While breast cancer is one of the most common cancers in women, it’s one of the least common in men. Both sexes have similar survival rates. However, researchers have discovered major differences in treatment approaches.
Men with breast cancer were more likely to have mastectomies (removal of one or both breasts) than women with the disease, according to a new study.
The researchers also learned that male breast cancer patients were less likely to receive radiation therapy than female patients.
A team of researchers led by Rachel Rabinovitch, MD, an investigator at the University of Colorado Cancer Center and professor of Radiation Oncology at the University of Colorado School of Medicine, analyzed decades of data to compare disease management and outcomes of male and female breast cancer patients.
These researchers examined the Surveillance, Epidemiology, and End Results (SEER) database for information about primary invasive breast cancers diagnosed in men and women from 1973 until 2008.
A very clear difference was the rate of breast cancer in women compared to men. Male breast cancer accounted for less than 1 percent of all breast cancer cases.
Another way of looking at rates is to record the number of cases seen in 100,000 individuals. For men, breast cancer occurred in 1.5 out of 100,000 men, compared to 164.2 out of 100,000 women.
For the treatment comparisons, the researchers classified the type of breast cancer the patients had. Localized disease is cancer that is confined to the breast tissue, and regional disease involves the skin, chest wall and/or nearby lymph nodes.
The data review involving 4,276 cases of male breast cancer and 718,587 cases of female breast cancer highlighted the following:
- Only 12 percent of the men were diagnosed with breast cancer under the age of 50, compared with about 24 percent of the women.
- More older men were diagnosed with the disease after the age of 70 than were women of the same age — 40 percent versus 30 percent.
- Among all the men diagnosed with breast cancer, 87 percent had a mastectomy, compared to 47 percent of women treated for the disease.
- Only 6 percent of the men with early stage breast cancer were treated with a lumpectomy (removal of the tumor) followed by radiation, and the remaining 94 percent received a mastectomy.
- In women with localized disease, 46 percent received a mastectomy and 54 percent were treated with a lumpectomy and radiation therapy.
- Radiation was given to 33.6 percent of men and 44.8 percent of women with regional disease.
- Use of radiation therapy following a mastectomy in men steadily increased between 1973 and 2008.
- There were no big differences in breast cancer survival among the men and women, although survival among men has been improving over the years.
When asked about the greater use of mastectomy to treat male breast cancer, Adam Brufsky, MD, PhD, professor of medicine at the University of Pittsburgh School of Medicine, said, "This is true due to the nature of breast tissue in men (not a lot of it) and there is no reason to change as far as I can tell.”
Dr. Brufsky, a dailyRx Contributing Expert, added “Appearance is not affected that much in my experience.”
The authors of this study disagree with Dr. Brufsky, who has treated men with breast cancer.
“Breast conservation is rarely performed in men with [localized breast cancer] and should be considered for its equivalent outcomes, improved cosmesis, and potential psychosocial benefits,” the researchers wrote.
Results from this study were published in the November issue of the International Journal of Radiation Oncology, Biology and Physics.
No conflicts of interest were disclosed.