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13.02.2019 | Breast Oncology

Is Breast-Conserving Therapy Appropriate for Male Breast Cancer Patients? A National Cancer Database Analysis

Zeitschrift:
Annals of Surgical Oncology
Autoren:
MD Sarah B. Bateni, MD Anders J. Davidson, MD Mili Arora, MD Megan E. Daly, PhD Susan L. Stewart, MD Richard J. Bold, MD Robert J. Canter, MD Candice A. M. Sauder
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-019-07159-4) contains supplementary material, which is available to authorized users.
This study was presented at the American Society of Clinical Oncology Annual Meeting, June 2, 2018, Chicago, Illinois.

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Abstract

Background

Current treatment guidelines for male breast cancer are predominantly guided by female-only clinical trials. With scarce research, it is unclear whether breast-conserving therapy (BCT) is equivalent to mastectomy in men. We sought to compare overall survival (OS) among male breast cancer patients who underwent BCT versus mastectomy.

Methods

We performed a retrospective analysis of 8445 stage I–II (T1–2 N0–1 M0) male breast cancer patients from the National Cancer Database (2004–2014). Patients were grouped according to surgical and radiation therapy (RT). BCT was defined as partial mastectomy followed by RT. Multivariable and inverse probability of treatment-weighted (IPTW) Cox proportional hazards models were used to compare OS between treatment groups, controlling for demographic and clinicopathologic characteristics.

Results

Most patients underwent total mastectomy (61.2%), whereas 18.2% underwent BCT, 12.4% underwent total mastectomy with RT, and 8.2% underwent partial mastectomy alone. In multivariable and IPTW models, partial mastectomy alone, total mastectomy alone, and total mastectomy with RT were associated with worse OS compared with BCT (p < 0.001 all). Ten-year OS was 73.8% for BCT and 56.3, 58.0 and 56.3% for other treatment approaches. Older age, higher T/N stage, histological grade, and triple-negative receptor status were associated with poorer OS (p < 0.05). Subgroup analysis by stage demonstrated similar results.

Conclusions

In this national sample of male breast cancer patients, BCT was associated with greater survival. The underlying mechanisms of this association warrant further study, because more routine adoption of BCT in male breast cancer appears to translate into clinically meaningful improvements in survival.

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Zusatzmaterial
Supplementary material 1 (DOCX 156 kb)
10434_2019_7159_MOESM1_ESM.docx
Literatur
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