Conclusions• Male breast cancer survivors experience substantial symptoms• Hormonal symptoms are prevalent in male breast cancer survivors; in

men without cancer, mean EPIC Hormonal Score is 91.7 (SD 9.7)• Sexual functioning may be impaired in male breast cancer survivors;

in men without cancer, mean EPIC Sexual Score is 61.4 (SD 23.6)• We plan to use data from this pilot study to inform a larger study and

develop targeted interventions to reduce symptom burden in male breast cancer survivors

Kathryn J. Ruddy, MD MPH,1 Anita Giobbie-Hurder, MS,1 Sharon Giordano, MD,2 Shari Goldfarb, MD,3 Sandra Kereakoglow, BA,1 Eric P. Winer,1 MD, Ann H. Partridge, MD MPH1

1Dana-Farber Cancer Institute, Boston, MA; 2M.D. Anderson Cancer Center, Houston, TX; 3Memorial Sloan Kettering Cancer Center, New York, NY

Physical and Psychological Sequelae of Breast Cancer in Men

BackgroundLittle is known about the physical and emotional health of men with breast cancer; data are also lacking regarding their informational and supportive care needs

AimTo assess attitudes, symptoms, experiences, and health perceptions in men with a history of breast cancer

MethodsStudy Setting• Online survey recruiting participants via three

websites focused on male breast cancer: www.outoftheshadowofpink.com www.malebreastcancer.org www.malebreastcancer.ca

Measurements• Anxiety and depression over prior month

using Hospitalized Anxiety and Depression Scale (HADS), scored 0-21 for each subscale

• Health-related quality of life (QOL) over prior 7 days using Functional Assessment of Cancer Therapy-Breast (FACT-B), scored 0-144

• Hormonal and sexual symptoms over prior 4 weeks using the Expanded Prostate Cancer Index Composite (EPIC) Hormonal and Sexual Scales, each scored 0-100

• Higher scores on the HADS indicate more symptoms; higher scores on FACT-B and EPIC imply better QOL

• History of genetic and fertility counseling

Limitations

Potential for sample bias, recall bias, and unmeasured confounders

Hormonal Symptoms N=36One or more hot flashes per week 4 (11%)

Breast tenderness at least once per week

6 (27%)

Depressed at least once per week 17 (47%)

Lack of energy at least once per week

27 (75%)

Weight gain 11 (31%)

Sexual Symptoms N=37“Poor” or “very poor” sexual desire 21 (57%)

“Poor” or “very poor” ability to have erection 18 (49%)

“Poor” or “very poor” ability to reach orgasm 13 (35%)

Erection not adequate for intercourse 20 (54%)

Erections not whenever desired 26 (70%)

Never awakened with erection 11 (30%)

No sexual activity 13 (35%)

No sexual intercourse 25 (68%)

“Poor” or “very poor” ability to function sexually 24 (65%)

“Moderate” or “big” problem with sexual desire 16 (43%)

“Moderate” or “big” problem with erection 16 (43%)

“Moderate” or “big” problem with orgasm 11 (30%)

“Moderate” or “big” problem with sexual functioning 17 (46%)

Genetic Counseling/Testing N=41Referred for genetic counseling or testingHad genetic testing

Tested positive for hereditary cancer syndrome

31 (74%)

25

3

Fertility Issues N=42No biological children 10 (24%)

Desire future biological children 2 (5%)

Informed about risks to fertility from treatment

3 (7%)

Stored sperm 1 (2%)

Distress and Quality of Life N=38Anxious (HADS Anxiety >10) 3 (8%)

Depressed (HADS Depression >10) 2 (5%)

EPIC Hormonal Score; Mean (SD) 81.3 (15.5)

EPIC Sexual Score; Mean (SD) 44.5 (26.3)

FACT-B Total Score; Mean (SD) 111.1 (19.9)

Respondent Characteristics N=42 Median age in years (range) 64 (25-80)

Median years since diagnosis (range) 1.8 (0.03-19.4)

Stage at diagnosis N (%)

0 3 (7%)

1 10 (24%)

2 15 (36%)

3 6 (14%)

4 4 (10%)

Unknown 4 (10%)

Have had a cancer other than breast cancer 14 (33%)

Cancer-free at time of survey 32 (74%)

Caucasian 41 (98%)

College/Post-college graduate 31 (74%)

Married or “living as married” 31 (74%)

Employed (full or part time) 14 (33%)

Stopped work for at least one month during treatment 7 (17%)

Financially comfortable (i.e., has “$ for special things”) 22 (52%)

Medically insured 41 (98%)

Before diagnosis, exercised less than once a week 9 (21%)

Reduced exercise since diagnosis 9 (21%)

Received chemotherapy 26 (62%)

Had mastectomy (uni- or bilateral) 38 (90%)

Received radiation 10 (24%)

Currently taking tamoxifen 19 (45%)

Currently taking gonadotropin-releasing hormone agonist

1 (2%)

Currently taking aromatase inhibitor 5 (12%)