Background: Breast cancer is one of the most common cancers in female adolescent and young adults (AYA; age 15-39 years). However, few data exist detailing either in situ or invasive breast cancer in male AYAs.
Methods: All male AYA breast cancer cases were identified in the National Cancer Data Base (1998-2010). Demographics, tumor, and treatment predictors of overall survival (OS) were determined for both patients with in situ and invasive tumors.
Results: Of 677 male AYAs, 122 patients (18 %) had in situ breast cancer, while 555 patients (82 %) were found to have invasive breast cancer. Compared to in situ breast cancer, invasive breast cancer in male AYAs was less likely to occur in patients with private or managed care insurance (p = 0.003) or <20 years of age (p = 0.028). In patients with invasive breast cancer, lower OS was associated with age ≤25 years (p = 0.006), black race (p = 0.018), not having Medicaid/Medicare/government/military insurance (p < 0.001), the lowest socioeconomic status (p = 0.001), higher overall stage (p < 0.001), T stage (p < 0.001), nodal stage (p < 0.001), and M stage (p < 0.001), as well as not having any surgery (p < 0.001) or nodal evaluation at surgery (p < 0.001). After controlling for competing factors, only age ≤25 years (hazard ratio 3.064, 95 % confidence interval 1.216-7.720) and not having nodal evaluation (hazard ratio 3.070, 95 % confidence interval 1.423-6.626) predicted decreased OS.
Conclusions: Younger age and not having nodal evaluation at the time of surgery are associated with decreased OS in AYA male patients with invasive cancer. This highlights the need to perform axillary node sampling through sentinel node biopsy at the time of mastectomy in these young male patients.