Hormone Receptor-Positive Breast Cancer Has a Worse Prognosis in Male Than in Female Patients

Abstract

Introduction: Male breast carcinoma (MBC) is treated similarly to female breast carcinoma (FBC), and similar survival rates for both have been assumed. We analyzed prognostic and clinicopathologic features of MBC to determine whether MBC subtypes differ from FBC subtypes.

Patients and methods: We reviewed data for 172,847 FBC and 1442 MBC patients from 2010 to 2012 from the National Cancer Institute Surveillance, Epidemiology, and End Results database. Carcinomas were subtyped according to hormone receptor (HR) and HER2 status as HR-positive (HR⁺)/HER2^-, HR⁺/HER2⁺, HR^-/HER2⁺, and HR^-/HER2^-.

Results: The overall incidence of MBC in all breast carcinoma cases was 0.8%. MBC was more frequently HR⁺/HER2^- than was FBC (78.3% vs. 67.4%) and less frequently HR^-/HER2^- (2.1% vs. 10.9%). More MBC was staged as III or IV (24.9% vs. 17.2%). MBC had significantly worse overall survival (OS) than FBC (P < .0001). After adjustment for age, ethnicity, and tumor grade, stage I and II MBC had significantly worse OS time than stage-matched FBC (P = .0011 for stage I, P = .0229 for stage II). When stage- and subtype-matched patients were compared, MBC had significantly worse OS than FBC for stage I overall, for substages IA and IIB HR⁺/HER2^- carcinoma, and for stage III HR⁺/HER2⁺ carcinoma. Furthermore, MBC patients with HR⁺/HER2^- T1aN0 carcinomas had worse OS than did FBC patients.

Conclusion: Patients with MBC have worse survival than patients with FBC, especially for early-stage HR⁺ breast cancers. More studies are needed optimize treatment for MBC.

Keywords: Breast cancer prognosis; Breast cancer subtype; Male breast cancer; Matched stage and subtype; Prognosis.