Abstract

Background: Male breast cancer (MBC) is a rare disease, comprising only 1% of all incidents of breast cancer diagnosed in the United States. Most of the treatment strategies for male breast cancer are based on the studies of female breast cancer and modified radical mastectomy (MRM) remains the standard of care for virtually all the MBC cases. Breast-conserving surgery (BCS) in MBC has been coming to the forefront as a reasonable treatment option. We elected to compare surgical outcomes between BCS and MRM in male breast cancer.

Methodology: National Surgical Quality Improvement Program (NSQIP) database was analyzed for the year 2015. We reviewed all male breast surgical patients. Mastectomy for gynecomastia, simple mastectomy, and radical mastectomy was excluded from analysis. Partial mastectomy (with and without) axillary lymph node biopsy were compared to MRM. Chi-square and independent t-tests were used to compare the two variables for demographics, comorbidities, and postoperative complications.

Results: A total of 175 patients underwent breast surgery for MBC in 2015. BCS was performed on 101 males (57.7%) and MRM was performed on 74 (42.3%). Patients that underwent MRM were older than the patients that underwent BCS (57 versus 66 years, respectively) (P < 0.0001). Comorbidities were overall similar in both groups. Postoperative complications were overall not statistically different. Patients that underwent BS had shorter length of hospital stays (P < 0.0001) and were more likely to have been operated on under MAC or IV sedation (14.85% vs 0%) (P < 0.0001).

Conclusion: BCS in male breast cancer is frequently performed in the United States with similar surgical outcomes and shorter length of stay as MRM.

Keywords: Male Breast Cancer (MBC); Modified Radical Mastectomy (MRM); Breast-Conserving Surgery (BCS); National Surgical Quality Improvement Program (NSQIP)

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