Skip to main content

Advertisement

Log in

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

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Giordano SH, Cohen DS, Buzdar AU, Perkins G, Hortobagyi GN. Breast carcinoma in men: a population-based study. Cancer. 2004;101:51–7.

    Article  Google Scholar 

  2. Anderson WF, Jatoi I, Tse J, Rosenberg PS. Male breast cancer: a population-based comparison with female breast cancer. J Clin Oncol. 2010;28:232–9.

    Article  Google Scholar 

  3. Goss PE, Reid C, Pintilie M, Lim R, Miller N. Male breast carcinoma: a review of 229 patients who presented to the Princess Margaret Hospital during 40 years: 1955–1996. Cancer. 1999;85:629–39.

    Article  CAS  Google Scholar 

  4. Cutuli B, Lacroze M, Dilhuydy JM, et al. Male breast cancer: results of the treatments and prognostic factors in 397 cases. Eur J Cancer. 1995;31A:1960–4.

    Article  CAS  Google Scholar 

  5. Guinee VF, Olsson H, Moller T, et al. The prognosis of breast cancer in males: a report of 335 cases. Cancer. 1993;71:154–61.

    Article  CAS  Google Scholar 

  6. Kwong A, Chau WW, Mang OW, et al. Male breast cancer: a population-based comparison with female breast cancer in Hong Kong, Southern China: 1997–2006. Ann Surg Oncol. 2014;21:1246–53.

    Article  Google Scholar 

  7. Foerster R, Foerster FG, Wulff V, et al. Matched-pair analysis of patients with female and male breast cancer: a comparative analysis. BMC Cancer. 2011;11:335.

    Article  Google Scholar 

  8. El-Tamer MB, Komenaka IK, Troxel A, et al. Men with breast cancer have better disease-specific survival than women. Arch Surg. 2004;139:1079–82.

    Article  Google Scholar 

  9. Speirs V, Shaaban AM. The rising incidence of male breast cancer. Breast Cancer Res Treat. 2009;115:429–30.

    Article  Google Scholar 

  10. Narod SA. Breast cancer in young women. Nat Rev Clin Oncol. 2012;9:460–70.

    Article  CAS  Google Scholar 

  11. Collins LC, Marotti JD, Gelber S, et al. Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer. Breast Cancer Res Treat. 2012;131:1061–6.

    Article  CAS  Google Scholar 

  12. Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol. 2008;26:3324–30.

    Article  Google Scholar 

  13. King TA. Selecting local therapy in the young breast cancer patient. J Surg Oncol. 2011;103:330–6.

    Article  Google Scholar 

  14. van Nes JG, van de Velde CJ. The preferred treatment for young women with breast cancer: mastectomy versus breast conservation. Breast. 2006;15(Suppl 2):S3–10.

    PubMed  Google Scholar 

  15. Pilewskie M, King TA. Age and molecular subtypes: impact on surgical decisions. J Surg Oncol. 2014;110:8–14.

    Article  Google Scholar 

  16. Wang K, Ren Y, Li H, et al. Comparison of clinicopathological features and treatments between young (≤ 40 years) and Older (> 40 years) female breast cancer patients in West China: a retrospective, epidemiological, multicenter, case-only study. PLoS One. 2016;11:e0152312.

    Article  Google Scholar 

  17. Martelli G, Boracchi P, Ardoino I, et al. Axillary dissection versus no axillary dissection in older patients with T1N0 breast cancer: 15-year results of a randomized controlled trial. Ann Surg. 2012;256:920–4.

    Article  Google Scholar 

  18. Rudenstam CM, Zahrieh D, Forbes JF, et al. Randomized trial comparing axillary clearance versus no axillary clearance in older patients with breast cancer: first results of International Breast Cancer Study Group Trial 10-93. J Clin Oncol. 2006;24:337–44.

    Article  Google Scholar 

  19. Hughes KS, Schnaper LA, Berry D, et al. Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med. 2004;351:971–7.

    Article  CAS  Google Scholar 

  20. Adami HO, Bergkvist L, Krusemo U, Persson I. Breast cancer as a risk factor for other primary malignant diseases: a nationwide cohort study. J Natl Cancer Inst. 1984;73:1049–55.

    CAS  PubMed  Google Scholar 

  21. Matesich SM, Shapiro CL. Second cancers after breast cancer treatment. Semin Oncol. 2003;30:740–8.

    Article  CAS  Google Scholar 

  22. Obedian E, Fischer DB, Haffty BG. Second malignancies after treatment of early-stage breast cancer: lumpectomy and radiation therapy versus mastectomy. J Clin Oncol. 2000;18:2406–12.

    Article  CAS  Google Scholar 

  23. Cutuli BF, Lacroze M, Dilhuydy JM, et al. Breast cancer in men: incidence and types of associated previous synchronous and metachronous cancers. Bull Cancer. 1992;79:689–96.

    CAS  PubMed  Google Scholar 

  24. Hemminki K, Scelo G, Boffetta P, et al. Second primary malignancies in patients with male breast cancer. Br J Cancer. 2005;92:1288–92.

    Article  CAS  Google Scholar 

  25. Satram-Hoang S, Ziogas A, Anton-Culver H. Risk of second primary cancer in men with breast cancer. Breast Cancer Res. 2007;9:R10.

    Article  Google Scholar 

  26. Auvinen A, Curtis RE, Ron E. Risk of subsequent cancer following breast cancer in men. J Natl Cancer Inst. 2002;94:1330–2.

    Article  Google Scholar 

  27. Cutuli B, Le-Nir CC, Serin D, et al. Male breast cancer: evolution of treatment and prognostic factors: analysis of 489 cases. Crit Rev Oncol Hematol. 2010;73:246–54.

    Article  CAS  Google Scholar 

  28. Gomez-Raposo C, Zambrana Tevar F, Sereno Moyano M, Lopez Gomez M, Casado E. Male breast cancer. Cancer Treat Rev. 2010;36:451–7.

    Article  Google Scholar 

  29. La Verde N, Collova E, Lonardi S, et al. Male breast cancer: clinical features and multimodal treatment in a retrospective survey analysis at Italian centers. Tumori. 2013;99:596–600.

    Article  Google Scholar 

  30. Cardoso F, Bartlett JMS, Slaets L, et al. Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Ann Oncol. 2018;29(2):405–17.

    CAS  PubMed  Google Scholar 

  31. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Kosary CL, et al. (eds). SEER cancer statistics review, 19752014. National Cancer Institute, Bethesda, MD. Retrieved at https://seer.cancer.gov/csr/1975_2014/, based on November 2016 SEER data submission, posted to the SEER web site April 2017. Accessed 11 Sep 2018.

  32. Leone JP, Zwenger AO, Iturbe J, et al. Prognostic factors in male breast cancer: a population-based study. Breast Cancer Res Treat. 2016;156:539–48.

    Article  Google Scholar 

  33. Brinton LA, Richesson DA, Gierach GL, et al. Prospective evaluation of risk factors for male breast cancer. J Natl Cancer Inst. 2008;100:1477–81.

    Article  Google Scholar 

  34. D’Avanzo B, La Vecchia C. Risk factors for male breast cancer. Br J Cancer. 1995;71:1359–62.

    Article  Google Scholar 

  35. Ewertz M, Holmberg L, Tretli S, Pedersen BV, Kristensen A. Risk factors for male breast cancer: a case-control study from Scandinavia. Acta Oncol. 2001;40:467–71.

    Article  CAS  Google Scholar 

  36. Hsing AW, McLaughlin JK, Cocco P, Co Chien HT, Fraumeni JF Jr. Risk factors for male breast cancer (United States). Cancer Causes Control. 1998;9:269–75.

    Article  CAS  Google Scholar 

  37. Johnson KC, Pan S, Mao Y. Risk factors for male breast cancer in Canada, 1994–1998. Eur J Cancer Prev. 2002;11:253–63.

    Article  CAS  Google Scholar 

  38. Brinton LA, Cook MB, McCormack V, et al. Anthropometric and hormonal risk factors for male breast cancer: male breast cancer pooling project results. J Natl Cancer Inst. 2014;106:djt465.

    Article  Google Scholar 

  39. Rohrmann S, Shiels MS, Lopez DS, et al. Body fatness and sex steroid hormone concentrations in US men: results from NHANES III. Cancer Causes Control. 2011;22:1141–51.

    Article  Google Scholar 

  40. Travis RC, Key TJ, Allen NE, et al. Serum androgens and prostate cancer among 643 cases and 643 controls in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2007;121:1331–8.

    Article  CAS  Google Scholar 

  41. Massarweh SA, Sledge GW, Miller DP, McCullough D, Petkov VI, Shak S. Molecular characterization and mortality from breast cancer in men. J Clin Oncol. 2018:27:JCO2017768861.

    Google Scholar 

  42. Hung MH, Liu CJ, Teng CJ, et al. Risk of second non-breast primary cancer in male and female breast cancer patients: a population-based cohort study. PLoS One. 2016;11:e0148597.

    Article  Google Scholar 

  43. Leibowitz SB, Garber JE, Fox EA, et al. Male patients with diagnoses of both breast cancer and prostate cancer. Breast J. 2003;9:208–12.

    Article  Google Scholar 

  44. Tajika M, Tuchiya T, Yasuda M, et al. A male case of synchronous double cancers of the breast and prostate. Intern Med. 1994;33:31–5.

    Article  CAS  Google Scholar 

  45. Ozet A, Yavuz AA, Komurcu S, et al. Bilateral male breast cancer and prostate cancer: a case report. Jpn J Clin Oncol. 2000;30:188–90.

    Article  CAS  Google Scholar 

  46. Lopez-Otin C, Diamandis EP. Breast and prostate cancer: an analysis of common epidemiological, genetic, and biochemical features. Endocr Rev. 1998;19:365–96.

    CAS  PubMed  Google Scholar 

  47. Wernberg JA, Yap J, Murekeyisoni C, Mashtare T, Wilding GE, Kulkarni SA. Multiple primary tumors in men with breast cancer diagnoses: a SEER database review. J Surg Oncol. 2009;99:16–9.

    Article  Google Scholar 

Download references

Acknowledgment

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

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mary L. Gemignani MD, MPH.

Ethics declarations

Disclosure

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

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cronin, P.A., Romanoff, A., Zabor, E.C. et al. Influence of Age on the Clinical Outcome of Breast Cancer for Men and the Development of Second Primary Cancers. Ann Surg Oncol 25, 3858–3866 (2018). https://doi.org/10.1245/s10434-018-6767-0

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-018-6767-0

Keywords

Navigation