Physical and Psychological Sequelae of Breast Cancer in Men 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 Background Little is known about the physical and emotional health of men with breast cancer; data are also lacking regarding their informational and supportive care needs 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 (%) 3 (7%) 1 10 (24%) 2 15 (36%) 3 6 (14%) 4 4 (10%) Unknown 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” Employed (full or part time) Stopped work for at least one month during treatment 7 (17%) Financially comfortable (i.e., has “$ for special things”) 22 (52%) Medically insured Before diagnosis, exercised less than once a week 9 (21%) Reduced exercise since diagnosis Received chemotherapy 26 (62%) Had mastectomy (uni- or bilateral) 38 (90%) Received radiation Currently taking tamoxifen 19 (45%) Currently taking gonadotropin-releasing hormone agonist 1 (2%) Currently taking aromatase inhibitor 5 (12%) Hormonal Symptoms N=36 One 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 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 “Moderate” or “big” problem with orgasm “Moderate” or “big” problem with sexual functioning 17 (46%) Aim To assess attitudes, symptoms, experiences, and health perceptions in men with a history of breast cancer Genetic Counseling/Testing N=41 Referred for genetic counseling or testing Had genetic testing Tested positive for hereditary cancer syndrome 31 (74%) 25 3 Methods Study 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 Fertility Issues N=42 No biological children 10 (24%) Desire future biological children 2 (5%) Informed about risks to fertility from treatment 3 (7%) Stored sperm 1 (2%) Limitations Potential for sample bias, recall bias, and unmeasured confounders 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 Distress and Quality of Life N=38 Anxious (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)