Rak piersi u mężczyzn – Rokowania, prognozy i postęp choroby

Rak piersi u mężczyzn
Rokowania, prognozy i postęp choroby

Rak piersi u mężczyzn (MBC) stanowi mniej niż 1% wszystkich nowotworów u mężczyzn, z około 20 000 nowych przypadków rocznie globalnie, a w USA prognozuje się 2 800 nowych diagnoz inwazyjnego raka piersi u mężczyzn w 2025 roku. Pięcioletnie względne przeżycie netto w Kanadzie wynosi około 80%, jednak mężczyźni mają o 19% wyższy wskaźnik śmiertelności niż kobiety, co wiąże się z późniejszą diagnozą i niedostatecznym leczeniem. Przeżycie według stadium choroby wynosi: stadium 1 – 96%, stadium 2 – 84%, stadium 3 – 52%, a stadium 4 – 20-24%. Niezależne czynniki prognostyczne obejmują stadium T i M, wiek, stopień histologiczny, status receptorów ER i HER2 oraz zastosowanie chemioterapii. Podtypy molekularne (HER2-/HR+, HER2+/HR+, HER2+/HR-, TN) różnią się istotnie pod względem 5-letniego przeżycia swoistego dla przyczyny (CSS), od 89,2% do 43,2%, co ma znaczenie dla indywidualizacji terapii.

Prognozy Rak piersi u mężczyzn

Wskaźniki przeżycia raka piersi u mężczyzn
Przeżycie według stadium zaawansowania
Czynniki prognostyczne
Podtypy molekularne a rokowanie
Wpływ leczenia na rokowanie
Modele prognostyczne i nomogramy
Różnorodność prognostyczna MBC
Ograniczenia w przewidywaniu rokowania
Kolejne rozdziały

Prognozy Rak piersi u mężczyzn

Rak piersi u mężczyzn (MBC – Male Breast Cancer) jest rzadką chorobą, stanowiącą mniej niż 1% wszystkich nowotworów u mężczyzn, z około 20 000 nowych przypadków diagnozowanych na całym świecie każdego roku¹. Według szacunków, w 2025 roku w Stanach Zjednoczonych zostanie zdiagnozowanych około 2 800 mężczyzn z inwazyjnym rakiem piersi². Z powodu znacznie niższej częstości występowania u mężczyzn oraz wyłączania mężczyzn z dużych badań nad rakiem piersi, obecna wiedza na temat raka piersi u mężczyzn jest znacznie mniejsza niż w przypadku kobiet i często opiera się na małych, retrospektywnych badaniach z pojedynczych ośrodków³.

Wskaźniki przeżycia raka piersi u mężczyzn

Wskaźniki przeżycia mogą dać wyobrażenie o odsetku osób z tym samym typem i stadium raka, które żyją określony czas (zwykle 5 lat) po zdiagnozowaniu. Względne wskaźniki przeżycia porównują osoby z tym samym typem i stadium raka do ogólnej populacji⁴. W Kanadzie 5-letnie przeżycie netto w przypadku raka piersi u mężczyzn wynosi 80%. Oznacza to, że średnio około 80% mężczyzn z diagnozą raka piersi przeżyje co najmniej 5 lat⁵.

Jednak według innego badania, 5-letni ogólny wskaźnik przeżycia po diagnozie raka piersi wynosił 77,6% dla mężczyzn, w porównaniu do 86,4% dla kobiet⁶. Nawet po uwzględnieniu różnic w charakterystyce klinicznej pacjentów, takich jak typ i stadium choroby, otrzymane leczenie, wiek, rasa/pochodzenie etniczne i dostęp do opieki, mężczyźni nadal mieli o 19% wyższy wskaźnik śmiertelności niż kobiety w ciągu 5 lat od diagnozy⁷.

Przeżycie według stadium zaawansowania

Stadium nowotworu jest najważniejszym czynnikiem prognostycznym raka piersi u mężczyzn. Lekarze uwzględniają liczbę węzłów chłonnych zawierających raka oraz wielkość guza w momencie diagnozy⁸. Przeżycie według stadium raka piersi u mężczyzn przedstawia się następująco (5-letnie względne przeżycie):

Stadium 1: 96%
Stadium 2: 84%
Stadium 3: 52%
Stadium 4: 24%

⁹

Według Amerykańskiego Towarzystwa Onkologicznego, 5-letni względny wskaźnik przeżycia dla raka piersi w stadium 4 u mężczyzn wynosi 20%. Ta niższa przeżywalność u mężczyzn wynika w dużej mierze z tego, że mężczyźni rzadziej przypisują guzek lub inną nieprawidłowość w tkance piersi jako potencjalnie nowotworową. W związku z tym mężczyźni rzadziej zgłaszają się do lekarza i często są diagnozowani w późniejszych stadiach, gdy nowotwór jest trudniejszy do leczenia¹⁰.

Czynniki prognostyczne

Badania zidentyfikowały szereg niezależnych czynników prognostycznych związanych z całkowitym przeżyciem (OS) u pacjentów z rakiem piersi u mężczyzn. W kompleksowym badaniu obejmującym 1224 pacjentów z rakiem piersi u mężczyzn w kohorcie szkoleniowej i 44 w kohorcie walidacyjnej, wykazano, że stadium T (p<0,001), wiek w momencie diagnozy (p<0,001), stopień histologiczny (p=0,008), stadium M (p<0,001), status ER (p=0,001), status Her2 (p=0,019) i chemioterapia (p=0,015) były niezależnie związane z OS¹¹.

Inne badanie przeprowadzone w Korei Południowej wykazało, że wiek powyżej 65 lat, niski dochód, brak interwencji chirurgicznej, niestosowanie tamoksyfenu oraz ≥2 choroby współistniejące korelowały z gorszym wynikiem¹². Najbardziej znaczącym czynnikiem związanym z złym rokowaniem była obecność więcej niż 2 chorób współistniejących (HR, 4,439; 95% CI, 2,084-9,453; p = 0,001)¹³.

Model predykcyjny opracowany w innym badaniu uwzględniał 7 zmiennych: wiek (współczynnik ryzyka [HR] 1,89, 95% CI 1,50-2,38), operację (HR 0,38, 95% CI 0,29-0,51), stan cywilny (HR 0,75, 95% CI 0,63-0,89), stadium guza (HR 1,17, 95% CI 1,05-1,29), stadium kliniczne (HR 1,41, 95% CI 1,15-1,74), chemioterapię (HR 0,62, 95% CI 0,50-0,75) i status HER2 (HR 2,68, 95% CI 1,20-5,98)¹⁴.

Podtypy molekularne a rokowanie

Podtypy molekularne różnią się również w raku piersi u mężczyzn i mogą być predyktorem przeżycia oraz poprawić strategie postępowania w praktyce klinicznej¹⁵. Pacjenci o różnych podtypach molekularnych znacznie różnili się pod względem 5-letniego przeżycia całkowitego i przeżycia swoistego dla przyczyny (CSS). 5-letnie wskaźniki CSS dla różnych podtypów molekularnych wynosiły odpowiednio 89,2% (HER2-/HR+), 78,4% (HER2+/HR+), 72,6% (HER2+/HR-) i 43,2% (TN)¹⁶.

Zgodnie z analizą regresji Coxa, wiek ≥65 lat, negatywny status ER, negatywny status PR, podtyp TN, stadium AJCC IV, wielkość guza ≥5 cm lub T4, stadium M1 oraz rasa czarna były niezależnymi czynnikami prognostycznymi gorszego CSS¹⁷.

Większość nowotworów piersi u mężczyzn (i kobiet) jest hormonalnie napędzana, gdzie genomowe działanie ER dyktuje programy transkrypcyjne, które napędzają proliferację komórek nowotworowych¹⁸. AR i PR są korzystnymi markerami prognostycznymi w raku piersi u kobiet¹⁹.

Wpływ leczenia na rokowanie

Najczęstszym leczeniem chirurgicznym guzów MBC była całkowita mastektomia, przy czym operacje oszczędzające pierś były wykonywane u znacznie mniejszego odsetka mężczyzn niż kobiet²⁰. Przeprowadzone badania wykazały, że:

mężczyźni leczeni adjuwantową radioterapią (tj. radioterapią jako uzupełnienie innych metod leczenia) mieli znacznie wyższe 5-letnie wskaźniki przeżycia całkowitego niż mężczyźni nieleczeni radioterapią
terapia tamoksyfenem poprawiła wskaźniki przeżycia całkowitego w porównaniu z leczeniem bez tamoksyfenu po 5 latach
terapia tamoksyfenem poprawiła 5-letnie wskaźniki przeżycia całkowitego w porównaniu z terapią inhibitorami aromatazy
terapia inhibitorem aromatazy plus agonistą GNRH poprawiła 5-letni wskaźnik przeżycia całkowitego w porównaniu z inhibitorem aromatazy bez agonisty GnRH

²¹

Mimo bardziej agresywnej choroby ogólnie, pacjenci płci męskiej byli częściej niedoleczeni w porównaniu z kobietami²². Charakterystyka kliniczna i niedoleczenie wyjaśniały tylko około dwóch trzecich różnicy w śmiertelności²³.

Warto zauważyć, że radioterapia nie poprawia OS w MBC (p = 0,476) według jednego z badań²⁴.

Modele prognostyczne i nomogramy

Ze względu na rzadkość MBC, opracowano kilka modeli predykcyjnych, które mogą pomóc w przewidywaniu rokowania u pacjentów. Naukowcy opracowali nomogram, który przewiduje 3-letnie i 5-letnie przeżycie u pacjentów z MBC²⁵. Model ten okazał się lepszy niż system klasyfikacji AJCC, co wykazano w analizie krzywej decyzyjnej (DCA)²⁶.

W innym badaniu opracowano nomogram przeżycia z 7 zmiennymi dla pacjentów z MBC. Model ten może przewidywać wynik przeżycia tych pacjentów i zapewnić naukową podstawę do diagnostyki i leczenia klinicznego²⁷. Wyniki wykazały, że nomogram może dokładnie i indywidualnie przewidywać wyniki przeżycia pacjentów z MBC. To narzędzie predykcyjne ma potencjał do informowania o podejmowaniu decyzji klinicznych i kierowania opracowywaniem odpowiednich strategii diagnostycznych i terapeutycznych²⁸.

Różnorodność prognostyczna MBC

Rak piersi u mężczyzn wydaje się być zróżnicowany pod względem rokowania w zależności od podtypów molekularnych, podobnie jak rak piersi u kobiet. Może to być predyktor rokowania i pomoc w leczeniu raka piersi u mężczyzn²⁹.

Inne badania wykazały, że rokowanie MBC, podobnie jak w przypadku raka piersi u kobiet, zależy od stadium TNM nowotworu; że stadium po stadium prognozy MBC wydają się podobne do raka piersi u kobiet; oraz że MBC ma nieco niższy 5-letni ogólny wskaźnik przeżycia niż rak piersi u kobiet³⁰.

Mężczyźni rasy czarnej z rakiem piersi mają tendencję do gorszego rokowania niż mężczyźni rasy białej z rakiem piersi³¹.

Ograniczenia w przewidywaniu rokowania

Należy pamiętać, że wskaźniki przeżycia są szacunkowe i często opierają się na wcześniejszych wynikach dużej liczby osób, które miały określony nowotwór, ale nie mogą przewidzieć, co stanie się w konkretnym przypadku³².

Jeśli masz raka piersi, możesz mieć pytania dotyczące rokowania. Rokowanie jest najlepszym oszacowaniem lekarza, jak rak wpłynie na kogoś i jak zareaguje na leczenie. Rokowanie i przeżycie zależą od wielu czynników. Tylko lekarz znający twoją historię medyczną, typ, stadium i charakterystykę raka, wybrane leczenie i odpowiedź na leczenie może połączyć wszystkie te informacje ze statystykami przeżycia, aby określić rokowanie³³.

Liczby te dotyczą tylko stadium raka w momencie pierwszej diagnozy. Nie mają zastosowania później, jeśli nowotwór rośnie, rozprzestrzenia się lub nawraca po leczeniu³⁴. Mężczyźni obecnie diagnozowani z rakiem piersi mogą mieć lepsze rokowanie niż pokazują te liczby. Leczenie poprawia się z czasem, a te liczby opierają się na mężczyznach, którzy zostali zdiagnozowani i leczeni co najmniej 5 lat wcześniej³⁵.

Każda osoba jest inna i będzie inaczej reagować na raka i leczenie. Dlatego nie ma gwarantowanej liczby dotyczącej oczekiwanej długości życia w przypadku raka piersi w stadium 4. W zależności od ciężkości diagnozy, podjętego leczenia i innych przyczyniających się czynników zdrowotnych, niektóre osoby żyją tylko 1 do 2 lat po diagnozie, podczas gdy inne mogą żyć do 10 lat lub dłużej z rakiem piersi w stadium 4³⁶.

Dzięki postępom w leczeniu, coraz więcej pacjentów żyje dłużej, traktując chorobę jako przewlekłą poprzez ciągłe leczenie i monitorowanie, z naciskiem na jakość życia jako główny cel³⁷.

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Materiały źródłowe

#1 Male breast cancer – Wikipedia
https://en.wikipedia.org/wiki/Male_breast_cancer
Male breast cancer (MBC) is a cancer in males that originates in their breasts. Males account for less than 1% of new breast cancers with about 20,000 new cases being diagnosed worldwide every year. […] Currently, one of every 800 men are estimated to develop this cancer during their lifetimes. […] Because it has a far lower incidence in males and because large-scale breast cancer studies have routinely excluded males, current knowledge of male breast cancer is far less than female breast cancer and often rests on small, retrospective, single-center studies. […] Consequently, the majority of strategies for evaluating and treating MBC have been adopted from those used for female breast cancer. […] However, MBC appears to have some features that warrant clinical approaches differing from those for female breast cancer.
#2 Breast Cancer Facts & Stats 2024 – Incidence, Age, Survival, & More
https://www.nationalbreastcancer.org/breast-cancer-facts/
1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime. In 2025, an estimated 316,950 women and 2,800 men will be diagnosed with invasive breast cancer, and an additional 59,080 new cases of non-invasive (in situ) breast cancer will be diagnosed. […] When caught in its earliest, localized stages, the 5-year relative survival rate is 99%. […] Risk of breast cancer recurrence depends on the type and staging of the initial breast cancer. Typically, the highest risk of recurrence is during the first few years after treatment and decreases over time. […] In 2025, an estimated 2,800 men will be diagnosed with invasive breast cancer in the United States. […] Black men with breast cancer tend to have a worse prognosis, or outlook, than white men with breast cancer.
#3 Male breast cancer – Wikipedia
https://en.wikipedia.org/wiki/Male_breast_cancer
Male breast cancer (MBC) is a cancer in males that originates in their breasts. Males account for less than 1% of new breast cancers with about 20,000 new cases being diagnosed worldwide every year. […] Currently, one of every 800 men are estimated to develop this cancer during their lifetimes. […] Because it has a far lower incidence in males and because large-scale breast cancer studies have routinely excluded males, current knowledge of male breast cancer is far less than female breast cancer and often rests on small, retrospective, single-center studies. […] Consequently, the majority of strategies for evaluating and treating MBC have been adopted from those used for female breast cancer. […] However, MBC appears to have some features that warrant clinical approaches differing from those for female breast cancer.
#4 Breast Cancer Survival Rates in Men | American Cancer Society
https://www.cancer.org/cancer/types/breast-cancer-in-men/detection-diagnosis-staging/survival-rates.html
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. […] The SEER database tracks 5-year relative survival rates for breast cancer in men in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] Men now being diagnosed with breast cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on men who were diagnosed and treated at least 5 years earlier.
#5 Breast cancer in men | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/breast/what-is-breast-cancer/breast-cancer-in-men
The stage of the cancer is the most important prognostic factor for breast cancer in men. Doctors will consider the number of lymph nodes that contain cancer and the size of the tumour when it was diagnosed. There is a lower risk that early stage breast cancer will come back (recur), so it has a more favourable prognosis. The risk for recurrence is greater when the cancer is at a later stage, so it has a less favourable prognosis. […] In Canada, the 5-year net survival for breast cancer in men is 80%. This means that, on average, about 80% of men diagnosed with breast cancer will survive for at least 5 years. […] Survival by stage of breast cancer in men is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer but who share similar characteristics (such as age and sex). […] Stage 1 has a 5-year relative survival of 96%, Stage 2 has 84%, Stage 3 has 52%, and Stage 4 has 24%.
#6 Men with Breast Cancer Have Higher Mortality than Women – NCI
https://www.cancer.gov/news-events/cancer-currents-blog/2019/male-breast-cancer-higher-mortality
Men may be more likely than women to die after being diagnosed with breast cancer, particularly during the first 5 years after diagnosis, a new study suggests. […] In the study, the 5-year overall survival rate after a diagnosis of breast cancer was 77.6% for men, compared with 86.4% for women, researchers reported in JAMA Oncology on September 19. […] However, after all those factors were accounted for, male patients still had 19% higher chance of dying than female patients within 5 years of diagnosis. […] In the study, men had higher death rates than women across all stages of breast cancer, even after the researchers adjusted for differences in patients clinical characteristics, such as the type and stage of disease, treatments received, age, race/ethnicity, and access to care. […] A higher percentage of men than women in the study had stage IV breast cancer at diagnosis (5.8% versus 3.8%), for example. […] Despite having more aggressive disease overall, male patients were more likely than women to be undertreated, the researchers found. […] Clinical characteristics and undertreatment explained only about two-thirds of the difference in mortality.
#7 Men with Breast Cancer Have Higher Mortality than Women – NCI
https://www.cancer.gov/news-events/cancer-currents-blog/2019/male-breast-cancer-higher-mortality
Men may be more likely than women to die after being diagnosed with breast cancer, particularly during the first 5 years after diagnosis, a new study suggests. […] In the study, the 5-year overall survival rate after a diagnosis of breast cancer was 77.6% for men, compared with 86.4% for women, researchers reported in JAMA Oncology on September 19. […] However, after all those factors were accounted for, male patients still had 19% higher chance of dying than female patients within 5 years of diagnosis. […] In the study, men had higher death rates than women across all stages of breast cancer, even after the researchers adjusted for differences in patients clinical characteristics, such as the type and stage of disease, treatments received, age, race/ethnicity, and access to care. […] A higher percentage of men than women in the study had stage IV breast cancer at diagnosis (5.8% versus 3.8%), for example. […] Despite having more aggressive disease overall, male patients were more likely than women to be undertreated, the researchers found. […] Clinical characteristics and undertreatment explained only about two-thirds of the difference in mortality.
#8 Breast cancer in men | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/breast/what-is-breast-cancer/breast-cancer-in-men
The stage of the cancer is the most important prognostic factor for breast cancer in men. Doctors will consider the number of lymph nodes that contain cancer and the size of the tumour when it was diagnosed. There is a lower risk that early stage breast cancer will come back (recur), so it has a more favourable prognosis. The risk for recurrence is greater when the cancer is at a later stage, so it has a less favourable prognosis. […] In Canada, the 5-year net survival for breast cancer in men is 80%. This means that, on average, about 80% of men diagnosed with breast cancer will survive for at least 5 years. […] Survival by stage of breast cancer in men is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer but who share similar characteristics (such as age and sex). […] Stage 1 has a 5-year relative survival of 96%, Stage 2 has 84%, Stage 3 has 52%, and Stage 4 has 24%.
#9 Breast cancer in men | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/breast/what-is-breast-cancer/breast-cancer-in-men
The stage of the cancer is the most important prognostic factor for breast cancer in men. Doctors will consider the number of lymph nodes that contain cancer and the size of the tumour when it was diagnosed. There is a lower risk that early stage breast cancer will come back (recur), so it has a more favourable prognosis. The risk for recurrence is greater when the cancer is at a later stage, so it has a less favourable prognosis. […] In Canada, the 5-year net survival for breast cancer in men is 80%. This means that, on average, about 80% of men diagnosed with breast cancer will survive for at least 5 years. […] Survival by stage of breast cancer in men is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer but who share similar characteristics (such as age and sex). […] Stage 1 has a 5-year relative survival of 96%, Stage 2 has 84%, Stage 3 has 52%, and Stage 4 has 24%.
#10 Stage 4 (IV) Breast Cancer: Survival Rates, Treatment & Prognosis
https://www.nationalbreastcancer.org/breast-cancer-stage-4/
Stage 4 breast cancer is the most advanced stage of breast cancer with the lowest survival rate of the breast cancer stages. Survival rates for breast cancer are calculated by the National Cancer Institute (NCI) using a 5-year relative survival rate. This rate compares women with the same type and stage of breast cancer to women in the general population. […] According to the American Cancer Society, the 5-year relative survival rate for Stage 4 breast cancer in women is 32%. This means 32% of women with Stage 4 breast cancer will still be living 5 years after diagnosis. […] While rare, men can also develop Stage 4 breast cancer. The 5-year relative survival rate for Stage 4 breast cancer in men is 20%, according to the American Cancer Society. […] This lower survival rate in men is largely due to men not attributing a lump or other irregularity in their breast tissue as potentially being cancerous. Therefore, men are less likely to see a doctor and are often diagnosed at later stages when cancer is harder to treat.
#11 A nomogram for predicting the risk of male breast cancer for overall survival
https://pmc.ncbi.nlm.nih.gov/articles/PMC10436472/
Male breast cancer (MBC) is a rare disease, accounting for 1% of all male carcinomas. […] We constructed a nomogram model for predicting the overall survival (OS) of MBC patients and verify its feasibility using data from China. […] The independent prognostic factors were selected by univariate and multivariate Cox regression analyses. […] A total of 1224 male breast cancer patients were in the training cohort and 44 in the validation cohort. […] T status (p0.001), age at diagnosis (p0.001), histologic grade (p=0.008), M status (p0.001), ER status (p=0.001), Her2 status (p=0.019), chemotherapy (p=0.015) were independently associated with OS. […] We developed a nomogram that predicts 3-year and 5-year survival in MBC patients. […] The results remain reproducible in the validation cohort which included Chinese data.
#12 Prognostic Factors in Male Breast Cancer: A Retrospective Nationwide Study in South Korea by the Study of SMARTSHIP Group
https://pmc.ncbi.nlm.nih.gov/articles/PMC8724376/
This study evaluated the incidence, the survival outcomes and its prognostic factors for male breast cancer (MBC) in Korea. […] The 5-year survival rate was 73.7%. Age 65 years, low income, no surgical intervention, no tamoxifen use, and 2 comorbidities correlated with a worse outcome. […] Age 65 years, 2 comorbidities, no surgical intervention, and no tamoxifen use correlate to poor prognosis. […] The factors related to overall survival are shown in Table 2. Men older than 65 years had worse overall survival than those younger than 65 years (hazard ratio [HR], 2.454; 95% confidence interval [CI], 1.9093.154; p 0.001). Patients with more than 2 coexisting comorbidities also had a poor prognosis. Low income, no surgical treatment, and not receiving chemotherapy were all associated with a probability of decreased survival.
#13 Prognostic Factors in Male Breast Cancer: A Retrospective Nationwide Study in South Korea by the Study of SMARTSHIP Group
https://pmc.ncbi.nlm.nih.gov/articles/PMC8724376/
The most significant factor associated with a poor prognosis was the presence of greater than 2 comorbidities (HR, 4.439; 95% CI, 2.0849.453; p = 0.001). The other independent predictors of survival were age over 65 years, low income, no history of surgery, and no tamoxifen use. […] This study showed that men with more than 2 comorbidities had significantly poorer prognoses. […] In conclusion, the incidence of MBC has increased over time, and the peak incidence of MBC is noted in patients aged 70 years. Age over 65 years, the presence of more than 2 comorbidities, undertreatment of the tumor (including no surgery), and no tamoxifen use were related to poor prognosis.
#14 JMIR Cancer – Predicting Overall Survival in Patients with Male Breast Cancer: Nomogram Development and External Validation Study
https://cancer.jmir.org/2025/1/e54625
Background: Male breast cancer (MBC) is an uncommon disease. Few studies have discussed the prognosis of MBC due to its rarity. […] The predictive model included 7 variables: age (hazard ratio [HR] 1.89, 95% CI 1.502.38), surgery (HR 0.38, 95% CI 0.290.51), marital status (HR 0.75, 95% CI 0.630.89), tumor stage (HR 1.17, 95% CI 1.051.29), clinical stage (HR 1.41, 95% CI 1.151.74), chemotherapy (HR 0.62, 95% CI 0.500.75), and HER2 status (HR 2.68, 95% CI 1.205.98). […] A survival prognosis prediction nomogram with 7 variables for patients with MBC was constructed in this study. The model can predict the survival outcome of these patients and provide a scientific basis for clinical diagnosis and treatment. […] The findings demonstrated that the nomogram can accurately and individually predict the survival outcomes of patients with MBC. This predictive tool holds the potential for informing clinical decision-making and guiding the development of appropriate diagnostic and therapeutic strategies.
#15 Molecular subtypes predict the prognosis of male breast cancer: a retrospective cohort study – Wang – Translational Breast Cancer Research
https://tbcr.amegroups.org/article/view/69417/html
Molecular subtypes also varied in male breast cancer. It could be a predictor for survival and improve the strategy making in clinical practice. […] Patients of different molecular subtypes differed significantly in 5 years overall survival and cause-specific survival (CSS). Five-year CSS (5y-CSS) rates of different molecular subtypes was 89.2% (HER2/HR+), 78.4% (HER2+/HR+), 72.6% (HER2+/HR) and 43.2% (TN), respectively. […] According to Cox regression, age 65 years, ER negative, PR negative, TN subtype, AJCC stage IV, tumor size 5 cm or T4, Stage M1 and Black race were independent prognostic factors for poorer CSS. […] Male breast cancer appears to be diverse in prognosis by molecular subtypes as female breast cancer. It could be a predictor for prognosis and assistant male breast cancer treatment.
#16 Molecular subtypes predict the prognosis of male breast cancer: a retrospective cohort study – Wang – Translational Breast Cancer Research
https://tbcr.amegroups.org/article/view/69417/html
Molecular subtypes also varied in male breast cancer. It could be a predictor for survival and improve the strategy making in clinical practice. […] Patients of different molecular subtypes differed significantly in 5 years overall survival and cause-specific survival (CSS). Five-year CSS (5y-CSS) rates of different molecular subtypes was 89.2% (HER2/HR+), 78.4% (HER2+/HR+), 72.6% (HER2+/HR) and 43.2% (TN), respectively. […] According to Cox regression, age 65 years, ER negative, PR negative, TN subtype, AJCC stage IV, tumor size 5 cm or T4, Stage M1 and Black race were independent prognostic factors for poorer CSS. […] Male breast cancer appears to be diverse in prognosis by molecular subtypes as female breast cancer. It could be a predictor for prognosis and assistant male breast cancer treatment.
#17 Molecular subtypes predict the prognosis of male breast cancer: a retrospective cohort study – Wang – Translational Breast Cancer Research
https://tbcr.amegroups.org/article/view/69417/html
Molecular subtypes also varied in male breast cancer. It could be a predictor for survival and improve the strategy making in clinical practice. […] Patients of different molecular subtypes differed significantly in 5 years overall survival and cause-specific survival (CSS). Five-year CSS (5y-CSS) rates of different molecular subtypes was 89.2% (HER2/HR+), 78.4% (HER2+/HR+), 72.6% (HER2+/HR) and 43.2% (TN), respectively. […] According to Cox regression, age 65 years, ER negative, PR negative, TN subtype, AJCC stage IV, tumor size 5 cm or T4, Stage M1 and Black race were independent prognostic factors for poorer CSS. […] Male breast cancer appears to be diverse in prognosis by molecular subtypes as female breast cancer. It could be a predictor for prognosis and assistant male breast cancer treatment.
#18 Characterizing steroid hormone receptor chromatin binding landscapes in male and female breast cancer | Nature Communications
https://www.nature.com/articles/s41467-018-02856-2
Male breast cancer (MBC) is rare and poorly characterized. […] The majority of male (and female) breast cancers are hormonally driven, where ER genomic action dictates transcriptional programs that drive tumor cell proliferation. […] Even though the genomic action of ER in MBC remains completely elusive, multiple reports have studied ER genomics in the female disease. […] AR and PR are favorable prognostic markers in female breast cancer. […] Although ER cistromics has previously been studied in female breast tumors, all these transcription factors have never been profiled together in a single study in human breast tumors. […] This comprehensive overview reveals gender-selective and genomic location-specific hormone receptor action, which associate with survival in MBC. […] MBC is ER-driven.
#19 Characterizing steroid hormone receptor chromatin binding landscapes in male and female breast cancer | Nature Communications
https://www.nature.com/articles/s41467-018-02856-2
Male breast cancer (MBC) is rare and poorly characterized. […] The majority of male (and female) breast cancers are hormonally driven, where ER genomic action dictates transcriptional programs that drive tumor cell proliferation. […] Even though the genomic action of ER in MBC remains completely elusive, multiple reports have studied ER genomics in the female disease. […] AR and PR are favorable prognostic markers in female breast cancer. […] Although ER cistromics has previously been studied in female breast tumors, all these transcription factors have never been profiled together in a single study in human breast tumors. […] This comprehensive overview reveals gender-selective and genomic location-specific hormone receptor action, which associate with survival in MBC. […] MBC is ER-driven.
#20 Male breast cancer – Wikipedia
https://en.wikipedia.org/wiki/Male_breast_cancer
The most common surgical treatment for MBC tumors has been total mastectomy with breast-conserving surgery being performed in a much smaller proportion of males than females. […] The study also found that: a) men treated with adjuvant radiotherapy (i.e. radiotherapy in addition to other treatments) had significantly higher 5 year overall survival rates than men not treated with radiation therapy; b) Tamoxifen therapy improved overall survival rates compared to treatments not using tamoxifen at 5 years; c) Tamoxifen therapy improved 5 year overall survival rates compared to therapy with aromatase inhibitors; and d) therapy with an aromatase inhibitor plus a GNRH agonist improved the 5 year overall survival rate over an aromatase inhibitor without a GnRH agonist. […] Other studies have found that the prognosis of MBC, similar to female breast cancer: depends on their cancer’s TNM stage; that stage for stage, the prognoses of MBC appears similar to that in female breast cancer; and that MBC has a somewhat lower 5-year overall survival rate than female breast cancer.
#21 Male breast cancer – Wikipedia
https://en.wikipedia.org/wiki/Male_breast_cancer
The most common surgical treatment for MBC tumors has been total mastectomy with breast-conserving surgery being performed in a much smaller proportion of males than females. […] The study also found that: a) men treated with adjuvant radiotherapy (i.e. radiotherapy in addition to other treatments) had significantly higher 5 year overall survival rates than men not treated with radiation therapy; b) Tamoxifen therapy improved overall survival rates compared to treatments not using tamoxifen at 5 years; c) Tamoxifen therapy improved 5 year overall survival rates compared to therapy with aromatase inhibitors; and d) therapy with an aromatase inhibitor plus a GNRH agonist improved the 5 year overall survival rate over an aromatase inhibitor without a GnRH agonist. […] Other studies have found that the prognosis of MBC, similar to female breast cancer: depends on their cancer’s TNM stage; that stage for stage, the prognoses of MBC appears similar to that in female breast cancer; and that MBC has a somewhat lower 5-year overall survival rate than female breast cancer.
#22 Men with Breast Cancer Have Higher Mortality than Women – NCI
https://www.cancer.gov/news-events/cancer-currents-blog/2019/male-breast-cancer-higher-mortality
Men may be more likely than women to die after being diagnosed with breast cancer, particularly during the first 5 years after diagnosis, a new study suggests. […] In the study, the 5-year overall survival rate after a diagnosis of breast cancer was 77.6% for men, compared with 86.4% for women, researchers reported in JAMA Oncology on September 19. […] However, after all those factors were accounted for, male patients still had 19% higher chance of dying than female patients within 5 years of diagnosis. […] In the study, men had higher death rates than women across all stages of breast cancer, even after the researchers adjusted for differences in patients clinical characteristics, such as the type and stage of disease, treatments received, age, race/ethnicity, and access to care. […] A higher percentage of men than women in the study had stage IV breast cancer at diagnosis (5.8% versus 3.8%), for example. […] Despite having more aggressive disease overall, male patients were more likely than women to be undertreated, the researchers found. […] Clinical characteristics and undertreatment explained only about two-thirds of the difference in mortality.
#23 Men with Breast Cancer Have Higher Mortality than Women – NCI
https://www.cancer.gov/news-events/cancer-currents-blog/2019/male-breast-cancer-higher-mortality
Men may be more likely than women to die after being diagnosed with breast cancer, particularly during the first 5 years after diagnosis, a new study suggests. […] In the study, the 5-year overall survival rate after a diagnosis of breast cancer was 77.6% for men, compared with 86.4% for women, researchers reported in JAMA Oncology on September 19. […] However, after all those factors were accounted for, male patients still had 19% higher chance of dying than female patients within 5 years of diagnosis. […] In the study, men had higher death rates than women across all stages of breast cancer, even after the researchers adjusted for differences in patients clinical characteristics, such as the type and stage of disease, treatments received, age, race/ethnicity, and access to care. […] A higher percentage of men than women in the study had stage IV breast cancer at diagnosis (5.8% versus 3.8%), for example. […] Despite having more aggressive disease overall, male patients were more likely than women to be undertreated, the researchers found. […] Clinical characteristics and undertreatment explained only about two-thirds of the difference in mortality.
#24 A nomogram for predicting the risk of male breast cancer for overall survival
https://pmc.ncbi.nlm.nih.gov/articles/PMC10436472/
The model was superior to the AJCC stage system as shown in the decision curve analysis (DCA). […] Therefore, clinical characteristics and overall survival of MBC need to be further investigated. […] In our study, in addition to surgery type, age, T status, M status, and histological grade, the expression status of ER and HER2, as well as the use of chemotherapy, also play important roles in the prognosis of MBC. […] It is worth noting that radiotherapy does not improve OS in MBC (p = 0.476). […] In this study, we developed a clinical prognostic model that combines the prognostic characteristics of male breast cancer and validated it with Chinese male breast cancer data.
#25 A nomogram for predicting the risk of male breast cancer for overall survival
https://pmc.ncbi.nlm.nih.gov/articles/PMC10436472/
Male breast cancer (MBC) is a rare disease, accounting for 1% of all male carcinomas. […] We constructed a nomogram model for predicting the overall survival (OS) of MBC patients and verify its feasibility using data from China. […] The independent prognostic factors were selected by univariate and multivariate Cox regression analyses. […] A total of 1224 male breast cancer patients were in the training cohort and 44 in the validation cohort. […] T status (p0.001), age at diagnosis (p0.001), histologic grade (p=0.008), M status (p0.001), ER status (p=0.001), Her2 status (p=0.019), chemotherapy (p=0.015) were independently associated with OS. […] We developed a nomogram that predicts 3-year and 5-year survival in MBC patients. […] The results remain reproducible in the validation cohort which included Chinese data.
#26 A nomogram for predicting the risk of male breast cancer for overall survival
https://pmc.ncbi.nlm.nih.gov/articles/PMC10436472/
The model was superior to the AJCC stage system as shown in the decision curve analysis (DCA). […] Therefore, clinical characteristics and overall survival of MBC need to be further investigated. […] In our study, in addition to surgery type, age, T status, M status, and histological grade, the expression status of ER and HER2, as well as the use of chemotherapy, also play important roles in the prognosis of MBC. […] It is worth noting that radiotherapy does not improve OS in MBC (p = 0.476). […] In this study, we developed a clinical prognostic model that combines the prognostic characteristics of male breast cancer and validated it with Chinese male breast cancer data.
#27 JMIR Cancer – Predicting Overall Survival in Patients with Male Breast Cancer: Nomogram Development and External Validation Study
https://cancer.jmir.org/2025/1/e54625
Background: Male breast cancer (MBC) is an uncommon disease. Few studies have discussed the prognosis of MBC due to its rarity. […] The predictive model included 7 variables: age (hazard ratio [HR] 1.89, 95% CI 1.502.38), surgery (HR 0.38, 95% CI 0.290.51), marital status (HR 0.75, 95% CI 0.630.89), tumor stage (HR 1.17, 95% CI 1.051.29), clinical stage (HR 1.41, 95% CI 1.151.74), chemotherapy (HR 0.62, 95% CI 0.500.75), and HER2 status (HR 2.68, 95% CI 1.205.98). […] A survival prognosis prediction nomogram with 7 variables for patients with MBC was constructed in this study. The model can predict the survival outcome of these patients and provide a scientific basis for clinical diagnosis and treatment. […] The findings demonstrated that the nomogram can accurately and individually predict the survival outcomes of patients with MBC. This predictive tool holds the potential for informing clinical decision-making and guiding the development of appropriate diagnostic and therapeutic strategies.
#28 JMIR Cancer – Predicting Overall Survival in Patients with Male Breast Cancer: Nomogram Development and External Validation Study
https://cancer.jmir.org/2025/1/e54625
Background: Male breast cancer (MBC) is an uncommon disease. Few studies have discussed the prognosis of MBC due to its rarity. […] The predictive model included 7 variables: age (hazard ratio [HR] 1.89, 95% CI 1.502.38), surgery (HR 0.38, 95% CI 0.290.51), marital status (HR 0.75, 95% CI 0.630.89), tumor stage (HR 1.17, 95% CI 1.051.29), clinical stage (HR 1.41, 95% CI 1.151.74), chemotherapy (HR 0.62, 95% CI 0.500.75), and HER2 status (HR 2.68, 95% CI 1.205.98). […] A survival prognosis prediction nomogram with 7 variables for patients with MBC was constructed in this study. The model can predict the survival outcome of these patients and provide a scientific basis for clinical diagnosis and treatment. […] The findings demonstrated that the nomogram can accurately and individually predict the survival outcomes of patients with MBC. This predictive tool holds the potential for informing clinical decision-making and guiding the development of appropriate diagnostic and therapeutic strategies.
#29 Molecular subtypes predict the prognosis of male breast cancer: a retrospective cohort study – Wang – Translational Breast Cancer Research
https://tbcr.amegroups.org/article/view/69417/html
Molecular subtypes also varied in male breast cancer. It could be a predictor for survival and improve the strategy making in clinical practice. […] Patients of different molecular subtypes differed significantly in 5 years overall survival and cause-specific survival (CSS). Five-year CSS (5y-CSS) rates of different molecular subtypes was 89.2% (HER2/HR+), 78.4% (HER2+/HR+), 72.6% (HER2+/HR) and 43.2% (TN), respectively. […] According to Cox regression, age 65 years, ER negative, PR negative, TN subtype, AJCC stage IV, tumor size 5 cm or T4, Stage M1 and Black race were independent prognostic factors for poorer CSS. […] Male breast cancer appears to be diverse in prognosis by molecular subtypes as female breast cancer. It could be a predictor for prognosis and assistant male breast cancer treatment.
#30 Male breast cancer – Wikipedia
https://en.wikipedia.org/wiki/Male_breast_cancer
The most common surgical treatment for MBC tumors has been total mastectomy with breast-conserving surgery being performed in a much smaller proportion of males than females. […] The study also found that: a) men treated with adjuvant radiotherapy (i.e. radiotherapy in addition to other treatments) had significantly higher 5 year overall survival rates than men not treated with radiation therapy; b) Tamoxifen therapy improved overall survival rates compared to treatments not using tamoxifen at 5 years; c) Tamoxifen therapy improved 5 year overall survival rates compared to therapy with aromatase inhibitors; and d) therapy with an aromatase inhibitor plus a GNRH agonist improved the 5 year overall survival rate over an aromatase inhibitor without a GnRH agonist. […] Other studies have found that the prognosis of MBC, similar to female breast cancer: depends on their cancer’s TNM stage; that stage for stage, the prognoses of MBC appears similar to that in female breast cancer; and that MBC has a somewhat lower 5-year overall survival rate than female breast cancer.
#31 Breast Cancer Facts & Stats 2024 – Incidence, Age, Survival, & More
https://www.nationalbreastcancer.org/breast-cancer-facts/
1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime. In 2025, an estimated 316,950 women and 2,800 men will be diagnosed with invasive breast cancer, and an additional 59,080 new cases of non-invasive (in situ) breast cancer will be diagnosed. […] When caught in its earliest, localized stages, the 5-year relative survival rate is 99%. […] Risk of breast cancer recurrence depends on the type and staging of the initial breast cancer. Typically, the highest risk of recurrence is during the first few years after treatment and decreases over time. […] In 2025, an estimated 2,800 men will be diagnosed with invasive breast cancer in the United States. […] Black men with breast cancer tend to have a worse prognosis, or outlook, than white men with breast cancer.
#32 Breast Cancer Survival Rates in Men | American Cancer Society
https://www.cancer.org/cancer/types/breast-cancer-in-men/detection-diagnosis-staging/survival-rates.html
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. […] The SEER database tracks 5-year relative survival rates for breast cancer in men in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] Men now being diagnosed with breast cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on men who were diagnosed and treated at least 5 years earlier.
#33 Breast cancer in men | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/breast/what-is-breast-cancer/breast-cancer-in-men
Men have breast tissue just like women, but their breasts are less developed. Breast cancer in men is similar to the disease in women, but there are some differences. For the most part, breast cancer in men is treated like breast cancer in women who have reached menopause (when the ovaries stop making estrogen). Less than 1% of all breast cancers occur in men. […] If you have breast cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
#34 Breast Cancer Survival Rates in Men | American Cancer Society
https://www.cancer.org/cancer/types/breast-cancer-in-men/detection-diagnosis-staging/survival-rates.html
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. […] The SEER database tracks 5-year relative survival rates for breast cancer in men in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] Men now being diagnosed with breast cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on men who were diagnosed and treated at least 5 years earlier.
#35 Breast Cancer Survival Rates in Men | American Cancer Society
https://www.cancer.org/cancer/types/breast-cancer-in-men/detection-diagnosis-staging/survival-rates.html
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. […] The SEER database tracks 5-year relative survival rates for breast cancer in men in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] Men now being diagnosed with breast cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on men who were diagnosed and treated at least 5 years earlier.
#36 Stage 4 (IV) Breast Cancer: Survival Rates, Treatment & Prognosis
https://www.nationalbreastcancer.org/breast-cancer-stage-4/
Every person is different and will respond to cancer and treatments differently. Therefore, there is no guaranteed number for Stage 4 breast cancer life expectancy. Depending on the severity of the diagnosis, treatments undertaken, and other contributing health factors, some women live only 1 to 2 years after a diagnosis, while others may live up to 10 years or more with Stage 4 breast cancer. […] Due to advancements in treatments, more and more women are living longer by treating the disease as a chronic illness through continuous treatment and monitoring, with a focus on quality of life as a primary goal.
#37 Stage 4 (IV) Breast Cancer: Survival Rates, Treatment & Prognosis
https://www.nationalbreastcancer.org/breast-cancer-stage-4/
Every person is different and will respond to cancer and treatments differently. Therefore, there is no guaranteed number for Stage 4 breast cancer life expectancy. Depending on the severity of the diagnosis, treatments undertaken, and other contributing health factors, some women live only 1 to 2 years after a diagnosis, while others may live up to 10 years or more with Stage 4 breast cancer. […] Due to advancements in treatments, more and more women are living longer by treating the disease as a chronic illness through continuous treatment and monitoring, with a focus on quality of life as a primary goal.