Work

Impact of adjuvant endocrine therapy utilization in male patients with early breast cancer: results from a large German real-world claims data analysis

Year: 2025

Type: article

Abstract: BACKGROUND: Male breast cancer (BC) is a rare entity and represents a significant clinical challenge due to its late diagnosis and resulting poorer prognosis compared to female BC. As shown by prior studies, approximately 99% of male BC patients are hormone receptor-positive (HR +). This study aimed to evaluate the utilization and impact of adjuvant endocrine therapy (ET) in male early BC patients using a large German real-world claims dataset. PATIENTS AND METHODS: Data were collected from a major German statutory health insurance provider (AOK Baden-Wuerttemberg) covering the period between January 1, 2010, and December 31, 2020. Male patients diagnosed with early BC who underwent breast surgery were included. ET use was determined by prescription records. The impact of ET on overall survival (OS) was assessed using univariable (log-rank) and multivariable (cox regression) analysis. RESULTS: Among 128 male early BC patients, 16% (n = 21) did not utilize adjuvant ET. On univariable analysis, ET was significantly associated with 5-year OS (74% with ET vs. 37% without ET; p < 0.0001). Multivariable analysis revealed ET use (Hazard Ratio [HR]: 0.31, 95% CI 0.14-0.69, p = 0.004) having a positive effect on OS, whereas age (HR: 1.04, 95% CI 1.00-1.09) and comorbidities (HR: 1.18, 95% CI 1.05-1.34, p = 0.007) were identified as negative predictive factors for OS. CONCLUSION: A significant proportion of male patients with early BC does not use ET. However, the use of ET plays a key role in improving survival outcomes for male patients with early BC. Efforts to improve the use of ET, including patient education and management of side effects, are essential to optimize treatment outcomes.

Source: Archives of Gynecology and Obstetrics

DOI: 10.1007/s00404-025-08198-x