Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Grupo Oncológico Cooperativo del Sur (GOCS), Neuquén, Argentina.
J Natl Cancer Inst. 2023 Apr 11;115(4):421-428. doi: 10.1093/jnci/djac241.
Breast cancer mortality in women has declined statistically significantly over the past several years. In men, it is unclear whether survival has changed over time. We evaluated changes in breast cancer-specific survival (BCSS) and overall survival (OS) in male breast cancer over the past 3 decades.
We evaluated men diagnosed with breast cancer between 1988 and 2017, reported in the Surveillance, Epidemiology, and End Results registry. Patients were categorized into 3 groups by year of diagnosis: 1988-1997, 1998-2007, and 2008-2017. BCSS and OS were estimated by Kaplan-Meier, and differences between groups were compared by log-rank test. Multivariable Cox regression evaluated the independent association of year of diagnosis with BCSS and OS. All tests were 2-sided.
We included 8481 men. Overall, BCSS at 5 years was 83.69%, 83.78%, and 84.41% in groups 1988-1997, 1998-2007, and 2008-2017, respectively (P = .86). There was no statistically significant difference in BCSS between the 3 groups within each stage of disease. Among all patients, OS at 5 years was 64.61%, 67.31%, and 69.05% in groups 1988-1997, 1998-2007, and 2008-2017, respectively (P = .01). In adjusted Cox models, each additional year of diagnosis had no statistically significant association with BCSS (hazard ratio = 1.00, 95% confidence interval = 0.99 to 1.01, P = .75), but there was statistically significant improvement in OS (hazard ratio = 0.99, 95% CI = 0.98 to 0.99, P = .009).
Over the past 3 decades, there has been no statistically significant improvement in BCSS in male breast cancer. Changes in OS over time are consistent with increasing life expectancy. Efforts to improve BCSS in male breast cancer are warranted.
过去几年,女性乳腺癌死亡率已呈明显统计学下降。但男性乳腺癌的生存率是否随时间变化尚不清楚。本研究评估了过去 30 年来男性乳腺癌的乳腺癌特异性生存率(BCSS)和总生存率(OS)的变化。
我们评估了 1988 年至 2017 年间在监测、流行病学和最终结果登记处诊断为乳腺癌的男性患者。患者按诊断年份分为 3 组:1988-1997 年、1998-2007 年和 2008-2017 年。通过 Kaplan-Meier 评估 BCSS 和 OS,并通过对数秩检验比较组间差异。多变量 Cox 回归评估诊断年份与 BCSS 和 OS 的独立关联。所有检验均为双侧。
共纳入 8481 例男性患者。总体而言,1988-1997 年、1998-2007 年和 2008-2017 年组的 5 年 BCSS 分别为 83.69%、83.78%和 84.41%(P=.86)。在每个疾病阶段,3 组之间的 BCSS 无统计学显著差异。在所有患者中,1988-1997 年、1998-2007 年和 2008-2017 年组的 5 年 OS 分别为 64.61%、67.31%和 69.05%(P=.01)。在调整后的 Cox 模型中,每增加 1 年诊断与 BCSS 无统计学显著关联(风险比=1.00,95%置信区间=0.99 至 1.01,P=.75),但 OS 有统计学显著改善(风险比=0.99,95%CI=0.98 至 0.99,P=.009)。
过去 30 年来,男性乳腺癌的 BCSS 无统计学显著改善。OS 随时间的变化与预期寿命的增加一致。需要努力改善男性乳腺癌的 BCSS。