Is Breast Conserving Therapy a Safe Modality for Early-Stage Male Breast Cancer?

Zaenger, D.; Rabatic, B.M.; Dasher, B.G.; Mourad, W.F.

doi:10.1016/j.clbc.2015.11.005

Cited by 50 publications

(38 citation statements)

References 20 publications

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“…Physical and emotive consequences of hormonal therapies and chemotherapies, including the fear for an emasculating therapy and sexual dysfunction, are more problematic than in the female counterpart, which limits their indications in male patients. As said by the recent literature [8], [11], [12], [16], [17] emerging BCS, in early stage MBC, has comparable survival rates to MRM and has been progressively more performed in the last years. Despite the current transition from radical to conservative surgical treatment of MBC, we retain that MRM is still regarded as the standard treatment due to the paucity of male breast tissue, the typical central sub-areolar location of the cancer with early nipple involvement and the debilitating side effects of adjuvant therapy necessary in BCS.…”

Section: Discussionmentioning

confidence: 86%

“…According to Zaenger study, in the preliminary data collected from the European Organization for Research and Treatment of Cancer (EORTC) 56% of MBC patients had stage T1 cancer, but only 4% had undergone breast conservation surgery [12]. We report a case of MBC treatment and we extensively reviewed pertinent literature of the last 10 years to investigate whether BCS can be considered as the gold standard treatment, or if a more radical surgery is preferable.…”

Section: Introductionmentioning

confidence: 99%

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Male breast cancer: Modified radical mastectomy or breast conservation surgery? A case report and review of the literature

Giunta

Rossi

Toia

et al. 2017

International Journal of Surgery Case Reports

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IntroductionMale breast cancer (MBC) is a rare disease that accounts for <1% of breast cancer cases. The most common treatment is modified radical mastectomy (MRM). Recently, breast conservative surgery (BCS) is getting popular for MBC treatment. We report a case and reviewed the literature to investigate whether emerging BCS can be considered as an alternative of a more radical surgery.Presentation of caseA 46 y.o. patient, presented with a painless left breast lump over a period of six months. The patient underwent a quadrantectomy at another institution. Pathology revealed an intraductal carcinoma in close proximity to the margins of excision. Adjuvant hormonal therapy was proposed to the patient, who refused and was referred to our Institution. We performed a MRM and a sentinel lymph node biopsy (SLNB). A contralateral breast liposuction and an adenectomy were also performed. The patient underwent also a nipple-areolar complex reconstruction. The patient didn’t receive adjuvant therapy.DiscussionBoth oncological safety and satisfactory cosmetic outcomes are the goals of MBC treatment. No specific guidelines for MBC treatment have been proposed. MRM is currently the surgical gold standard of MBC (approximately 70% of all cases). Some authors reported that male BCS associated with radiation therapy is a feasible alternative MRM. Taking into account data from the literature and considering the previous surgery, in the case we report, we offered a MRM, SLNB and a contralateral breast symmetrization.ConclusionMRM with SLNB and reconstruction of male breast asymmetry should be still considered as the treatment of choice of MBC.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Male breast cancer: Modified radical mastectomy or breast conservation surgery? A case report and review of the literature

Giunta

Rossi

Toia

et al. 2017

International Journal of Surgery Case Reports

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“…The largest publication to date is a series evaluating the Surveillance, Epidemiology, and End Results (SEER) database for MBCs performed by Zaenger et al This report evaluated 6,263 men treated diagnosed with breast cancer from 1998 to 2011, and included 1777 men who had T1‐T2, node negative disease. Of this population, BCS was performed in 296 of these patients, with 135 (46%) of these patients receiving adjuvant radiation.…”

Section: Discussionmentioning

confidence: 99%

“…There are a few publications which evaluate disease free survival The largest publication to date is a series evaluating the Surveillance, Epidemiology, and End Results (SEER) database for MBCs performed by Zaenger et al 16 This report evaluated 6,263 men treated diagnosed with breast cancer from 1998 to 2011, and included 1777 men who had T1-T2, node negative disease.…”

Section: Discussionmentioning

confidence: 99%

Breast conservation for male breast cancer: Case report of intraoperative radiation

et al. 2017

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Male breast cancer (MBC) comprises <1% of all breast cancers in the United States.MBC is typically treated with total mastectomy while the majority of female breast cancer is treated with breast conservation therapy combined with various forms of radiation. One method that has developed over the last two decades is the use of intraoperative radiation therapy (IORT) as a type of accelerated partial breast irradiation to direct the treatment field to the tumor bed. Since overall prognosis and systemic therapy recommendations for MBC are similar to breast cancer in women, we describe the first case of MBC treated with BCS and IORT. Our patient is a 62-year-old male who was found to have a right breast 1.6 cm palpable mass at the 10:00 position 1 cm radially from the nipple. Core biopsy demonstrated invasive ductal carcinoma, moderately differentiated, estrogen and progesterone receptor positive, and Her 2 Negative. The patient had a strong desire for breast conservation, and needed to minimize daily radiation treatments due to his work schedule. After discussion among our multidisciplinary tumor board, we felt this patient to be suitable for BCS and IORT given his age, favorable tumor subtype, size, and clinically early stage breast cancer. A right axillary sentinel lymph node biopsy and central lumpectomy was performed. The INTRABEAM device (Carl Zeiss Meditec, Oberkochen, Germany) was utilized for radiation delivery.The patient had negative margins on his final pathology. The postoperative course was uneventful and at the 6 month follow-up visit there were no issues and he had an excellent cosmetic outcome. BCS and IORT is an option in appropriately selected male patients with favorable subtype early stage breast cancer. K E Y W O R D Sbreast cancer, breast conservation surgery, intraoperative radiation, male breast cancer

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“…More frequently patients undergo nipple reconstruction and tattooing to provide visual balance to the chest. Recent data published in 2016 shows that for early stage male breast cancer, breast conserving surgery yields comparable cause specific survival rates to modified radical mastectomy [13] , [14] , [15] , [16] , [17] . Such data may support a paradigm shift away from larger radical procedures, as was seen in female breast cancer over two decades ago.…”

Section: Discussionmentioning

confidence: 99%

The surgical management of male breast cancer: Time for an easy access national reporting database?

Staruch¹,

Rouhani

Ellabban

2016

Annals of Medicine &Amp; Surgery

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IntroductionMale breast cancer is extremely rare with an incidence of less than 1% of all breast cancers. Literature reports a peak of incidence at roughly 71 years of age. Management currently follows the same clinical pathways as female breast cancer as a general rule.MethodsA retrospective search for all patients who were referred and diagnosed with male breast cancer at our centre was undertaken. Patients notes were then explored for demographics, histological staging, multidisciplinary team meeting outcome and treatment.A literature search including the search terms ‘Male Breast Cancer AND Surgery’ or ‘Male Breast Cancer AND Experience’ were used. Non English language articles, or those without abstracts were excluded.ResultsSeven patients were reviewed over 3 years (2006–2009). Mean agea was 69 years and mean lesion size was 15 mm. Histology was invasive ductal carcinoma for all patients. All patients were ER receptor positive. Two patients were HER2 positive. Five patients were offered mastectomy. One patient refused treatment. In follow up at 36 months there were 3 recurrences. 1 patient was lost to follow up. There were 3 mortalities.The literature search identified 72 articles. Articles were subdivided into those that discussed the surgical management of male breast cancer (n = 8), articles that discussed male breast cancer as podium presentations or posters with no full text article publication (n = 13) and finally full text publications of case experience of male breast cancer (n = 21).DiscussionWe report a series of seven cases of male breast cancer encountered over three years, evaluating patient demographics as well as treatment and outcomes. In our series patients were managed with mastectomy. New evidence is questioning the role of mastectomy against breast conserving surgery in male patients. Furthermore there is a lack of reporting infrastructure for national data capture of the benefits of surgical modalities. Literature review highlights the varied clinical experience between units that remains reported as podium presentation but not published. The establishment of an online international reporting registry would allow for efficient analysis of surgical outcomes to improve patient care from smaller single centres. This would facilitate large scale meta analysis by larger academic surgical centres.

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Is Breast Conserving Therapy a Safe Modality for Early-Stage Male Breast Cancer?

Cited by 50 publications

References 20 publications

Male breast cancer: Modified radical mastectomy or breast conservation surgery? A case report and review of the literature

Male breast cancer: Modified radical mastectomy or breast conservation surgery? A case report and review of the literature

Breast conservation for male breast cancer: Case report of intraoperative radiation

The surgical management of male breast cancer: Time for an easy access national reporting database?

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