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Mortality Risks Over 20 Years in Men With Stage I to III Hormone Receptor-Positive Breast Cancer
Julieta Leone1, Michael J Hassett2,3, Rachel A Freedman2,3
1Grupo Oncológico Cooperativo del Sur, Neuquén, Argentina.
JAMA Oncology
|February 29, 2024
Summary
Men with hormone receptor-positive (HR+) breast cancer face a persistent risk of breast cancer-specific mortality (BCSM) for at least 20 years. This risk is influenced by age, tumor stage, and grade, with higher stages showing different mortality patterns than in women.
Area of Science:
- Oncology
- Men's Health
- Cancer Epidemiology
Background:
- The long-term risk of mortality in men with HR+ breast cancer is not well-established.
- Women with HR+ breast cancer experience persistent distant recurrence and death risk for over 20 years.
Purpose of the Study:
- To determine the 20-year risks of breast cancer-specific mortality (BCSM) and non-BCSM in men with stage I-III HR+ breast cancer.
- To identify factors associated with late BCSM in this population.
Main Methods:
- Observational cohort study using SEER data (1990-2008) of men with stage I-III HR+ breast cancer.
- Cumulative incidence function and Fine and Gray multivariable regression were used to analyze BCSM and non-BCSM risks.
- Smoothed hazard estimates over time were plotted to visualize BCSM risk kinetics.
Main Results:
- Included 2836 men with a median follow-up of 15.41 years.
- 20-year cumulative BCSM risk was 12.4% (stage I), 26.2% (stage II), and 46.0% (stage III).
- Late BCSM risk was higher in younger men (<50), those with higher tumor grade (II/III/IV), and advanced stage (II/III).
Conclusions:
- BCSM risk persists for at least 20 years in men with HR+ breast cancer.
- Risk is dependent on age, tumor stage, and grade.
- Mortality patterns in men may differ from those reported in women, particularly in higher disease stages.
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