Higher Survival Rates Found in Male Hispanic, API Patients With Early Breast Cancer

Hispanic and Asian or Pacific Islander (API) male patients with early breast cancer (EBC) had higher overall survival (OS) rates than White male patients with EBC, according to a poster presented at this year’s San Antonio Breast Cancer Symposium (SABCS).

The researchers explained that male breast cancer (BC) is rare as it accounts for less than 1.0% of all BC cases in the United States. Because of this, there is limited national data on the racial/ethnic differences in survival outcomes among men with EBC. Consequently, they conducted a study to estimate 5-year survival rates and assess how OS in male patients with EBC differed by race/ethnicity and by hormone receptor (HR) status, which was classified as either negative or positive.

The study population, which consisted of male patients with stage I to III BC, was created using data from the 2004 to 2019 National Cancer Database (NCDB); it included API, non-Hispanic Black, non-Hispanic White, and Hispanic patients. The researchers used the Kaplan-Meier method to estimate 5-year OS by race/ethnicity. OS, which they defined as “death or censored from the date of diagnosis to the date of death or last contact,” was stratified by HR status and modeled using a multivariable Cox regression that they adjusted for sociodemographic and clinicopathologic factors.

Male breast cancer (BC) accounts for less than 1.0% of all cases in the United States, so there is limited data on the survival outcome among men with BC | Image credit: NaMong Productions - stock.adobe.com

Of the 22,340 patients included in the study population, 56.4% were aged 65 or older, 81.7% were White, 12.4% were Black, 3.7% were Hispanic, and 2.3% were API; the researchers noted that 94.3% of included patients had HR-positive tumors. Also, the researchers found higher 5-year OS rates in API (84.5%) and Hispanic (84.2%) patients compared to those of White patients (77.2%). Conversely, Black patients had the lowest 5-year OS rate (73.4%; P < .001).

The researchers had similar findings after adjusting for clinicopathologic factors as they found Black patients to have a higher mortality risk than White patients (adjusted hazard ratio [aHR], 1.13; 95% CI, 1.01-1.25) and Hispanic (aHR, 0.65; 95% CI, 0.51-0.85) and API (aHR, 0.62; 95% CI, 0.45-0.86) patients to have a lower mortality risk than White patients. However, after further adjusting for sociodemographics, there was no significant OS difference between Black and White patients (aHR, 0.98; 95% CI, 0.87-1.11). Despite this, OS rates remained significantly higher in Hispanic (aHR, 0.60; 95% CI, 0.46-0.79) and API (aHR, 0.69; 95% CI, 0.50-0.96) patients compared to White patients.

Additionally, in terms of the impact of HR status, the researchers observed similar racial/ethnic mortality risks in the HR-positive cohort. Conversely, of those in the HR-negative cohort, API patients had a greater risk of death than White patients after adjusting for clinicopathologic and sociodemographic factors (aHR, 2.75; 95% CI, 1.25-6.03).

Lastly, those with a household income between $50,354 and $63,332 (aHR, 0.86; 95% CI, 0.75-0.99), or $63,333 or greater (aHR, 0.74; 95% CI, 0.64-0.86), had a lower mortality risk than those with a household income less than $40,227. Also, patients with private insurance had a lower mortality risk than those with Medicare (aHR, 1.54; 95% CI, 1.36-1.75), those with Medicaid (aHR, 1.41; 95% CI, 1.13-1.77), or those uninsured (aHR, 1.54; 95% CI, 1.12-2.12).

Based on their findings regarding the impact of race/ethnicity on the 5-year OS rates of male patients with EBC, the researchers suggested focusing on solving the inequities that may be causing these differences.

“Addressing socioeconomic disparities and inequities that impact access to health care and services may help improve survival outcomes across racial/ethnic groups of male EBC patients,” the authors concluded.

Reference

Hara J, Omoleye O, Li J, Guo W. Racial/ethnic differences in survival of male patients with stage I-III breast cancer by hormone receptor status using real-world data. Poster presented at: San Antonio Breast Cancer Symposium; December 5-9, 2023; San Antonio, TX. Accessed December 18, 2023. Poster: PO2-09-09