MALE breast cancer risk stratification may help identify which patients with luminal early disease benefit from chemotherapy.
Male Breast Cancer Risk Tool Shows Prognostic Value
A newly developed online prognostic model may help guide perioperative chemotherapy decisions for men with luminal early breast cancer. Investigators created and validated the tool using data from 2,845 patients in a U.S. cohort and 586 patients in a Chinese cohort, with overall survival used as the primary endpoint. The model was designed to address a persistent evidence gap in male breast cancer, where chemotherapy indications remain less clearly defined than in other breast cancer populations.
Patients from the U.S. dataset were divided into training, test, and validation cohorts, while the Chinese dataset served as an external validation cohort. Researchers evaluated four machine learning models alongside a Cox based nomogram, then selected the best performing model to generate 5-year risk scores. These scores were used to stratify patients into low risk and high-risk groups.
Chemotherapy Benefit Varied by Risk Group
The prognostic risk stratification tool consistently separated patients into groups with significantly different overall survival across all datasets. This finding suggests the model could offer meaningful clinical support when weighing the role of perioperative chemotherapy in male breast cancer.
Importantly, chemotherapy was not associated with an overall survival benefit in low-risk patients in any dataset examined. In contrast, high risk patients showed a significant survival advantage with chemotherapy across the training, test, U.S. validation, and Chinese validation cohorts. Multivariable analyses showed comparable results, supporting the robustness of the findings.
These results suggest that the male breast cancer risk tool may be particularly useful for identifying low risk candidates who could potentially omit chemotherapy, while also highlighting high risk patients more likely to derive benefit.
Potential to Support More Individualized Decisions
The authors concluded that the model accurately predicts and stratifies overall survival in American and Chinese men with luminal early breast cancer. With the web-based tool now deployed, this approach may support more individualized treatment discussions and help reduce unnecessary chemotherapy exposure in selected patients, while preserving treatment intensity for those at higher risk.
Reference
Gao Y et al. Development and validation of an online prognostic risk stratification tool to assist decisions on perioperative chemotherapy for men with luminal early breast cancer. Breast Cancer Res. 2026. doi:10.1186/s13058-026-02252-5.
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