- Men with breast cancer in the United States have nearly 20% poorer survival than women.
Why this matters
- Undertreatment and clinical characteristics (eg, higher proportion of late-stage diagnoses) account for about 63.3% of the excess mortality.
- More research is needed on survival disparity.
- Retrospective cohort (n=16,025 men and 1,800,708 women with breast cancer) drawn from the National Cancer Database (2004-2014).
- Funding: China Scholarship Council.
- Males had lower OS than women:
- 3-year OS rates: 86.4% vs 91.7% of women.
- 5-year OS rates: 77.6% vs 86.4% of women.
- Excess mortality in men applied across all breast cancer stages at diagnosis.
- Clinical characteristics and undertreatment accounted for 63.3% of the excess mortality:
- Men were older at diagnosis, at 63.3 vs 59.9 years for women.
- Men also had a higher percentage of late-stage diagnosis, at 14.0% vs 8.9% at stage III; 5.8% vs 3.8% at stage IV.
- Men also were less likely to get endocrine therapy (57.9% vs 70.2% of hormone receptor-positive cases) and radiotherapy (64.9% vs 78.6% after breast conserving surgery).
- After adjustment for clinical and treatment factors, men had higher total mortality (aHR, 1.18; 95% CI, 1.15-1.22).
- Cause of death not captured.