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Annals of Surgical Oncology

, Volume 25, Issue 13, pp 3858–3866 | Cite as

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
Breast Oncology

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/m2. 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.

Notes

Acknowledgment

The preparation of this manuscript was supported by NIH/NCI Cancer Center Support Grant No. P30 CA008748 to Memorial Sloan Kettering Cancer Center.

Disclosure

Dr. Monica Morrow has received speaking honoraria from Genomic Health.

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Patricia A. Cronin
    • 1
  • Anya Romanoff
    • 1
  • Emily C. Zabor
    • 2
  • Michelle Stempel
    • 1
  • Anne Eaton
    • 2
  • Lillian M. Smyth
    • 3
  • Alice Y. Ho
    • 4
  • Monica Morrow
    • 1
  • Mahmoud El-Tamer
    • 1
  • Mary L. Gemignani
    • 1
  1. 1.Breast Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Department of Radiation OncologyMemorial Sloan Kettering Cancer CenterNew YorkUSA

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