Cardiovascular and Other Competing Causes of Death in Male Breast Cancer Patients: A Population-Based Epidemiologic Study

Zhang, Hanbin; Lin, Wenrui; Chen, Dongting; Wang, Kenie; Tu, Wei; Lin, Hui-Wen; Li, Kun; Ye, Shangzhu; Guan, Tianwang; Chen, Yuerong

doi:10.2147/cia.s314689

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…Neither study adequately accounted for competing risks and resulted in biased conclusions, while our competing risk model provided a more reliable framework to analyze the interaction between BC and CVD, as it correctly estimated the marginal probability of an event in the presence of competing events [ 26 ]. Further supporting evidence comes from another study using the competing risk model that found that the risk of CVD-related death is higher than cancer-related death in older patients with early-stage breast cancer [ 32 ]. Interestingly, aging is a well-known risk factor for CVD and cancer, but current guidelines remain controversial about defining the age cutoff for high-risk CVD death in cancer patients.…”

Section: Discussionmentioning

confidence: 98%

Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer

Guan

Luo

et al. 2022

Cancers

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Background: To identify the risk of death from cardiovascular disease (CVD) in older patients with bladder cancer (BC). Methods: This population-based study included 80,042 older BC patients (≥65 years) diagnosed between 1975 and 2018, with a mean follow-up of 17.2 years. The proportion of deaths, competing risk models, standardized mortality ratio (SMR), and absolute excess risk (AER) per 10,000 person-years were applied to identify the risk of CVD-related deaths among older BC patients. Results: For older patients with BC, CVD-related death was the chief cause of death, and cumulative CVD-related mortality also exceeded primary BC as the leading cause of death mostly 5–10 years after BC diagnosis, especially in localized-stage and low-grade subgroups. The risk of short- and long-term CVD-related death in older BC patients was higher than in the general older adult population (SMR = 1.30, 95% CI 1.28–1.32; AER = 105.68). The risk of sex-specific CVD-related deaths also increased compared to the general population of older adults, including heart disease, cerebrovascular diseases, hypertension without heart disease, atherosclerosis, aortic aneurysm and dissection, and other diseases of the arteries, arterioles, and capillaries. Conclusions: CVD-related death is an important competing risk among older BC patients and has surpassed primary BC as the chief cause of death, mainly 5–10 years after BC diagnosis. The risk of CVD-related death in older patients with BC was greater than in the general population. The management of older patients with BC should focus not only on the primary cancer but also on CVD-related death.

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Section: Discussionmentioning

confidence: 98%

Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer

Guan

Luo

et al. 2022

Cancers

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“…Although we were not able to run a survival analysis due to the small sample size, we noted that one out of the four patients who died, died from non-breast cancerrelated causes, while three died due to metastatic disease. While the survival rate for male and female breast cancer is similar, male patients are more likely to die from non-breast cancer-related causes (22). This may be explained by their older age at diagnosis and increased cardiovascular comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Treatment of Breast Cancer in Men: A 12-year Single-Institution Review

Matheka,

Wasike

2023

Ann Afr Surg.

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Background: Male breast cancer has a low incidence, hence there are few studies evaluating the disease, and no recent studies from Kenya. Objective: The objective of this study was to evaluate the clinical and pathological characteristics, and treatment of men diagnosed with breast cancer. Methods: This is a retrospective descriptive study, carried out at a tertiary hospital in Nairobi, Kenya, of men diagnosed with breast cancer between January 2009 and December 2021. Data on the clinicopathological characteristics, treatment, and outcome were collected. Standard descriptive statistics were used to describe the patient characteristics. Results: Seventeen male patients were diagnosed with breast cancer, representing 1.40% of all breast cancer patients. Four patients were excluded due to incomplete records. The median age at diagnosis was 68 years (range 28–83). The majority were African Bantu (n=11, 84.6%). Most patients presented with clinical T1 (n=10, 76.9%) and N0 (n=8, 61.5%) disease. Luminal A molecular subtype was the most common (n=8, 61.5%). All 11 patients who underwent operative management underwent modified radical mastectomy. Conclusion: The rate of male breast cancer was similar to the global rate. The majority of our patients presented with early breast cancer and estrogen receptor-positive disease. Treatment was primarily modified radical mastectomy followed by adjuvant systemic therapy.

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“…Zhang et al, in their SEER-based analysis of 6426 MBCs in period 1975-2016, observed that among all the MBCs who died, 42.75% died of breast cancer and 57.3% died of nonbreast cancer causes including cardiovascular disease (CVD) (26.9%), other cancers, and nervous system disease. CVD as the cause of death was more common than breast cancer in age >75 years [29]. 4 International Journal of Breast Cancer…”

Section: Treatment Treatment Of Localised Invasive Early Mbc Usually ...mentioning

confidence: 99%

Male Breast Cancer: An Updated Review of Patient Characteristics, Genetics, and Outcome

Khare,

Huda,

Misra

et al. 2024

International Journal of Breast Cancer

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Male breast cancer (MBC) is a rare entity, underrepresented in population studies and clinical trials, resulting in management of MBC to be informed by current research on female breast cancer (FBC). A literature review was conducted by accessing relevant articles on 2 databases, by searching keywords “male breast cancer”. A total of 29 articles from year 2011 to 2022 were selected for this review. The authors found that male breast cancer generally occurs later in life with higher stage, higher grade, and more estrogen receptor (ER) positive tumours. Most of the studies noted the mean age for MBCs at the time of presentation as >60 years. Risk factors for male breast cancer include family history, obesity, lower physical activity, and syndromes like the Klinefelter syndrome. Positive family history is much higher in MBC compared to FBC (30.9 vs. 18.4%). BRCA 2 cancers constitute a higher proportion compared to FBCs. A lot of genetic mutations have been observed. Some show promise to assess disease-specific survival and proliferative rate like TWIST1 and RUNX3, among others. MBCs usually present with a palpable lump in central region, with a bigger size and chance of nodal involvement and metastasis compared to FBCs. They are mostly infiltrating ductal type and hormone receptor positive, with worse histological grade. Treatment usually follows the same principles as FBCs (systemic therapy, surgical excision, and radiotherapy), with poorer prognosis to same treatment approach, possibly owing to its advanced stage at presentation. This is a rare entity which requires further research to ascertain need for different management approach than FBCs.

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Cardiovascular and Other Competing Causes of Death in Male Breast Cancer Patients: A Population-Based Epidemiologic Study

Cited by 5 publications

References 32 publications

Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer

Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer

Characteristics and Treatment of Breast Cancer in Men: A 12-year Single-Institution Review

Male Breast Cancer: An Updated Review of Patient Characteristics, Genetics, and Outcome

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