Treatment results in males with breast cancer

Between 1948 and 1978, 39 previously untreated males with breast cancer received curative treatment at M. D. Anderson Hospital; an additional 30 males were referred for first treatment failure after outside definitive treatment. Of 21 patients who were treated with mastectomy, six had radical mastectomy alone, and 15 had radical mastectomy and postoperative irradiation. Of 18 patients who had less than radical surgery and postoperative irradiation to the chest wall and peripheral lymphatic areas, 7 had simple mastectomy, 3 excision biopsy and 8 had needle biopsy. Chest wall recurrences developed in four of six patients with grave signs treated with radical mastectomy, one had a recurrence in an unirradiated chest wall following peripheral lymphatic irradiation and three others had orthovoltage irradiation of 2400, 3000, and 4200 rad. No local or regional recurrences had developed in patients treated with simple mastectomy, excision, or needle biospy, and radiation therapy to the chest wall and peripheral lymphatics. The ten-year disease-free survival (Kaplan-Meier) is 50% for the entire group, 70% for patients with histologically or a clinically negative axilla, and 34% for those patients with histologically or clinically positive axilla. Recommendations for the management of primary and regional disease are reviewed.