Among men with breast cancer, mortality is three times higher for black men than for white men, according to a report in the March 20th Journal of Clinical Oncology. Among men with breast cancer, mortality is three times higher for black men than for white men, according to a report in the March 20th Journal of Clinical Oncology.

The authors note that black women with breast cancer also have a higher mortality than white women. "By understanding the similarities between men and women with regard to disparities in breast cancer survival, we may better understand the reasons for these disparities, and we will be one step closer to resolving the disparities in survival between blacks and whites," Dr. Dawn L. Hershman told Reuters Health.

Dr. Hershman from Columbia University, New York and associates investigated factors influencing the outcomes of treatment among 456 white men and 34 black men diagnosed with stage I-III breast cancer identified in the SEER Medicare database.

The median age of the patients was 76 years. Black men were more likely than white men to have advanced-stage disease, larger tumor sizes, positive lymph nodes, poorly differentiated tumors, and higher comorbidity scores, the authors report.

After adjustment for known clinical and demographic factors, the results indicate, black men were about 48 per cent less likely to be referred to a medical oncologist and 56 per cent less likely to receive chemotherapy, compared with white men. However, those differences did not reach statistical significance.

During a median follow-up of almost 5 years, about half the men died. The investigators found that the adjusted breast cancer-specific mortality hazard ratio was 3.29 for blacks versus whites.

Neither chemotherapy nor radiation therapy was associated with reduced mortality, the report indicates, but mastectomy was associated with lower overall and breast cancer mortality than lumpectomy was.

"The etiology of the disparity in survival between white and black women with breast cancer has been the subject of much research. On a stage-for-stage basis, black women have worse survival," Dr. Hershman commented.

"Male breast cancer is primarily a disease of the elderly and is mostly a cancer that is hormone sensitive," she pointed out. "It is interesting that in this disease, as well, there are also (racial) disparities in survival."

Dr. Hershman added, "Efforts should be made to ensure that patients with breast cancer receive and complete standard adjuvant therapy. Current data suggest this is not the case."

J Clin Oncol 2007;25:1089-1098.

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