More Men Should Be in Breast Cancer Trials to Improve Their Treatment, Expert Asserts

More Men Should Be in Breast Cancer Trials to Improve Their Treatment, Expert Asserts

More men should be included in breast cancer trials to try to improve treatment for them, a British expert contends.

Robert Mansel, an emeritus professor at Wales’ Cardiff University School of Medicine, was commenting on ground-breaking research that Professor Isabel Rubio conducted.

Her study showed that if women are treated with tumor-shrinking drugs before surgery to remove part or all of a breast, they may be able to avoid radical surgery. The study focused on women with breast cancer containing the HER2 protein.

Rubo presented her findings at the 11th European Breast Cancer Conference in Barcelona, March 21-23. The presentation was titled “Breast and axillary conservative surgery after neoadjuvant treatment in HER 2 positive breast cancer patients: The time is now.”

“These findings could apply to men also, but we just don’t know because men with breast cancer are almost never included in clinical trials,” Mansel said in a press release. “We need trials to start including men, so that we can discover whether or not they respond in the same way to targeted treatments as women. They may not, because the hormones involved in the cancer are different, but until this is investigated in trials, we do not know what the best treatment for them is.

“The cosmetic result after surgery is important for men, too,” Mansel said. “At present, men with breast cancer often undergo radical surgery to remove all the cancer, but why should surgeons remove the nipple and the areola [the darker area around the nipple], if it’s not necessary? Men feel self-conscious about how this looks because if they want to swim or go to the beach their chests are uncovered if they wear swimming trunks. They could benefit from more conservative surgery that preserves the nipple and areola.”

About one in 1,000 men develops breast cancer. In the United Kingdom, about 390 are diagnosed with the disease each year, compared with 54,800 women. In the United States, there were an estimated 2,240 new cases of breast cancer in men in 2013.

Meanwhile, researchers are doing a major study of men with breast cancer to decide, among other things, what types of patients could be recruited for trials. The effort is called the International Program on Male Breast Cancer.

Sharon Hermes Giordano, a co-coordinator of the study, said “the first part of this program consists of a retrospective analysis of a large series of men previously diagnosed with breast cancer over the past twenty years. The data being gathered includes patient characteristics, tumor features, treatment and outcomes.”

By analyzing breast cancer samples, “we hope to understand the biological characteristics of this disease and identify important potential prognostic and predictive markers,” Giordano added.

The first part of the research will cover about 1,700 men, making it the largest group of these breast cancer patients ever studied. The second part will involve looking at the disease characteristics of men treated for 30 months to determine how many might be recruited for a clinical trial.

The program is being led by the European Organisation for Research and Treatment of Cancer, the Breast International Group, and the North American Breast Cancer Groups. Financial support is provided by the Breast Cancer Research Foundation, the Breast Cancer Group of the European Organisation for Research and Treatment of Cancer, the Dutch Pink Ribbon, the European Breast Cancer Conference council, and the Breast Cancer Working Group.

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