Risk of Death Lasts for 20 Years in Men With Early-Stage, Hormone Receptor-Positive Breast Cancer
The risk of dying from breast cancer remains high at least 20 years after diagnosis for men with a history of stage I, stage II, or stage III hormone receptor-positive breast cancer.
The research was published online on Feb. 29, 2024, by the journal JAMA Oncology. Read the abstract of “Mortality Risks Over 20 Years in Men With Stage I to Stage III Hormone Receptor-Positive Breast Cancer.”
About breast cancer in men
Male breast cancer is rare, but it does happen. Worldwide, about 1% of all breast cancers are diagnosed in men. 1
Because breast cancer in men is so uncommon, few studies have focused on it. Still, we do know that more than 90% of male breast cancers are hormone receptor-positive. Triple-negative breast cancer is rare in men.
Why do the study?
Research shows that the risk of distant or metastatic recurrence — the cancer coming back in a part of the body away from the breast — and death lasts for 20 years after diagnosis for women diagnosed with early-stage, hormone receptor-positive disease.
Not much research has been on breast cancer mortality more than five years after diagnosis in men, which is why this study was done.
About the study
The researchers looked at information from the SEER (Surveillance, Epidemiology, and End Results) databases for men diagnosed with stage I, stage II, or stage III breast cancer between 1990 and 2008. The SEER databases are large registries of cancer cases from sources throughout the United States maintained by the National Institutes of Health.
The study included 2,836 men:
34.5% were diagnosed with stage I disease
46% were diagnosed with stage II disease
19.5% were diagnosed with stage III disease
80.5% were white
56.5% were diagnosed after age 64
93.1% had mastectomy
Follow-up time ranged from 12 to about 18.5 years.
At the end of the study:
34.8% of the men were alive
22.4% had died from breast cancer
42.9% had died of causes not related to breast cancer
Among men diagnosed with stage I breast cancer:
22.6% of the breast cancer deaths happened less than five years after diagnosis
50% of the breast cancer deaths happened five to 10 years after diagnosis
Men with stage I breast cancer had a 12.4% risk of dying from breast cancer in the 20 years after diagnosis and a 52.4% risk of dying from a cause not related to breast cancer.
Among men diagnosed with stage II breast cancer:
nearly 40% of the breast cancer deaths happened less than five years after diagnosis
nearly 40% of the breast cancer deaths happened five to 10 years after diagnosis
23.5% of the breast cancer deaths happened more than 10 years after diagnosis
Men with stage II breast cancer had a 26.2% risk of dying from breast cancer in the 20 years after diagnosis and a 51.2% risk of dying from a cause not related to breast cancer.
Among men diagnosed with stage III breast cancer:
49.2% of the breast cancer deaths happened less than five years after diagnosis
Men with stage III breast cancer had a 46% risk of dying from breast cancer in the 20 years after diagnosis and a 42.8% risk of dying from a cause not related to breast cancer.
Among men who were alive five years after diagnosis, the risk of dying from breast cancer was higher for:
men younger than 50 compared to men older than 64
men diagnosed with stage II or stage III breast cancer compared to stage I
men diagnosed with grade 2 or grade 3 breast cancer compared to grade 1
“The findings of this study suggest that, in men with stage I to III hormone receptor-positive breast cancer, the risk of [breast cancer-specific mortality] persists for at least 20 years and depends on traditional clinicopathologic factors, such as age, tumor stage, and tumor grade,” the researchers concluded. “Among men with higher stages of disease, the kinetics of the [breast cancer-specific mortality] risk appear different from the risk that has been reported in women.”
What this means for you
The results of this study are concerning. A large 2019 study found that among people diagnosed with breast cancer, men have lower overall survival rates than women. The study found that undertreatment was likely the reason for much of the survival difference.
Because many men don’t consider the possibility that they might develop breast cancer, they may wait a year or longer to talk to their doctor after noticing a breast symptom. This means the cancer is diagnosed at a later stage, which also contributes to higher mortality rates.
If you’re a man, it’s very important to talk to your doctor right away about any changes in your breasts, including:
nipple pain
inverted nipple
nipple discharge
sores on the nipple or areola area
enlarged lymph nodes under the arm
If you are diagnosed with breast cancer, it’s important to be your own best advocate to make sure you get the treatments that are best for your unique situation.
Zheng, G. Male Breast Cancer: An Updated Review of Epidemiology, Clinicopathology, and Treatment. 2022. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9155932/
— Last updated on July 18, 2024 at 7:39 PM