Abstract
Background
Male breast cancer (MBC) accounts for approximately 1% of all breast cancers. Given
the rarity of this disease, treatment of MBC generally follows the same principles
as treatment of female breast cancer. However, the traditional surgical approach for
MBC is modified radical mastectomy (MRM) or total simple mastectomy (TSM) instead
of breast conservation surgery (BCS). The purpose of this study was to examine the
feasibility of BCS as an alternative to mastectomy for MBC with respect to musculoskeletal
functionality and treatment outcome.
Patients and Methods
A retrospective analysis was undertaken of all male patients with breast cancer who
presented to Massachusetts General Hospital or Boston Medical Center for localized
therapy from 1990 to 2003. Musculoskeletal functionality (tissue fibrosis, arm edema,
and range of motion) and treatment outcome (local-regional control, disease-free survival,
and overall survival) were evaluated. Functional/cosmetic outcomes were assessed by
multidisciplinary review of patient follow-up visits and were scored as either “good-excellent”
or “fair-poor” to account for subjectivity between different clinicians.
Results
Forty-two patients in total were identified to undergo localized treatment. Thirty
patients (71%) received MRM, 4 (10%) had TSM, and 8 (19%) underwent BCS. Actuarial
overall 1-year fair-poor documented tissue fibrosis, arm edema, and decreased range
of motion rates were 13%, 23%, and 27% for patients receiving MRM; 25%, 0%, and 50%
for patients who underwent TSM; and 13%, 0%, and 0% for those undergoing BCS, respectively.
Overall survival and disease-free survival were not statistically different between
the groups.
Conclusions
These data suggest that breast conservation therapy may be considered a reasonable
local treatment option for male patients presenting with breast cancer because it
may offer functional advantages over mastectomy with comparable rates of local control
and disease-free survival and overall survival.
Keywords
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Article info
Publication history
Published online: July 29, 2013
Accepted:
May 7,
2013
Received:
February 21,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
