Abstract
Male breast cancer (MBC) is rare. Due to limited information, MBC has always been understudied. We conducted a retrospective population-based cohort study using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. The clinical and biological features of female breast cancer (FBC) patients were compared with MBC patients. Cox regression models and competing risks analyses were used to identify risk factors associated with cancer-related survival in MBC and FBC groups. Results showed that MBC patients suffered from higher TNM stages, tumor grades, and a higher percentage of hormone receptor-positive tumors, compared with FBC patients (all p < 0.05). In addition, the breast tumor locations varied a lot between males and females (p < 0.05). FBC patients were associated with superior overall survival than MBC patients. Results from multivariate cox regression and competing risks analyses showed age, race, T, N, M-stages, tumor grades, estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) overexpression were independent prognosis factors in FBC patients (all p < 0.05). MBC patients had similar risk factors to FBC patients, but PR and HER-2 status did not independently influence survival (all p > 0.05). Tumor location was an independent prognostic factor for both gender groups.
Highlights
In terms of pathological types, 84.86% of Male breast cancer (MBC) patients were invasive ductal carcinoma compared with 77.81% in female breast cancer (FBC) patients
Lobular carcinomas accounted for only 0.62% of breast cancer in MBC patients by the contract of 8.14% in FBC patients (p < 0.001)
Compared with FBC patients, MBC patients exhibited a lower percentage of human epidermal growth factor receptor-2 (HER-2) overexpression (11.04% vs. 14.68%, p < 0.001)
Summary
The clinical and biological features of female breast cancer (FBC) patients were compared with MBC patients. Results showed that MBC patients suffered from higher TNM stages, tumor grades, and a higher percentage of hormone receptor-positive tumors, compared with FBC patients (all p < 0.05). Results from multivariate cox regression and competing risks analyses showed age, race, T, N, M-stages, tumor grades, estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) overexpression were independent prognosis factors in FBC patients (all p < 0.05). Abbreviations MBC Male breast cancer FBC Female breast cancer ER Estrogen receptor PR Progesterone receptor HER-2 Human epidermal growth factor receptor 2 OS Overall survival SEER Surveillance, epidemiology, and end results IMN Internal mammary nodes CS model Cause-specific hazard model SD model Sub-distribution hazard function model. It may be inappropriate to adopt the clinical applications of female-to-male extrapolation
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