Association between Hormone Receptor Status and Prognosis among Male Compared with Female Breast Cancer Patients: 2004-2014 SEER Data Open Access

Hu, Xiaowen (Spring 2018)

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OBJECTIVES: Male breast cancer (MBC) tends to have more common hormone receptor positivity but worse survival than female breast cancer (FBC). The study aims to explore the effect of hormone receptor on the association between gender and breast cancer prognosis at each tumor stage.

METHODS: 3971 MBC cases and 40,109 FBC cases were obtained from National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox proportional hazard analyses were conducted to explore the hazard ratio of MBC vs. FBC in different hormone receptor strata (ER+, ER-, PR+, PR-) by stage and by age.

RESULTS: The age-adjusted rate of MBC fluctuated between 1.2 per 100,000 and 1.4 per 100,000 from 2004 to 2014. The overall survival of MBC was significantly worse than those of FBC (P<.0001). The 10-year hazard of breast cancer among MBC patients was 1.173 (P < .0001) times the hazard among FBC patients after adjustment for stage. When controlling for all confounders other than hormone status, the hazard ratio of MBC outcome to FBC outcome was 1.115 (P < .0001). MBC had worse survival than FBC in early stage among ER-positive patients (stage I: HR=1.0869; stage II: HR=1.1564) and PR-positive patients (stage I: HR=1.0934; stage II: HR=1.1792).

CONCLUSIONS: There was no significant difference in the 10-year survival of breast cancers which were diagnosed in late stages (III and IV) in each hormone receptor strata. For ER-positive and PR-positive patients, there existed strong differences in the MBC and FBC outcomes in early stage, especially stage II.

KEY WORDS: SEER, Male breast cancer, prognosis, hormone receptor

Table of Contents

Chapter I    1


Chapter II  4



METHODS       5




TABLES    16

Table 1. Distribution of Factors for Male Cases and Female Cases     16

Table 2. Univariate Cox Proportional Hazard Analysis 17

Table 3. All Cases Combined and ER/PR Status Subgroups Multivariate Cox Proportional Hazard Analysis for 10-year Survival by Stage  18

Table 4. All Cases Combined and ER/PR Status Subgroups Multivariate Cox Proportional Hazard Analysis for 10-year Survival by Age    19


Figure 1. Figure of Exclusion on Study Cohort     20

Figure 2. Male Breast Cancer Incidence Trend by Year of Diagnosis in 2004-2014  21

Figure 3. Age-adjusted Rate of Male Breast Cancer in 2004-2014      22

Figure 4. Crude Kaplan-Meier Curve for the Overall Survival of Male and Female Breast Cancer (Log-rank Test: P < .001) 23

Chapter III 23

SUMMARY      23


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