risk factor for the development of this disease. More accurate stratification of risk relative to body mass index (BMI) has not yet been determined in the Czech Republic, although the risk of overweight (BMI 25-29.9) has been reported in one study as comparable to that of first or second degree obesity (BMI 30-30.9). PATIENTS AND METHODS: The study population included 376 women of Caucasian race diagnosed with endometrial adenocarcinoma, with BMI measured simultaneously, in 2005-2017. A control group consisted of an equal number of age-matched women not diagnosed with any oncological or gynecological disease. These two files were statistically processed. RESULTS: Odds (OR, 95% CI) relative to normal weight women, overweight women were at 2.26-times higher odds of endometrial adenocarcinoma, and women with obesity were at 5.18-8.67-, and 24.70-times higher odds, depending on the severity of obesity. CONCLUSION: The hypothesis that overweight represents same risk for the development of endometrial adenocarcinoma, as lower degrees of obesity was not verified. However overweight is serious risk for endometrial adenocarcinoma development. The odds of endometrial adenocarcinoma is correlated with increasing BMI and in the population studied is higher than reported previously for all endometrial carcinoma subtypes. This work was carried out with the support of an internal grant of Krajská zdravotní, a.s., for the years 2017-2019: IGA217129002. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 29. 4. 2019 Accepted: 22. 7. 2019.

Estrogen Receptor Status Oppositely Modifies Breast Cancer Prognosis in BRCA1/BRCA2 Mutation Carriers Versus Non-Carriers.

Breast cancer (BC) prognosis in BRCA1 and BRCA2 mutation carriers has been reported contradictorily, and the significance of variables influencing prognosis in sporadic BC is not established in BC patients with hereditary BRCA1/BRCA2 mutations. In this retrospective cohort study, we analyzed the effect of clinicopathological characteristics on BC prognosis (disease-free survival [DFS] and disease-specific survival [DSS]) in hereditary BRCA1/BRCA2 mutation carriers. We enrolled 234 BRCA1/BRCA2 mutation carriers and 899 non-carriers, of whom 191 carriers and 680 non-carriers, with complete data, were available for survival analyses. We found that patients with ER-positive tumors developed disease recurrence 2.3-times more likely when they carried a BRCA1/BRCA2 mutation (23/60; 38.3% ER-positive carriers vs. 74/445; 16.6% ER-positive non-carriers; p < 0.001). ER-positive mutation carriers also had a 3.4-times higher risk of death due to BC compared with ER-positive non-carriers (13/60; 21.7% vs. 28/445; 6.3%; p < 0.001). Moreover, prognosis in ER-negative BRCA1/BRCA2 mutation carriers was comparable with that in ER-positive non-carriers. Our study demonstrates that ER-positivity worsens BC prognosis in BRCA1/BRCA2 mutation carriers, while prognosis for carriers with ER-negative tumors (including early-onset) is significantly better and comparable with that in ER-positive, older BC non-carriers. These observations indicate that BRCA1/BRCA2 mutation carriers with ER-positive BC represent high-risk patients.