Breast Cancer in Men: Survival by Race, Age, Region and Stage, 2007–2016

Breast cancer in men is rare: about 2,300 new cases and 500 deaths in the United States in 2017, roughly 1% of all breast cancers. Risk rises with age, and compared with women, men tend to be diagnosed older and at a later stage. Survival gains between 1976–1985 and 1996–2005 were clearer for women than for men. Because so few men get it, little research had examined differences in their survival.

A CDC team — Taylor D. Ellington, S. Jane Henley, Reda J. Wilson and Jacqueline W. Miller — used National Program of Cancer Registries data from 45 registries covering about 94% of the U.S. population to study 14,805 men diagnosed from 2007 to 2016.

How survival was measured

Relative survival here is the percentage of men who did not die of breast cancer 1 and 5 years after diagnosis. It was calculated by race and ethnicity, age, region and stage at diagnosis: localized, regional, distant or unknown.

Results

"Other" is non-Hispanic Asian/Pacific Islander and American Indian/Alaska Native men. Source: CDC, MMWR.

Survival by stage at diagnosis, 2007–2016. Credit: CDC, MMWR.

• Stage matters most. Of everything examined, survival varied most with stage.
• Late diagnosis is common. 45.8% of cancers were found at a localized stage and 41.9% at a regional stage; 8.7% were already distant and 3.6% unknown. About half of men were diagnosed after the cancer had spread.
• Age and region. Cases split roughly into thirds: under 60, 60–69, and 70 and older. Survival was similar across age groups and across regions.
• Race. One-year survival was lower among Black men than among White and Hispanic men.

Survival by race and ethnicity, 2007–2016. Credit: CDC, MMWR.

What it means

Earlier research found no racial difference in whether men received primary cancer treatment once stage was taken into account, but survival did differ by type of treatment: men who had no treatment or only radiation fared worse than those who had any kind of mastectomy. Ensuring access to the best treatment might narrow the racial gap.

Men should know the signs and see a doctor right away. Symptoms are the same as in women:

• a painless lump or thickening in breast tissue;
• dimpling, puckering, thickening, redness or scaling of the skin;
• nipple discharge, sores or a nipple turning inward.

Knowing who is at higher risk.

• Transgender women have a higher breast cancer risk than cisgender men, and transgender men a lower risk than cisgender women; knowing a patient's transgender status helps providers assess risk and choose screening.
• Discussing family health history can identify men who should have genetic counseling and testing. The Surgeon General's My Family Health Portrait tool can record family history of breast, ovarian and other cancers.
• Men with BRCA1 or BRCA2 mutations are more likely to get breast cancer, and also face higher risk of prostate and pancreatic cancer. For them, breast self-exam training and yearly clinical breast exams from age 35 may be recommended.

After diagnosis. The risk of recurrence continues for 15 years after treatment and beyond. The American Society of Clinical Oncology recommends offering men with breast cancer genetic counseling and testing, and continuing care from a physician experienced in cancer and breast examination, including of irradiated breasts. CDC's National Comprehensive Cancer Control Program helps communities support survivors and caregivers.

Limitations

• Higher relative survival for a group does not necessarily mean a lower death rate.
• Race and ethnicity may be misclassified in the records.

Sources

Based on Ellington TD, Henley SJ, Wilson RJ, Miller JW, "Breast Cancer Survival Among Males by Race, Ethnicity, Age, Geographic Region, and Stage — United States, 2007–2016," MMWR, Centers for Disease Control and Prevention; a work of the United States government in the public domain.