Male breast cancer worse for blacks than whites
NEW YORK (Reuters Health) - While rare, breast cancer can occur in men. When it does, mortality is three times higher among black men than white men, according to a new study.
The researchers note in the March 20th Journal of Clinical Oncology that black women with breast cancer also have a higher mortality than white women. "It is interesting that in (male breast cancer), as well, there are also disparities in survival," Dr. Dawn L. Hershman told Reuters Health.
"By understanding the similarities between men and women with regard to disparities in breast cancer survival," she added, "we may better understand the reasons for these disparities, and we will be one step closer to resolving the disparities in survival between blacks and whites."
Hershman, from Columbia University, New York, and her associates investigated factors influencing outcomes among 456 white men and 34 black men diagnosed with breast cancer identified in a Medicare database.
The average age of the patients was 76 years. "Male breast cancer is primarily a disease of the elderly and is mostly a cancer that is hormone sensitive," Hershman pointed out.
Black men were more likely than white men to have advanced-stage disease, larger tumor sizes, disease that had spread to the lymph nodes, poorly differentiated tumors, and higher rates of other illnesses, the team reports.
After accounting for known clinical and demographic factors, black men were about 48 percent less likely to be referred to a medical oncologist and 56 percent less likely to receive chemotherapy, compared with white men.
During an average follow-up of almost 5 years, about half the men died. The investigators found that blacks were 3.29-times more likely to die from the breast cancer (rather than another cause) than whites.
"Efforts should be made to ensure that patients with breast cancer receive and complete standard (add-on) therapy," Dr. Hershman added. "Current data suggest this is not the case."
SOURCE: Journal of Clinical Oncology, March 20, 2007
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Male breast cancer worse for blacks than whites
The study reviewed here is a reminder that breast cancer does occur in men, especially in elderly men. And like African American women, African American men are hit harder by breast cancer than their white counterparts. After diagnosis, African American men are three times more likely to die from breast cancer than white men. This difference is probably due to the same factors suggested by research involving African American women.
One factor may be different approaches to treatment. In this study, African American men were less likely than white men to be referred to an oncologist or get chemotherapy for breast cancer; this may be because of disparities in healthcare for African American men.
Still, research suggests that breast cancers in African American men and women may have different genes than breast cancers in whites. These different genes could explain why the breast cancers in African American men were much more likely to be large and spread to the lymph nodes when diagnosed.
It's very difficult to change genetics. But disparities in healthcare shouldn't be any part of the reason for a less favorable outlook after breast cancer treatment. No matter your gender or ethnicity, do your best to make sure that you're getting the best care possible. Learn about your options. Ask questions. Seek out second opinions. Insist that the healthcare system do its best for YOU.