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

Abstract

Hanbin Zhang,1 Wenrui Lin,2 Dongting Chen,1 Kenie Wang,3 Wei Tu,4 Huiwen Lin,4 Kun Li,4 Shangzhu Ye,5 Tianwang Guan,6 Yuerong Chen4 1Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Department of Clinical Medicine, The Sixth Clinical College of Guangzhou Medical University, Guangzhou, People’s Republic of China; 3The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, People’s Republic of China; 4Department of Oncology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 5Department of Ophthalmology and Otorhinolaryngology, Yangjiang Hospital of Traditional Chinese Medicine, Yangjiang, People’s Republic of China; 6Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of ChinaCorrespondence: Tianwang GuanDepartment of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of ChinaTel [phone]Email [email protected] ChenDepartment of Oncology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of ChinaTel [phone]Email [email protected]: Male breast cancer (MBC) is a rare disease that tends to occur in elderly men. Little is known about the causes of death in MBC because of the small sample size of most studies. This study aimed to investigate the causes of death in MBC patients.Patients and Methods: MBC patient data were obtained from the Surveillance, Epidemiology, and End Results database (1975– 2016). Time trends of MBC mortality in the US population were analyzed using Joinpoint software. We calculated the proportion of each cause of death in the overall cohort and in different patient subgroups. Competing risk models were used to calculate cumulative mortality at different follow-up times. The risk of cardiovascular death (CVD) in MBC patients was compared to that of the age-matched general population by calculating standardized mortality ratio (SMR).Results: In total, 6426 patients were included in the analysis. MBC mortality rate increased between 2004 and 2019 (annual percentage change=1.16, 95% confidence interval [CI]: 0.50, 1.80). There were 1757 patients (27.3%) who died of non-breast cancer causes. CVD was the leading cause of death in patients who were elderly or had localized disease. MBC patients had a 6.58-fold higher risk of CVD than the general population (SMR=6.58, 95% CI: 6.14, 7.05).Conclusion: Non-breast cancer death accounts for the majority of deaths in MBC patients who are elderly or have localized cancer. Compared to the general population, MBC patients have an increased risk of CVD. These results highlight the importance of monitoring cardiovascular comorbidities in MBC patients.Keywords: male breast cancer, cardio-oncology, elderly patients, cause of death, non cancer death, cardiovascular death

Keywords

• breast cancer in males
• elderly patients
• cause of death
• non cancer death
• cardiovascular death