A new retrospective study presented at the 2011 Breast Cancer Symposium has reported that age over 65 years, large tumor size, positive lymph node status, negative estrogen receptor status (ER-) and poorly differentiated grade each are associated with decreased survival in men with breast cancer.
The study was designed to update information about receptor status, pathology, survival rates, and prognostic factors for male breast cancer. Secondary study objectives were to compare male and female breast cancer, and to examine racial differences in survival. Male breast cancer accounts for less than 1% of all cancers in men and its rarity contributes to late diagnosis, which translates into significant illness and mortality. To conduct the study, the authors analyzed data included in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database from 1990 to 2007. A total of 2,475 men and 393,259 women with breast cancer were included in the analysis.
Age at diagnosis was found to be higher in men than women (median 67 years of age for men compared to 61 years for women). Men were also more likely to have positive lymph nodes (32% compared to 22%), ER+ tumors (66% compared to 57%), and progesterone receptor positive (PR+) tumors (57% compared to 49%) than women. Overall, the men survived for a median of nine years. The five-year survival rate was 63% and 10-year survival was 43%. Higher age at diagnosis, larger tumor size, higher grade, positive lymph node status, ER- status, and PR- status were significantly associated with reduced survival when the variables were analyzed one by one. In multivariate analysis, age over 65 years, large tumor size, positive lymph node status, ER- status and poorly differentiated grade each were independently associated with decreased survival. On the other hand, PR status was not found to be a significant predictor of survival. African-American men experienced shorter survival (median 7.08 years) after diagnosis than Caucasian men (9.2 years). The authors conclude that male breast cancer differs from female breast cancer in important ways, with a higher age at diagnosis and frequent lymph node involvement. Age over 65 years, large tumor size, poorly differentiated grade, positive lymph node status and ER- status all are independent predictors of reduced survival in male breast cancer.