Poorer survival outcomes for male breast cancer compared with female breast cancer may be attributable to in-stage migration

Ann Surg Oncol. 2011 Jul;18(7):1837-44. doi: 10.1245/s10434-010-1468-3. Epub 2010 Dec 14.

Abstract

Background: Male breast cancer accounts for less than 1% of all breast cancers, yet males have a worse prognosis than females with breast cancer.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / epidemiology
  • Carcinoma, Intraductal, Noninfiltrating / mortality*
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Young Adult