The Impact of Race on Survivorship, Time to Treatment in Male Breast Cancer

According to a study presented during the 2021 ASCO Annual Meeting, there were no significant differences in mortality by race among male patients with breast cancer. However, researchers found that non-white patients may experience longer times to treatment, less survivorship screening, and worse disease-related mortality.

The researchers collected data on all patients diagnosed with breast cancer at a large, integrated health delivery system from January 1, 2010, through December 31, 2018, and analyzed clinical and demographic factors that affected breast cancer-related mortality. They performed a detailed chart review in the male breast cancer (MBC) group to examine the mean time to treatment, defined as time from diagnosis to surgery, surgery to chemotherapy, and surgery to radiation.

The final analysis included 32,848 female patients and 226 MBC patients, with the MBC group comprising 0.63% of the cohort. Racial representation did not largely differ between the female and MBC groups. The overall breakdown was: white, 62%; Asian, 19%; Black, 8%; and Hispanic, 11%.

Compared to the female group, at the time of diagnosis, MBC patients were much older, more obese, and sicker (per the Charlson Comorbidity Index); they were also more likely to be diagnosed with later-stage disease than females (19.2% vs. 12.5%). Mean follow-up was five years, at which time the MBC group had a much higher overall mortality rate than the female group (23% vs. 12%), as well as higher breast cancer-related mortality (8.1% vs. 4.5%).

When only evaluating the MBC group, there was no association between stage at diagnosis and race. The mean time from diagnosis to surgery was shortest for MBC patients who were Asian (27 days) and white (29 days), while the longest time was for the Hispanic group (46 days). The shortest mean time from surgery to chemotherapy was for Black patients (39 days) and longest for Asian patients (50 days). The rate of screening mammography was lowest for Black (33.3%) and Asian patients (43.3%) and highest for Hispanic (50%) and white patients (52%). White and Black patients were least likely to die of breast cancer (6.2% and 6.7%, respectively), while Hispanic and Asian patients were the most likely (11% and 13%, respectively).

“Future study can elucidate these racial inequalities, enabling more equitable breast cancer treatment among patient subgroups,” the study authors concluded.