Male breast cancer in Northern Tanzania: Clinicopathology and predictors of two-year survival (2016–2022)

BACKGROUND: Male breast cancer (BC) is rare, accounting to approximately 1% of all breast cancers worldwide. Patients often present with advanced disease, contributing to poor outcomes. This study aimed to estimate two-year overall survival (OS) and identify clinicopathological and health-system-related predictors of survival among men with breast cancer treated at Kilimanjaro Christian Medical Centre (KCMC). METHODS: A retrospective cohort study was conducted among 55 histologically confirmed male BC patients managed at KCMC between 2016 and 2022. The primary outcome was two-year overall survival, defined as time from histological diagnosis to death from any cause or censoring at two years. The dependent variables were clinical and pathological factors and the key independent variable was overall survival (OS). Descriptive statistics summarized participants characteristics. Kaplan-Meier curves, log-rank and Cox proportional hazards regression were used to estimate the OS and the factors associated. A p-value <0.05 was considered statistically significant. RESULTS: The mean age at diagnosis was 62.2 ± 14.3 years, with most patients (54.6%) aged between 50-70 years. Over half (52.7%) presented with stage III or IV disease, and 21.8% had distant metastasis. Invasive ductal carcinoma (IDC) was the predominant histological subtype (85.5%), and luminal B was the most common molecular profile (23.6%). Surgery was performed in 60% of patients, chemotherapy in 47.3%, hormonal therapy in 30.9%, and radiotherapy in only 9.1%. The overall two-year survival rate was 67.3%. Independent predictors of poor survival included age > 70 years (p = 0.009), stage IV disease (p = 0.005), delayed receipt of histopathological results (> 2 weeks), delayed surgery (>6 weeks), and non-receipt of hormonal therapy or radiotherapy. CONCLUSION: Male BC in Northern Tanzania remains a disease for older who frequently present with advanced-stages. Two-year overall survival remains suboptimal and is strongly influenced by advanced disease stage, older age, diagnostic and treatment delays, and limited access to adjuvant therapies. Strengthening early diagnosis, timely pathology reporting, and access to radiotherapy and hormonal therapy may substantially improve outcomes.