Differences in Male Breast Cancer Stage, Tumor Size at Diagnosis, and Survival Rate Between Metropolitan and Nonmetropolitan Regions

Although the incidence for breast cancer in men is lower than for women, male breast cancer (MBC) patients are diagnosed at a later stage and have a higher mortality rate than women. This study examined male cases reported from 1988 through 2006 in the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute for differences in cancer stage, tumor size at diagnosis, and survival rate between metropolitan and nonmetropolitan regions. Pearson’s chi-square was used to evaluate differences in stage and tumor size at diagnosis. Cox proportional hazards regression was used to assess survival differences after adjusting for confounders (race, marital status, median family income, age, and education). Regional differences in tumor grade size and stage at diagnosis were not statistically significant; however, survival differences were observed between metropolitan and nonmetropolitan regions. An interaction between nonmetropolitan area and regional stage MBC was a significant predictor of poorer survival. Raising awareness of MBC in nonmetropolitan areas could save the lives of many men and action should be taken to improve health care access, treatment, and thus prognosis in this population.

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Factors Affecting Survival in Patients with Breast Cancer in Hamedan Province from 2001 to 2018

10.30699/ijbd.12.4.31 ◽

2019 ◽

Vol 12 (4) ◽

pp. 31-38

Author(s):

Rasoul Najafi ◽

Fatemeh Amiri ◽

Ghodrat Roshanaei ◽

Mohammad Abbasi ◽

Mahdi Razi

Keyword(s):

Breast Cancer ◽

Survival Rate ◽

Cancer Progression ◽

Tumor Size ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Factors Affecting

Introduction: Breast cancer is the most common cancer and one of the leading causes of death in women. Identification of factors affecting the survival rate of these patients is important for the prevention of breast cancer progression and better treatment. Methods: This retrospective cohort study was performed on 493 women with breast cancer referred to Imam Khomeini clinic in Hamadan between 2001 and 2018. The Kaplan-Meier method and the Cox proportional hazard model were used to estimate the survival rate and factors affecting patient survival. All analyses were performed using SPSS 21. Results: The mean (standard deviation) age of the patients was 49.75 (11.34) years, and the 5- and 10-year survival rates were 61% and86%, respectively. The Cox proportional hazards model showed a significant relationship between age(HR (%95 CI)=1.53(1.23-2.78)) and tumor size (HR (%95 CI)=1.49(1.16-2.89)) and mortality risk (P < 0.05). Conclusion: Age and tumor size are associated with survival in patients with breast cancer. Therefore, increasing women’s awareness of the benefits of periodic examinations and early diagnosis can contribute to early detection of the disease and improved survival.

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Clinical features of patients with male breast cancer in Shanxi province of China from 2007 to 2016

Journal of Investigative Medicine ◽

10.1136/jim-2018-000823 ◽

2018 ◽

Vol 67 (3) ◽

pp. 699-705

Author(s):

Weigang Wang ◽

Xiaoqin Xu ◽

Baoguo Tian ◽

Yan Wang ◽

Lili Du ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Features ◽

Male Breast Cancer ◽

Hormone Receptors ◽

Ductal Carcinoma ◽

Cox Proportional Hazards ◽

Male Breast ◽

Shanxi Province ◽

Smoking History ◽

Large Sample Size

This study aims to understand the clinical features, treatment, and prognosis of patients with male breast cancer (MBC) in Shanxi province of China from 2007 to 2016. Data for 77 patients with MBC were collected for analysis. Immunohistochemistry, pathological results, and other data such as demographic characteristics (age, marital status, smoking history, drinking history, and family history of cancer) as well as clinical data were investigated by retrieving information from the patients’ medical records. A total of 12,404 patients were diagnosed with breast cancer between 2007 and 2016, and 77 were patients with MBC among them. The median diagnosis age of patients with MBC was 62 years (range, 24–84 years). The most common complaint was a painless lump in the breast, accounting for 68.8% of the patients, and the main pathological type in MBC was infiltrating ductal carcinoma (66.2%). In terms of hormone receptors, 80.5% (62/77) of patients with MBC were estrogen receptor positive, 75.3% (58/77) of patients were progesterone receptor positive, and only 6.5% (5/77) of patients were HER2 overexpressing. The multivariant Cox proportional hazards regression analysis showed that M stage is an independent prognostic factor (p=0.018, HR=18.791, 95% CI 1.663 to 212.6). The epidemiological and clinical features of Chinese MBC are similar to that of other countries. As the Chinese public have limited knowledge of MBC, it is necessary to increase awareness among them about it. Further research with a large sample size is required for better understanding of the risks associated with MBC.

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Male breast carcinoma in United States: Survival rate and determinants of prognosis.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.32 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 32-32

Author(s):

S. Talluri ◽

R. Kakarala ◽

T. Karedan ◽

M. Kakarala

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Median Survival ◽

Male Breast Cancer ◽

Tumor Size ◽

Lymph Node Involvement ◽

Female Breast Cancer ◽

Male Breast ◽

Female Breast ◽

Node Involvement

32 Background: Male breast cancer (MBC) is rare and accounts for less than 1% of all cancers in men. It causes significant morbidity and mortality due to late diagnosis. The primary objective of our study is to update information about the receptor status, pathology, survival rates, and prognostic factors for MBC. Our secondary objective is to determine racial differences in survival of MBC and compare tumor characteristics with female breast cancer (FBC) patients. Methods: We analyzed a retrospective cohort of breast cancer patients included in National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) from 1990 to 2007. Differences between patient and disease characteristics at the time of diagnosis among MBC and FBC patients were compared using chi-square test. Overall survival was estimated using Kaplan-Meier method. Cox proportional hazards regression model was used to determine the independent variables that affect survival. Results: We included 2,475 men and 393,259 women with breast cancer in our analysis. Median age at diagnosis was higher in men compared to women (67 vs 61years). Men had more frequent lymph node involvement (32% vs. 22%), ER positivity (66% vs. 57%) and PR positivity (57% vs. 49%) breast cancer than women (P<0.001). Overall median survival in MBC was 9 years, 5-year survival was 63% and 10-year survival was 43%. Increased age, larger tumor size, higher grade, lymph node involvement, ER and PR negative status were significantly associated with decreased survival in univariate analysis (P <0.05). In multivariate analysis, age > 65 years at the time of diagnosis, larger tumor size, positive lymph node status, ER negative status and poorly differentiated grade were associated with decreased survival (P <0.02). However PR status was not a significant predictor of survival. The median survival in African American males was lower as compared to Caucasians (7.08 vs. 9.2 yrs.) (P=0.02). Conclusions: Male breast cancer differs from female breast cancer in important biological characteristics with a higher age at diagnosis and frequent lymph node involvement. Age greater than 65 years, tumor size, grade, lymph node involvement and ER status of the tumor are independent predictors of survival in MBC.

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Tree-Based Model for Breast Cancer Prognostication

Journal of Clinical Oncology ◽

10.1200/jco.2004.11.141 ◽

2004 ◽

Vol 22 (13) ◽

pp. 2567-2575 ◽

Cited By ~ 68

Author(s):

Mousumi Banerjee ◽

Julie George ◽

Eun Young Song ◽

Anuradha Roy ◽

William Hryniuk

Keyword(s):

Breast Cancer ◽

Marital Status ◽

Tumor Size ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Lymph Node Status ◽

Recurrence Free Survival ◽

Free Survival ◽

Significant Difference ◽

Prognostic Groups

Purpose To define prognostic groups for recurrence-free survival in breast cancer, assess relative effects of prognostic factors, and examine the influence of treatment variations on recurrence-free survival in patients with similar prognostic-factor profiles. Patients and Methods We analyzed 1,055 patients diagnosed with stage I-III breast cancer between 1990 and 1996. Variables studied included socioeconomic factors, tumor characteristics, concurrent medical conditions, and treatment. The primary end point was recurrence-free survival (RFS). Multivariable analyses were performed using recursive partitioning and Cox proportional hazards regression. Results The most significant difference in prognosis was between patients with fewer than four and those with at least four positive nodes (P < .0001). Four distinct prognostic groups (5-year RFS, 97%, 78%, 58%, and 27%) were developed, defined by the number of positive nodes, tumor size, progesterone receptor (PR) status, differentiation, race, and marital status. Patients with fewer than four positive nodes and tumor ≤ 2 cm, PR positive, and well or moderately differentiated had the best prognosis. RFS in this group was unaffected by type of adjuvant therapy (P = .38). Patients with at least four positive nodes and PR-negative tumors had the worst prognosis, and those treated with tamoxifen plus chemotherapy had the best outcome in this group (P = .0001). Among patients in the two intermediate-risk groups, those treated with tamoxifen or a combination of tamoxifen and chemotherapy had the best outcome. Conclusion Lymph node status, PR status, tumor size, differentiation, race, and marital status are valuable for prognostication in breast cancer. The prognostic groups derived can provide guidance for clinical trial design, patient management, and future treatment policy.

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Secondary Breast Cancer Sociodemographic Characteristics and Survival by Age Group

Annals of Surgical Oncology ◽

10.1245/s10434-021-10340-3 ◽

2021 ◽

Author(s):

Candice A. M. Sauder ◽

Qian Li ◽

Richard J. Bold ◽

Kathryn J. Ruddy ◽

Theresa H. M. Keegan

Keyword(s):

Breast Cancer ◽

Proportional Hazards ◽

Primary Diagnosis ◽

Cox Proportional Hazards ◽

Hormone Receptor Positive ◽

Survival Difference ◽

Asian Pacific ◽

Organ Site ◽

Survival Differences ◽

Secondary Breast Cancer

Abstract Background Secondary cancers account for 16% of all new cancer diagnoses, with breast cancer (BC) the most common secondary cancer. We have shown that secondary BC has unique characteristics and decreased survival compared with primary BC in adolescent and young adults (AYA; 15–39 years old). However, older BC populations are less well studied. Methods Females (age ≥ 15 years) diagnosed with primary BC during 1991–2015 (n = 377,167) and enrolled in the California Cancer Registry were compared with those with secondary BC (n = 37,625) by age (15–39, 40–64, ≥ 65 years). We examined BC-specific survival (BCSS) accounting for other causes of death as a competing risk using multivariable Cox proportional hazards regression. Results Most secondary BC patients were of older age (15–39, n = 777; 40–64, n = 15,848; ≥ 65, n = 21,000). Compared with primary BC treatment, secondary BCs were more often treated with mastectomy and less often with chemotherapy and/or radiation. BCSS was shorter in secondary BC patients than primary BC patients, but the survival difference between secondary and primary BC diminished with age [15–39 hazard ratio (HR): 2.09, 95% confidence interval (CI) 1.83–2.39; 40–64 HR: 1.51; 95% CI 1.44–1.58; ≥ 65 HR: 1.14; 95% CI 1.10–1.19]. Survival differences were most pronounced in women with hormone receptor positive disease and Hispanic and Asian/Pacific Islanders 40–64 years of age. Conclusions When BC is diagnosed following a prior cancer of any organ site, BCSS is worse than when compared with patients for whom BC is the primary diagnosis, suggesting that we may need to tailor our treatments for women with secondary BC.

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Molecular Subtype May Be More Associated With Prognosis and Chemotherapy Benefit Than Tumor Size in T1N0 Breast Cancer Patients: An Analysis of 2,168 Patients for Possible De-Escalation Treatment

Frontiers in Oncology ◽

10.3389/fonc.2021.636266 ◽

2021 ◽

Vol 11 ◽

Author(s):

Siji Zhu ◽

Yafen Li ◽

Weiguo Chen ◽

Xiaochun Fei ◽

Kunwei Shen ◽

...

Keyword(s):

Breast Cancer ◽

Tumor Size ◽

Proportional Hazards ◽

Cox Regression ◽

Molecular Subtype ◽

Growth Factor Receptor ◽

Disease Free Survival ◽

Cox Proportional Hazards ◽

Breast Cancer Patients ◽

Cancer Specific Survival

PurposeBreast cancer (BC) patients with T1N0 tumors have relatively favorable clinical outcomes. However, it remains unclear whether molecular subtypes can aide in prognostic prediction for such small, nodal-negative BC cases and guide decision-making about escalating or de-escalating treatments.Patients and MethodsT1N0 BC patients diagnosed between 2009 and 2017 were included and classified into three subgroups according to receptor status: 1) hormonal receptor (HR)+/human epidermal growth factor receptor-2 (HER2)−; 2) HER2+; and 3) triple negative (TN) (HR−/HER2−). Patients’ characteristics and relapse events were reviewed. Kaplan–Meier analysis and Cox regression were used to assess the iDFS and BCSS. The effects of risk factors and adjuvant treatment benefits were evaluated by calculating hazard ratios (HRs) for invasive disease-free survival (iDFS) and breast cancer-specific survival (BCSS) with Cox proportional hazards models.ResultsIn total, 2,168 patients (1,435 HR+/HER2−, 427 HER2+, 306 TN) were enrolled. The 5-year iDFS rates were 93.6, 92.7, and 90.6% for HR+/HER2−, HER2+, and TN patients, respectively (P = 0.039). Multivariate analysis demonstrated that molecular subtype (P = 0.043), but not tumor size (P = 0.805), was independently associated with iDFS in T1N0 BC. TN patients [HRs = 1.77, 95% confidence interval (CI) = 1.11–2.84, P = 0.018] had a higher recurrence risk than HR+/HER2− patients. Adjuvant chemotherapy benefit was not demonstrated in all T1N0 patients but interacted with molecular subtype status. TN (adjusted HRs = 2.31, 95% CI = 0.68–7.54) and HER2+ (adjusted HRs = 2.26, 95% CI = 0.95–5.63) patients receiving chemotherapy had superior iDFS rates. Regarding BCSS, molecular subtype tended to be related to outcome (P = 0.053) and associated with chemotherapy benefit (P = 0.005).ConclusionMolecular subtype was more associated with disease outcome and chemotherapy benefit than tumor size in T1N0 BC patients, indicating that it may guide possible clinical de-escalating therapy in T1N0 BC.

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