Mo Miao, Feng Xiaoshuang, Wu Chunxiao, Gong Yangming, Shen Jie, He Yulian, Zhou Changming, Wang Zezhou, Fu Chen, Zheng Ying
Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Cancer Control and Prevention, Branch of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Transl Breast Cancer Res. 2024 Jul 25;5:19. doi: 10.21037/tbcr-24-3. eCollection 2024.
Previous studies found that the long-term survival of male breast cancer patients differed from those of female patients, however, the conclusions were contradictory. We conducted the study to examine the sex disparity in breast cancer survival by carefully controlling demographic and clinical factors using data from the Shanghai Cancer Registry (SCR).
Every male breast cancer patient was matched with four female patients by the diagnosis year, age, stage, and histology. We used Kaplan-Meier survival estimates to calculate the cumulative observed overall survival (OS) and cancer-specific survival (CSS) rates and log-rank tests to compare the survival rates by sex. We used Cox proportional-hazards regression models to assess the association between sex and risk of death.
A total of 50,958 patients with breast cancer (0.85% male) were registered in the SCR between 2002 and 2013. After matching, 434 male and 1,736 female patients were included in the study. With a median follow-up of 10 years, men with breast cancer showed worse OS (P<0.001) and CSS (P<0.001) than did women. The 5- and 10-year OS rates for male and female patients were 67.27% and 77.75%, and 45.95% and 62.60%, respectively; the 5- and 10-year CSS rates for male and female patients were 70.19% and 79.79%, and 50.57% and 67.20%, respectively. Compared with women, men had 65% increased risk of overall death [95% confidence interval (CI): 1.42-1.92] and 70% increased risk of cancer-specific death (95% CI: 1.44-2.00).
This study found male patients with breast cancer had poorer long-term survival than women in China.
既往研究发现男性乳腺癌患者的长期生存率与女性患者不同，然而，结论相互矛盾。我们开展本研究，利用上海癌症登记处（SCR）的数据，通过仔细控制人口统计学和临床因素，来检验乳腺癌生存方面的性别差异。
按照诊断年份、年龄、分期和组织学，将每位男性乳腺癌患者与四位女性患者进行匹配。我们使用Kaplan-Meier生存估计来计算累积观察到的总生存（OS）率和癌症特异性生存（CSS）率，并使用对数秩检验来比较按性别划分的生存率。我们使用Cox比例风险回归模型来评估性别与死亡风险之间的关联。
2002年至2013年期间，SCR共登记了50958例乳腺癌患者（男性占0.85%）。匹配后，434例男性和1736例女性患者纳入研究。中位随访10年，男性乳腺癌患者的OS（P<0.001）和CSS（P<0.001）均比女性差。男性和女性患者的5年和10年OS率分别为67.27%和77.75%，以及45.95%和62.60%；男性和女性患者的5年和10年CSS率分别为70.19%和79.79%，以及50.57%和67.20%。与女性相比，男性的总死亡风险增加65%[95%置信区间（CI）：1.42 - 1.92]，癌症特异性死亡风险增加70%（95% CI：1.44 - 2.00）。
本研究发现，中国男性乳腺癌患者的长期生存率低于女性。
