Breast cancer survival 18% poorer in men than women

  • JAMA Oncol

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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).

Limitations

  • Cause of death not captured.