nach oben

Erschienen in:

10.02.2020 | Epidemiology

Male breast cancer: a closer look at patient and tumor characteristics and factors that affect survival using the National Cancer Database

verfasst von: Samuel Sarmiento, Michael McColl, Leila Musavi, Faiz Gani, Joseph K. Canner, Lisa Jacobs, Fanmeng Fu, Charalampos Siotos, Mehran Habibi

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2020

Einloggen, um Zugang zu erhalten

Abstract

Objective

To comprehensively describe the tumor and clinical characteristics of breast cancer in a cohort of male patients and to assess the factors that affect survival.

Background

Much of the standard care of male breast cancer is based on the diagnosis and treatment strategies of female breast cancer. However, important clinical differences between the two have been elucidated, which suggests the need for unique attention to male breast cancer.

Methods

We evaluated the records of male patients who were diagnosed with breast cancer between 2004 and 2015 using the National Cancer Database (NCDB). Data obtained were demographic characteristics, clinical and tumor data, type of therapy, as well as survival data. We used descriptive statistics to characterize our study population. We then performed a survival and Cox proportional hazards analysis.

Results

We identified 16,498 patients (median age: 63 years). Several treatment modalities were used, of which surgery was the most common (14,882 [90.4%]). The total follow-up time was 13 years (156 months). Five-year survival was 77.7% (95% CI 76.9–78.4) and 10-year survival was 60.7%. In a Cox proportional hazards model, mastectomy was associated with the greatest survival (hazard ratio [HR] 0.49; p < 0.001).

Conclusion

We report what is to our knowledge the largest national population-based cohort of male breast cancer patients. Importantly, our data suggests that similar to female patients, several treatment modalities are significantly associated with improved survival in male patients, particularly surgery. Increasing age, black race, government insurance, more comorbidities, and higher tumor stages are associated with decreased survival.

Ottini L (2014) Male breast cancer: a rare disease that might uncover underlying pathways of breast cancer. Nat Rev Cancer 14(10):643–644. https://doi.org/10.1038/nrc3806 CrossRefPubMed

Speirs V, Shaaban AM (2009) The rising incidence of male breast cancer. Breast Cancer Res Treat 115(2):429–430. https://doi.org/10.1007/s10549-008-0053-y CrossRefPubMed

Stang A, Thomssen C (2008) Decline in breast cancer incidence in the United States: What about male breast cancer? Breast Cancer Res Treat 112(3):595–596. https://doi.org/10.1007/s10549-007-9882-3 CrossRefPubMed

Sarmiento S, McColl M, Habibi M (2019) The management of male breast cancer. In: Cameron JL (ed) Current surgical therapy, 13th edn. Elsevier, Philadelphia

Fentiman IS, Tirelli U, Monfardini S et al (1990) Cancer in the elderly: why so badly treated? Lancet 335(8696):1020–1022CrossRefPubMed

Rizzolo P, Silvestri V, Tommasi S et al (2013) Male breast cancer: genetics, epigenetics, and ethical aspects. Ann Oncol 24(suppl 8):viii75–viii82. https://doi.org/10.1093/annonc/mdt316 CrossRefPubMed

Korde LA, Zujewski JA, Kamin L et al (2010) Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol 28(12):2114–2122. https://doi.org/10.1200/JCO.2009.25.5729 CrossRefPubMedPubMedCentral

Henriques Abreu M, Emia Afonso N, Henriques Abreu P et al (2016) Male breast cancer: looking for better prognostic subgroups. Breast. https://doi.org/10.1016/j.breast.2015.12.001 CrossRef

Miao H, Verkooijen HM, Chia K-S et al (2011) Incidence and outcome of male breast cancer: an international population-based study. J Clin Oncol 29(33):4381–4386. https://doi.org/10.1200/JCO.2011.36.8902 CrossRefPubMed

10.

Serdy KM, Leone JP, Dabbs DJ, Bhargava R (2017) Male breast cancer. Am J Clin Pathol 147(1):aqw207. https://doi.org/10.1093/ajcp/aqw207 CrossRef

11.

El-Tamer MB, Komenaka IK, Troxel A et al (2004) Men with breast cancer have better disease-specific survival than women. Arch Surg 139(10):1079. https://doi.org/10.1001/archsurg.139.10.1079 CrossRefPubMed

12.

Iorfida M, Bagnardi V, Rotmensz N et al (2014) Outcome of male breast cancer: a matched single-institution series. Clin Breast Cancer 14(5):371–377. https://doi.org/10.1016/j.clbc.2014.02.008 CrossRefPubMed

13.

Yu X-F, Feng W-L, Miao L-L, Chen B, Yang H-J, Yang H-J (2013) The prognostic significance of molecular subtype for male breast cancer: a 10-year retrospective study. The Breast 22:824–827. https://doi.org/10.1016/j.breast.2013.02.005 CrossRefPubMed

14.

Polverini AC, Nelson RA, Marcinkowski E et al (2016) Time to treatment: measuring quality breast cancer care. Ann Surg Oncol 23(10):3392–3402. https://doi.org/10.1245/s10434-016-5486-7 CrossRefPubMed

15.

Greif JM, Pezzi CM, Klimberg VS, Bailey L, Zuraek M (2012) Gender differences in breast cancer: analysis of 13,000 breast cancers in men from the national cancer data base. Ann Surg Oncol 19(10):3199–3204. https://doi.org/10.1245/s10434-012-2479-z CrossRefPubMed

16.

Giordano SH, Cohen DS, Buzdar AU, Perkins G, Hortobagyi GN (2004) Breast carcinoma in men. Cancer 101(1):51–57. https://doi.org/10.1002/cncr.20312 CrossRefPubMed

17.

Fields EC, DeWitt P, Fisher CM, Rabinovitch R (2013) Management of male breast cancer in the united states: a surveillance, epidemiology and end results analysis. Int J Radiat Oncol 87(4):747–752. https://doi.org/10.1016/J.IJROBP.2013.07.016 CrossRef

18.

Losurdo A, Rota S, Gullo G et al (2017) Controversies in clinicopathological characteristics and treatment strategies of male breast cancer: a review of the literature. Crit Rev Oncol Hematol 113:283–291. https://doi.org/10.1016/J.CRITREVONC.2017.03.013 CrossRefPubMed

19.

Patten DK, Sharifi LK, Fazel M (2013) New approaches in the management of male breast cancer. Clin Breast Cancer 13(5):309–314. https://doi.org/10.1016/J.CLBC.2013.04.003 CrossRefPubMed

20.

Chia S, Bryce C, Gelmon K (2005) The 2000 EBCTCG overview: a widening gap. Lancet 365(9472):1665–1666. https://doi.org/10.1016/S0140-6736(05)66524-5 CrossRefPubMed

21.

Ragaz J, Jackson SM, Le N et al (1997) Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med 337(14):956–962. https://doi.org/10.1056/NEJM199710023371402 CrossRefPubMed

22.

Overgaard M, Hansen PS, Overgaard J et al (1997) Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. N Engl J Med 337(14):949–955. https://doi.org/10.1056/NEJM199710023371401 CrossRefPubMed

23.

Early Breast Cancer Trialists’ Collaborative Group (1992) Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy: 133 randomised trials involving 31 000 recurrences and 24 000 deaths among 75 000 women. Lancet 339(8784):1–15. https://doi.org/10.1016/0140-6736(92)90139-T CrossRef

24.

Jabo B, Lin AC, Aljehani MA et al (2018) Impact of breast reconstruction on time to definitive surgical treatment, adjuvant therapy, and breast cancer outcomes. Ann Surg Oncol 25(10):3096–3105. https://doi.org/10.1245/s10434-018-6663-7 CrossRefPubMed

25.

Eriksson L, Bergh J, Humphreys K, Wärnberg F, Törnberg S, Czene K (2018) Time from breast cancer diagnosis to therapeutic surgery and breast cancer prognosis: a population-based cohort study. Int J Cancer 143(5):1093–1104. https://doi.org/10.1002/ijc.31411 CrossRefPubMed

26.

Mansfield SA, Abdel-Rasoul M, Terando AM, Agnese DM (2017) Timing of breast cancer surgery-how much does it matter? Breast J 23(4):444–451. https://doi.org/10.1111/tbj.12758 CrossRefPubMed

27.

Bleicher RJ, Ruth K, Sigurdson ER et al (2016) Time to surgery and breast cancer survival in the United States. JAMA Oncol 2(3):330. https://doi.org/10.1001/jamaoncol.2015.4508 CrossRefPubMedPubMedCentral

Titel: Male breast cancer: a closer look at patient and tumor characteristics and factors that affect survival using the National Cancer Database
verfasst von: Samuel Sarmiento
Michael McColl
Leila Musavi
Faiz Gani
Joseph K. Canner
Lisa Jacobs
Fanmeng Fu
Charalampos Siotos
Mehran Habibi
Publikationsdatum: 10.02.2020
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 2/2020
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05556-y

Springer Medizin

Male breast cancer: a closer look at patient and tumor characteristics and factors that affect survival using the National Cancer Database