Population based analysis of male patients with breast cancer.
Bibliographic record
Abstract
e18715 Background: We aimed to evaluate the clinical and pathological characteristics, management and outcomes of male patients with breast cancer (BC) in a large Canadian province. Methods: We identified and reviewed all male patients diagnosed with BC between 2004 and 2016.The provincial cancer registry was merged with electronic medical records to compare aggregated data of this male cohort with contemporary female patients with BC. Results: We included 31,228 patients; 180 (0.6 %) were men (M). Median age was 66 years in M and 61 years in women (W) (P < 0,001).18 (10%) of M vs 1643 (5%) of W presented as stage IV (p≤ 0.001).84% of male patients had a modified radical mastectomy. The most frequent pathology was invasive ductal carcinoma (89% in M and 77% in W; p≤ 0.001). Tumors were estrogen receptor positive in 92% of M and 81% of W (p = 0.001); progesterone receptor positive in 83% and 70%, respectively (p = 0.003) and Her2 positive in 22% and 31%, respectively (p < 0.001). Tamoxifen was the preferred hormonal therapy in both the adjuvant (89.6 %) and palliative settings (83%). Sites of metastases were bone (66%), visceral (57%), skin (16%) and brain (14%). Median overall survival (OS) for M was significantly shorter than for W (7.6 years vs not reached at 12.5 years; p < 0.001). When analyzed by stage, there was no difference in survival by sex in patients with advanced BC (Stage III p = 0.203; Stage IV p = 0.255). In patients with Stage I and II, however, male patients had significantly shorter survival (p = 0.006 and p < 0.001, respectively) (Table). Sex was associated with worse OS even when after adjusting for confounders (p = 0.001). Conclusions: In this population-based study, sex-based differences in outcomes were limited to early stage BC where surgery is the main treatment modality. These variations in outcomes may be driven by differences in access, delivery, or quality of surgical care, which should be the focus of further studies. Table. Median OS in Male BC vs. Female BC Stratified by Stage. Median OS, years Male BC patients Female BC patients P value Stage I 8.67 (95%CI 7.88 to 11.13) not reached 0.006 Stage II 9.08 (95%CI 5.39 to 12.78) not reached < 0.001 Stage III 7.08 (95%CI 2.86 to 11.30) 10.42 (95%CI 9.58 to 11.25) 0.203 Stage IV 1.58 (95%CI 0.90 to 2.27) 2.17 (95%CI 2.01 to 2.32) 0.255
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".