Influence of Age on the Clinical Outcome of Breast Cancer for Men and the Development of Second Primary Cancers

Patricia A. Cronin, Anya Romanoff, Emily C. Zabor, Michelle Stempel, Anne Eaton, Lillian M. Smyth, Alice Y. Ho, Monica Morrow, Mahmoud El-Tamer, Mary L. Gemignani

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2 Scopus citations

Abstract

Background: Low incidence of breast cancer in men (BCM) (< 1% of all breast cancers) has led to a paucity of outcome data. This study evaluated the impact of age on BCM outcomes. Methods: For this study, BCM patients treated between 2000 and 2011 were stratified by age (≤ 65 or > 65 years). Kaplan–Meier methods were used to compare overall survival (OS) and breast cancer-specific survival (BCSS). Competing-risk methods analyzed time to second primary cancers (SPCs), with any-cause death treated as a competing risk. Results: The study identified 152 BCM patients with a median age of 64 years (range 19–96 years). The median body mass index (BMI) was 28 kg/m 2 . Men age 65 years or younger (n = 78, 51%) were more overweight/obese than men older than 65 years (n = 74, 49%) (89% vs 74%, respectively; P = 0.008). Both groups had similar nodal metastases rates (P = 0.4), estrogen receptor positivity (P = 1), and human epidermal growth factor receptor 2 (HER2)neu overexpression (P = 0.6). Men 65 years of age or younger were more likely to receive chemotherapy (P = 0.002). The median follow-up period was 5.8 years (range 0.1–14.4 years). The 5-year OS was 86% (95% confidence interval [CI] 80–93%), whereas the 5-year BCSS was 95% (95% CI 91–99%). The BCM patients 65 years of age and younger had better OS (P = 0.003) but not BCSS (P = 0.8). The 5-year cumulative incidence of SPC was 8.4% (95% CI 3.4–13.4%). The prior SPC rate was higher for men older than 65 years (n = 20, 31%) than for those age 65 years or younger (n = 7, 11%) (P = 0.008). This did not account for differences in life years at risk. No difference was observed in SPC cumulative incidence stratified by age (P = 0.3). Conclusions: Men 65 years of age or younger received more chemotherapy and had improved OS, but not BCSS, compared with men older than 65 years. For all BCM, SPC is a risk, and appropriate screening may be warranted.

Original languageEnglish (US)
Pages (from-to)3858-3866
Number of pages9
JournalAnnals of Surgical Oncology
Volume25
Issue number13
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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    Cronin, P. A., Romanoff, A., Zabor, E. C., Stempel, M., Eaton, A., Smyth, L. M., Ho, A. Y., Morrow, M., El-Tamer, M., & Gemignani, M. L. (2018). Influence of Age on the Clinical Outcome of Breast Cancer for Men and the Development of Second Primary Cancers. Annals of Surgical Oncology, 25(13), 3858-3866. https://doi.org/10.1245/s10434-018-6767-0