Characterization and prognosis of estrogen receptor-positive/progesterone receptor-negative male breast cancer: a population-based study

BackgroundThe aim of this study was to explore the characteristics and prognostic information of estrogen receptor-positive/progesterone receptor-negative (ER+/PR-) male breast cancer.MethodsUsing the US National Cancer Institute's Surveillance, Epidemiology, and End Results database, we compared the demographics, clinical characteristics, and outcome of estrogen receptor-positive/progesterone receptor-positive (ER+/PR+) patients with ER+/PR- male breast cancer patients from 1990 to 2010. Two thousand three hundred twenty-two patients with ER+/PR+ tumors and 355 patients with ER+/PR- tumors were included in our study.ResultsER+/PR- patients were younger (P=0.008) and more likely to be African American (P<0.001) while presented with higher histological grade (P<0.001), larger tumor size (P=0.010), and more invasion to the lymph nodes (P=0.034) and distant sites (P<0.001), thus later stage (P=0.001). Despite higher chance of receiving chemotherapy (51.0% vs 36.5%, P<0.001), ER+/PR- patients experienced significantly worse breast cancer-specific survival (BSCC) (P<0.001) and shorter overall survival (OS) (P=0.003). Multivariate Cox model confirmed that tumor size, lymph node invasion, metastasis, and surgery were independent prognostic factors of both BSCC and OS for ER+/PR- male breast cancer. Age at diagnosis and chemotherapy were significantly associated with OS but not with BSCC.ConclusionER+/PR- male breast cancer was more aggressive and experienced shorter survival than ER+/PR+ patients. The prognosis was mainly associated with tumor size, lymph node invasion, metastasis, and surgery.