Poorer Survival of Male Breast Cancer Compared with Female Breast Cancer Patients May Be Due to Biological Differences.
ABSTRACT The objective of the study was to compare disease-free survival and overall survival in a group of matched males and females with breast cancer, and to analyze possible treatment- and gender-related differences.
We retrospectively analyzed the data of 150 operable male breast cancer patients treated in our hospital from December 1980 to June 2012. Each male breast cancer patient recorded in the database was matched with two female breast cancer patients of equal stage. Prognosis in terms of disease-free survival and overall survival was evaluated.
The mean age at diagnosis was 58.6 ± 9.7 years for males and 57.2 ± 10.3 years for females. The median follow-up was 69 months for males and 81 months for females. Significant differences were identified for tumor location, hormone receptor status, molecular subtypes and hormone therapy between the two groups. Monofactorial analysis demonstrated that tumor size, lymph node state, American Joint Committee on Cancer stage, molecular subtypes and adjuvant chemotherapy treatment were prognostic factors in male breast cancer patients. The 5- and 10-year disease-free survival rates were 65.6 and 40.1% for males, and 74.9 and 51.5% for females, respectively. The 5- and 10-year overall survival rates were 72.9 and 53.9% for males, and 83.2 and 68.5% for females, respectively. There was significantly difference in disease-free survival and overall survival between the two matched groups (P = 0.002).
Male breast cancer patients had inferior outcome despite of equal stage in comparison with matched female breast cancer patients, which demonstrates that biological differences may contribute to the worse prognosis.
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ABSTRACT: Background Breast cancer occurs rarely in males accounting for approximately 1% of all breast carcinomas. Data on prognosis principally derives from retrospective studies and from extrapolation of female breast cancer series. Patients and methods A total of 99 male patients with invasive breast cancer were matched with 198 female breast cancer patients who had surgery at the same institution from 1999 to 2010. Matching variables were: year of surgery, age, primary tumor size, nodal involvement, hormone receptor status, status of HER2, ki67 and grade. Median follow-up was 8.6 years. Results Disease free survival (DFS) was significantly poorer in male breast cancer patients (10-year DFS 51.7% vs. 66.5%; HR 1.79; 95% CI 1.19-2.68; P=0.004). Similar results were observed for overall survival (OS) (10-year OS 70.7% vs. 84.2%; HR 1.79; 95% CI 1.01-3.15; P=0.043). The cumulative incidence (CI) of death for causes not related to the primary breast cancer was significantly higher for male rather than female breast cancer patients (HR 2.87, 95%CI 1.58-5.22;p= 0.001), while the breast cancer specific survival (BCSS) was similar between the two groups (10-year BCSS 81.5% vs. 88%; HR 1.27; 95% CI 0.62-2.59; P=0.517). Conclusions Our comparative series revealed that male breast cancer patients had a poorer DFS and OS when compared with female patients. Male patients showed also a higher risk of controlateral tumors and second primaries that contribute to the difference between the two groups. Appropriate counseling, surveillance, and prevention are recommended to improve survival for these individuals.Clinical Breast Cancer 01/2014; · 2.63 Impact Factor
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ABSTRACT: Breast cancer is the most common cancer form in women and it has been extensively studied on the molecular level. Male breast cancer (MBC), on the other hand, is rare and has not been thoroughly investigated in terms of transcriptional profiles or genomic aberrations. Most of our understanding of MBC has therefore been extrapolated from knowledge of female breast cancer. Although differences in addition to similarities with female breast cancer have been reported, the same prognostic and predictive markers are used to determine optimal management strategies for both men and women diagnosed with breast cancer. This review is focused on prognosis for MBC patients, prognostic and predictive factors and molecular subgrouping; comparisons are made with female breast cancer. Information was collected from relevant literature on both male and female breast cancer from the MEDLINE database between 1992 and 2014. MBC is a heterogeneous disease, and on the molecular level many differences compared to female breast cancer have recently been revealed. Two distinct subgroups of MBC, luminal M1 and luminal M2, have been identified which differ from the well-established intrinsic subtypes of breast cancer in women. These novel subgroups of breast cancer therefore appear unique to MBC. Furthermore, several studies report inferior survival for men diagnosed with breast cancer compared to women. New promising prognostic biomarkers for MBC (e.g. NAT1) deserving further attention are reviewed. Further prospective studies aimed at validating the novel subgroups and recently proposed biomarkers for MBC are warranted to provide the basis for optimal patient management in this era of personalized medicine.The international journal of biochemistry & cell biology. 05/2014; 53:526-35.
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ABSTRACT: Less than 1% of all breast cancer cases are found in men, who reportedly have inferior outcomes compared with matched women patients. Ethnic differences may also affect their prognosis. Here, we investigated overall survival (OS) and major prognostic factors for male breast cancer (MBC) in a cohort of Egyptian patients. We retrospectively analyzed OS in a cohort of 69 male patients with MBC who were surgically treated at the Mansoura Cancer Center, Egypt between 2000 and 2007. We registered demographic data, age, height, weight and body mass index, tumor size, histology, number of infiltrated axillary lymph nodes, hormone receptor (HR) status and metastatic presence, and TNM staging. Patients' OS was the primary endpoint. Patients received treatment to the medical standards at the time of their diagnosis. In the 69 patients who met the inclusion criteria and had complete stored patient data, tumors ranged from T1c to T3. We could gather cancer-related survival data from only 56 patients. The collective 5-year survival in this cohort was 46.4%. Only five patients had distant metastasis at diagnosis, but they showed a null percent 5-year survival, whereas those with no lymph node infiltration showed a 100% 5-year survival. Lymph node status and tumor grading were the only prognostic factors that significantly affected OS. Lymph node status and tumor grade are the most important prognostic factors for overall survival of MBC in Egyptian male patients; whereas even remarkably low HR expression in MBC did not significantly affect OS. Further research is needed to understand the factors that affect this disease.BMC Cancer 03/2014; 14(1):227. · 3.32 Impact Factor