Effect of Breast Conservation Therapy vs Mastectomy on Overall Survival and Breast Cancer-Specific Survival Among Men With Stage I-II Breast Cancer: Analysis of SEER, 2000-2018

Published:March 30, 2022DOI:



      Male breast cancer is a rare malignant tumor, and outcomes of breast conservation therapy (BCT) are currently lacking.


      The retrospective, population-based cohort study included 1369 stage I-II (T1–2 N0–1 M0) male breast cancer patients from the SEER database (2000-2018). The patients were grouped in two groups: BCT group and mastectomy group, according to surgical and radiation therapy. Kaplan-Meier method and univariable Cox proportional hazard analysis were used to compare overall survival (OS) and breast cancer-specific survival (BCSS) between two treatment groups. Propensity score matching (PSM) was performed to balance the confounding factors.


      Of the 1369 men, 97 (7%) patients received BCT, 1272 (93%) received mastectomy alone. The 5- and 10-year OS rates were 92.3% and 80.7% for BCT group compared with 80.4% and 61.4% for mastectomy group. The 5- and 10-year BCSS rates were 96.5% and 93.9% for patients undergoing BCT, as compared with 93.1% and 84.4% for patients undergoing mastectomy. Compared with mastectomy group, BCT group showed improved OS (hazard ratio [HR], 0.294; 95% CI 0.138-0.623, P = .002) and BCSS (hazard ratio [HR], 0.182; 95% CI 0.040-0.820, P = .027). Of the 791 patients with T1 stage, BCT showed insignificant association with OS (hazard ratio [HR], 0.555; 95% CI 0.207-1.488, P = .242) and BCSS (hazard ratio [HR], 1.217; 95% CI 0.171-8.675, P = .844).


      The results of this cohort study suggest that BCT is at least equivalent to mastectomy in male breast cancer patients. The underlying mechanism of this association needs further research.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Breast Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Rebecca LS
        • Kimberly DM
        • Ahmedin J.
        Cancer statistics, 2020.
        CA Cancer J Clin. 2020; 70: 7-30
        • Michael JH
        • Mark RS
        • Elisha RB
        • et al.
        Management of male breast cancer: ASCO guideline.
        J Clin Oncol. 2020; 38: 1849-1863
      1. William JG, Meena SM, Jame A, et al. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Version 1. 2022. Accessed.

        • Suleiman AM
        • George WS
        • Dave PM
        • Debbie M
        • Valentina IP
        • Steven S
        Molecular characterization and mortality from breast cancer in men.
        J Clin Oncol. 2018; 36: 1396-1404
        • Cardoso F
        • Bartlett JMS
        • Slaets L
        • et al.
        Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program.
        Ann Oncol. 2018; 29: 405-417
        • Ian SF.
        The biology of male breast cancer.
        Breast. 2018; 38: 132-135
        • Samuel S
        • Michael M
        • Leila M
        • et al.
        Male breast cancer: a closer look at patient and tumor characteristics and factors that affect survival using the National Cancer Database.
        Breast Cancer Res Treat. 2020; 180: 471-479
        • Maryam E
        • Sangita S
        • Arash A
        • Ahmad E
        • David RM
        • Tulin DC
        Evolving surgical treatment decisions for male breast cancer: an analysis of the National Surgical Quality Improvement Program (NSQIP) database.
        Breast Cancer Res Treat. 2018; 171: 427-434
        • Bernard F
        • Stewart A
        • John B
        • et al.
        Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.
        N Engl J Med. 2002; 347: 1233-1241
        • Siddhartha Y
        • Dhauna K
        • Irbaz BR
        • et al.
        Male Breast Cancer in the United States: Treatment patterns and prognostic factors in the 21st century.
        Cancer. 2020; 126: 26-36
        • Jennifer KP
        • Yi R
        • Caitlin EM
        • et al.
        Surgery for men with breast cancer: do the same data still apply?.
        Ann Surg Oncol. 2020; 27: 4720-4729
        • Sarah BB
        • Anders JD
        • Mili A
        • et al.
        Is breast-conserving therapy appropriate for male breast cancer patients? A National Cancer Database Analysis.
        Ann Surg Oncol. 2019; 26: 2144-2153
        • Jose´ PL
        • Julieta L
        • Ariel OZ
        • Julia´n I
        • Bernardo AL
        • Carlos TV
        Locoregional treatment and overall survival of men with T1a,b,cN0M0 breast cancer: a population-based study.
        Eur J Cancer. 2017; 71: 7-14
        • Jordan MC
        • Tina HB
        • Irene LW.
        Outcomes of partial mastectomy in male breast cancer patients: analysis of SEER, 1983-2009.
        Ann Surg Oncol. 2013; 20: 1545-1550
        • Bernard F
        • Madeline B
        • Richard M
        • et al.
        Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer.
        N Engl J Med. 1985; 312: 665-673
        • Yinlong Y
        • Liangwei P
        • Zhiming S.
        Trend and survival benefit of contralateral prophylactic mastectomy among men with stage I-III unilateral breast cancer in the USA, 1998-2016.
        Breast Cancer Res Treat. 2021; 190: 503-515
        • Pauline J
        • Stephane V
        • Bruno C
        • et al.
        Should adjuvant radiation therapy be systematically proposed for male breast cancer? A systematic review.
        Anticancer Res. 2018; 38: 23-31
        • Candice AMS
        • Sarah BB
        • Anders JD
        • Daniel KN.
        Breast conserving surgery compared with mastectomy in male breast cancer: a brief systematic review.
        Clin Breast Cancer. 2020; 20 (e309-e314)
        • Oluchi O
        • Jiangong N
        • Mariana CM
        • Hui Z
        • Sharon HG.
        Adjuvant tamoxifen adherence in men with early-stage breast cancer.
        Cancer. 2021; 128: 59-64
        • Sarah BB
        • Lauren MP
        • Xiao Z
        • et al.
        The role of radiation therapy in addition to lumpectomy and hormone therapy in men 70 years of age and older with early breast cancer: a NCDB analysis.
        Ann Surg Oncol. 2021; 28: 2463-2471