Endocrine Implications In Male Breast Cancer In Bulgaria

Background: The vast majority of male breast cancers (male BC) are luminal-like hormone receptor (HR) positive invasive ductal carcinomas. Agter surgery, endocrine treatment (ET) therefore should be the mainstay in both adjuvant and metastatic setting. According to the RARECAREnet study, 5-year relative survival until 2007 in Bulgarian male BC patients is 59%, compared to 77% on average for Europe. We therefore analyze available data from the National Cancer Registry to identify reasons for these low survival rates and aim to assess the role of ET in the management of male BC patients in Bulgaria. Methods: This is a retrospective population based study of all 521 male BCs (520 patients, one had bilateral BC), diagnosed between 2002 and 2013 in Bulgaria. Data was collected from the National Cancer Registry. To compare trends in the use of ET, numbers were divided in two time intervals (2002-2007 and 2008 – 2013) and data about ET were recorded and analyzed. Results: Median age of all 243 patients, diagnosed in the period 2002-2007 was 65 years; for the 278 patients, diagnosed in 2008-2013 median age was 66.6 years. Data for hormone receptors (HR) were available in 118/243 (84.7%) male BCs for the first time interval and in 156/278 (80.8%) for the second. HR positivity (ER+ or ER/PR+) was considered as indication for endocrine treatment (ET), both adjuvant (ADJ) or in the metastatic setting. Data on HR positivity, M status and ET are shown in Table. Conclusions: As a rare disease, management of male BC is suboptimal in Bulgaria. Despite the fact that male BC is predominantly endocrine-responsive disease, in Bulgaria ET is still largely underused, both in the adjuvant and in the metastatic setting. Still, there is a clear trend towards an increase in the use of adjuvant ET, but unfortunately this is not seen in the metastatic setting. The underuse of ET might be one of the reasons for the shorter survival of Bulgarian male BC patients. We hope that identification of the problem after analysis of available data from the National Cancer registry, together with improvement of the knowledge about male BC might serve as first steps towards better management of this rare disease. Editorial acknowledgement: Minka Yordanova, Expert System Software and Database. Legal entity responsible for the study: Assia Konsoulova. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest. Table36P HR status and ETTime periodPatients with HR+HR+, cM0Adj ET, n/%HR+, cM1ET for metastatic disease, n/%2002-20071007010/14.3%3010/ 33.3%2008-20131269636/37.5%307/23.3% Open table in a new tab