Abstract
The purpose of this study is to compare the racial differences in treatment and overall survival (OS) of male breast cancer (MBC) patients. Data were extracted from the NCI SEER database that included population-based registries from 1988 to 2010 and analyzed using SPSS 20.0. 4,279 MBC patients were identified. 3,266 (76.3%) patients were White, 552 (12.9%) Black, 246 (5.7%) Hispanic, and 215 (5.0%) Asian. Black patients were more likely to be diagnosed at younger age (P < 0.001), have advanced stage disease (P = 0.001), and be unmarried (P < 0.001) and less likely to undergo lymph node dissection (P = 0.006). When stratified by stage, there was no difference in receipt of primary treatment by race. The 5-year OS for White, Black, Hispanic, and Asian races was 73.8%, 66.3%, 74.0%, and 85.3% (P < 0.001). This significant worse 5-year OS for Blacks persisted regardless of age, stage II or III disease, and grade 2 or 3 disease. On multivariate analysis, Black race was a significant independent prognostic factor for worse OS. Blacks were less likely to receive lymph node dissection of which patients may derive benefit, though we did not observe receipt of primary treatment, after stratifying for disease stage, to be an underlying factor contributing to racial outcome differences.
Highlights
In 2014, there will be an estimated 2,240 new cases of male breast cancer (MBC) in the United States, accounting for approximately 1% of all breast cancers annually [1]
An interesting finding from our study is the significantly better overall survival (OS) observed in Asian MBC patients compared to the other races of those ≥65 years (P = 0.011), married (P = 0.037), with invasive ductal carcinoma (P < 0.001), with estrogen receptor (ER)+/progesterone receptor (PR)+ disease (P = 0.006), receiving modified radical mastectomy (P = 0.002), undergoing lymph node dissection (P < 0.001), with nodal metastasis (P < 0.001), and with grade 2-3 disease (P = 0.005, P = 0.014)
The results of this SEER analysis of 4,279 MBC patients showed that race, age at diagnosis, year of diagnosis, T stage, stage of disease, and tumor grade are independent predictors for survival
Summary
In 2014, there will be an estimated 2,240 new cases of male breast cancer (MBC) in the United States, accounting for approximately 1% of all breast cancers annually [1]. Tumor size, and nodal status have been shown to impact outcome in MBC patients [3,4,5,6]. The impact of race on MBC survival is still somewhat conflicting [7,8,9,10,11], which is in contrast to that seen in female breast cancer in which Blacks have been shown to have worse survival than Whites [12, 13].
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