The Effect of Clinicopathological Features and Postoperative Management on Prognosis in Male Breast Cancer

Abstract

Background Male breast cancer (MBC) represents a rare type of malignant tumor, comprising less than 1% of all breast cancer cases. Therapies for MBC patients are typically adapted from breast cancer treatments in women. This study systematically performed a retrospective evaluation of the clinicopathological features and prognostic determinants to offer evidence for a therapeutic strategy for MBC patients. Methods A total of 29 MBC patients were selected from PLA General Hospital in China from 2006 to 2023 and 2589 patients were retrieved from the Surveillance, Epidemiology, and End Results database with their registration periods spanning from 2016 to 2020. The clinicopathological features between different groups were compared using Pearson’s chi‐square test (χ 2 test) or Fisher’ s exact test, as appropriate. Multivariate Cox proportional hazards regression analysis was utilized to assess the predictors of overall survival (OS). Subgroup analyses were further conducted to evaluate the therapeutic efficacy across different stages. Results We identified 2618 patients totally. The primarily diagnosed median age of Chinese patients was younger than that of Western patients (59.8 years old vs 67.7 years old, p = 0.001). The infiltrating duct carcinoma was the most common pathological type for both groups. The subtypes (p = 0.622) and stages (p = 0.385) at diagnosis were similar between the two groups. Surgery at the primary site could improve the OS of MBC patients including Stage IV (p = 0.019). In stratified subgroup analyses, postoperative chemotherapy significantly improved OS in stages T2N1‐3M0 and T3‐4N1‐3M0 MBC patients. Postoperative radiation was associated with favorable OS in early‐stage (T1N0M0) and locally advanced (T3‐4N1M0 and T1‐4N2‐3M0) MBC patients. Conclusions The median age at diagnosis for MBC patients in China was significantly younger compared to other populations. Postoperative chemotherapy significantly improved OS in patients with positive axillary lymph nodes and primary lesions exceeding 2 cm. Postoperative radiotherapy demonstrated survival benefits in partial early‐stage and locally advanced patients. Additionally, surgery at the primary site represented a viable therapeutic option for selected Stage IV patients. Trial Registration: Chinese Clinical Trial: ChiCTR2500110646