WASHINGTON — Less than 1% of breast cancer occurs in men, although it continues to rise.
Because of that rarity—and the related scarcity of clinical studies on the topic—management of male breast cancer (MBC) tends to be generalized from studies on female breast cancer, according to a new report in Clinical Breast Cancer.1
DC VAMC-led researchers gathered data from 152 VA medical centers to analyze the database of veteran patients with breast cancer diagnosed between 1998 and 2016 using biostatistical software. The primary objective was to compare patients’ demographics, breast cancer characteristics and outcomes for male and female veterans.
Researchers compared 1,528 MBC cases with 7,336 FBC with a mean follow-up time of 5.5 years (SD 4.17). Among patients, the mean age at diagnosis was 68.6 years and 57.3 years for MBC and FBC, respectively (P <0.0001).
The study determined that higher numbers of MBC patients (95%) were 50 or older, compared to FBC patients (72%). More MBC patients (16.8 vs. 9.1% and 9.0 vs. 4.0%) also presented with higher disease stage (III and IV, respectively).
The study also found that estrogen receptor-positive tumors were more common in men with breast cancer, 59%, vs. women, 52%.
Treatment differences also were observed:
- Hormonal treatment was received by 27% of MBC vs. 19% FBC;
- Chemotherapy 21.3% vs. 41.5%; and
- Radiation 23.5% vs. 60.9%.
Mortality rates also were considerably higher among men: 42% of MBC and 20% of FBC veterans died during the study. The authors pointed out that male patients had higher death rates, 1.285 (95% CI: 1.150, 1.434, P < 0.0001) compared to females after adjusting data for age, race, stage and grade.
“To the best of our knowledge, this is the largest comparison series of MBC and FBC to date in the veteran population,” the authors wrote. “The higher mortality rate in MBC patients may be due to late presentation, higher stage at the time of diagnosis and/or tumor biology. Veterans’ exposures to hazardous materials during their military deployments as an additional factor for worse prognosis need further investigation.”
- Aggarwal A, Adepoju B, Yacur M, Maron D, Sharma MC. Gender Disparity in Breast Cancer: A Veteran Population-Based Comparison. Clin Breast Cancer. 2021 Jan 26:S1526-8209(21)00026-4. doi: 10.1016/j.clbc.2021.01.013. Epub ahead of print. PMID: 33619003.
