Poorer Survival Outcomes for Male Breast Cancer Compared with Female Breast Cancer May Be Attributable to In-Stage Migration
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Male breast cancer accounts for less than 1% of all breast cancers, yet males have a worse prognosis than females with breast cancer.
Using the 1988–2003 Surveillance, Epidemiology, and End Results Program data, we conducted a retrospective, population-based cohort study to investigate stage-specific differences in breast cancer-specific and all-cause mortality between males and females. We calculated adjusted hazard ratios (aHR) and 95% confidence intervals (CI) using Cox regression models to compare breast cancer-specific and all-cause mortality by stage between males and females, controlling for potential confounding variables.
There were 246,059 patients with a first, single, primary breast cancer [1,541 (0.6%) male; 244,518 (99.4%) female]. Compared with females, males were more likely to be older, Black, married, diagnosed at more advanced stages, and treated with mastectomy (each P < 0.001). Males also were more likely to have lower grade and estrogen/progesterone receptor-positive tumors (each P < 0.001). After controlling for confounders, males were more likely to die from their breast cancer when compared with females, only if diagnosed with stage I disease (aHR 1.72, CI 1.15–2.61). For all-cause mortality, males were more likely than females to die at each stage of disease except stage IV.
Although all-cause mortality was higher for men than women at all stages of nonmetastatic breast cancer, higher male breast cancer-specific mortality was attributed to poorer survival in stage I disease. However, this statistical difference is unlikely to be clinically relevant and attributable to in-stage migration.
KeywordsBreast Cancer Male Breast Male Breast Cancer Female Breast Cancer Female Breast Cancer Patient
We thank the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, Missouri, for the use of the Health Behavior, Communication and Outreach Core. The Core is supported in part by the National Cancer Institute Cancer Center Support Grant #P30 CA91842 to the Siteman Cancer Center.
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