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White and Black Men With Breast Cancer Receive Similar Treatment but Black Men Have Worse Outcomes

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 Journal of Clinical Oncology

2015

Breast cancer in men is rare, but it does happen. Less than 1% of all breast cancers occur in men. About 2% of all breast cancer diagnosed in the United States is in men. Like black women, black men are more likely to be diagnosed with breast cancer at a younger age compared to white men.

While it’s been known for 20 years that black women have worse survival rates than white women after a breast cancer diagnosis — and are also more likely to have more time pass between diagnosis and treatment — similar research hasn’t been done in men.

A study looking at differences in early-stage breast cancer treatment and outcomes between white and black men found that the groups receive similar treatment, but black men were 76% more likely to die from breast cancer than white men.

Helmneh M. Sineshaw⇑, Rachel A. FreedmanElizabeth M. WardW. Dana Flanders and Ahmedin Jemal

The study was published online on May 4, 2015 by the Journal of Clinical Oncology. Read the abstract of“Black/White Disparities in Receipt of Treatment and Survival Among Men With Early-Stage Breast Cancer.”

In the study, the researchers looked at records in the National Cancer Data Base and identified 725 black men and 5,247 white men age 18 or older who were diagnosed with early-stage (stage I, II, or III) breast cancer between 2004 and 2011. The National Cancer Data Base is sponsored by the American Cancer Society and the American College of Surgeons.

To analyze treatment and outcomes, the researchers split the men into two groups by age:

  • 18 to 64 years
  • 65 years and older

Overall, the results showed that treatment was similar between black and white men in both age groups. Both black and white men age 65 and older were less likely to be treated with chemotherapy compared to black and white men who were younger.

Diagnosed black and white men 65 and older had about the same risk of dying from breast cancer. But black men ages 18 to 64 had a 76% higher risk of dying from breast cancer than white men of the same age. Still, when the researchers accounted for insurance and income levels, this gap went down: the numbers showed that younger black men had a 37% higher risk of dying from breast cancer. The researchers said the results suggest that poverty may play an important role in racial differences in male breast cancer outcomes.

The researchers also said that the differences in outcomes could be the result of other factors, including:

  • differences in quality of care
  • whether or not the men stuck to their treatment plans
  • the cancer’s hormone-receptor status
  • other unmeasured variables (for example, other genetic characteristics of the cancer that haven’t been identified yet)

The results showing that black and white men diagnosed with breast cancer received similar treatment are in contrast to some studies showing treatment differences between black and white women diagnosed with breast cancer.

“Although our finding is encouraging, it could be influenced by the rarity of male breast cancer, differences in receipt of treatment between men and women, and/or other unmeasured factors and requires further research,” the authors said. “In the coming years, it will also be important to examine whether the implementation of the Affordable Care Act (ACA) attenuates or removes the excess risk of death in younger black men diagnosed with early-stage breast cancer.”

To learn more about breast cancer in men, including treatments and symptoms, visit the Breastcancer.orgMale Breast Cancer pages.

 

Read more at: Journal of Clinical Oncology