Trends in surgery and survival for T1-T2 male breast cancer: A study from the National Cancer Database |
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| Institution: | 1. Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA;2. University Hospitals Research in Surgical Outcomes and Effectiveness (UH-RISES), USA;3. Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA;1. Warren Alpert Medical School of Brown University, Providence, RI, USA;2. University of North Carolina School of Medicine, Chapel Hill, NC, USA;3. Saint Louis University, St. Louis, MO, USA;4. Shriner''s for Children Medical Center, Pasadena, CA, USA;5. Novant Health, Charlotte, NC, USA |
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| Abstract: | BackgroundDespite evidence that early-stage male breast cancer (MBC) can be treated the same as in females, we hypothesized that men undergo more extensive surgery.MethodsPatients with clinical T1-2 breast cancer were identified in the National Cancer Database 2004–2016. Trends in surgery type and overall survival were compared between sexes.ResultsOf 9,782 males and 1,078,105 females, most were cN0 with AJCC stage I/II disease. Unilateral mastectomy was most common in men (67.1% vs. 24.1%, p < 0.001) and partial mastectomy in women (64.7% vs. 26.4%, p < 0.001), with no significant change over time. Over 1/3 of men received ALND in 2016. While overall survival was superior in females (HR 0.83, 95% CI 0.73–0.94, p = 0.003), partial mastectomy was associated with a 42% reduction in mortality risk for males (HR 0.58, 95% CI 0.4–0.8, p = 0.003).ConclusionsDe-escalation of surgery could be considered for MBC to improve survival and align with current standards of care. |
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| Keywords: | Male breast cancer Early stage breast cancer Breast surgery Axillary surgery Survival outcomes Gender disparities Treatment trends MBC"} {"#name":"keyword" "$":{"id":"pc_8Y5wvvE0jp"} "$$":[{"#name":"text" "_":"male breast cancer BCS"} {"#name":"keyword" "$":{"id":"pc_w1N05jczIn"} "$$":[{"#name":"text" "_":"breast-conserving surgery MRM"} {"#name":"keyword" "$":{"id":"pc_6mTE1Uqzbi"} "$$":[{"#name":"text" "_":"modified radical mastectomy SLNB"} {"#name":"keyword" "$":{"id":"pc_pyZy4i3466"} "$$":[{"#name":"text" "_":"sentinel lymph node biopsy ALND"} {"#name":"keyword" "$":{"id":"pc_SQ5G9UHAwa"} "$$":[{"#name":"text" "_":"axillary lymph node dissection |
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