Abstract P6-19-06: Breast conservation surgery in male breast cancer: A systematic literature review

Abstract

BACKGROUND Male breast cancer (BC) incidence is low and management is extrapolated from female BC. Breast conservation surgery (BCS) is commonly used for female BC, however, mastectomy remains the most frequently used surgical procedure for male breast cancer. We performed a literature review to assess the use of BCS in male BC as well as outcomes following BCS. METHODS A systematic literature review identified peer-reviewed articles in PubMed evaluating male BC and surgery. Abstracts were screened to identify studies that measured overall survival (OS), disease-free survival (DFS), or local recurrence (LR) in patients undergoing BCS. For all studies, we extracted the total number of patients and number of BCS cases. Of patients undergoing BCS, we further extracted mean age, mean follow-up time, clinical stage, type of axillary surgery [sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND)], radiation therapy, hormonal therapy, and chemotherapy. Weighted averages, based on number of patients in each study, were performed for LR, DFS and 5-year OS. The time period for LR and DFS was the duration of follow-up time for each study. RESULTS The literature search yielded 4341 articles. Twelve studies published from 1998 to 2016 met the inclusion criteria and were selected for the systematic literature review. Among the 12,616 male breast surgery cases included, 1,633 (12.9%) underwent BCS. Only patients who underwent BCS were included in our analysis. The mean follow-up time was 54.4 months and mean age was 62.4 with stage II as the most common presentation. Two studies reported that 50-71.4% of patients underwent SLNB and 4 studies reported ALND in 14.3-100%. Seven studies reported that adjuvant radiation therapy was administered in 12.0-100% of 474 total patients undergoing BCS. Four studies reported use of hormonal therapy in 73.8-100% of patients. Four studies reported use of chemotherapy in 25-66.7% of patients. Seven studies reported LR among 122 patients, with a weighted average 11.8%. Four studies reported on 5-year OS in 1511 patients, with a weighted average of 85.8%. CONCLUSION While less commonly used than mastectomy, BCS can be considered a safe alternative in the surgical treatment of male BC. We have demonstrated that the use of adjuvant radiation following BCS is variable in this patient group. Future research should focus on better standardization of local therapy for male BC and improved reporting of outcomes. Citation Format: Fisher CS, de la Cruz L, Joshi S, Mah T-J, Blankenship S, Thiruchelvam P. Breast conservation surgery in male breast cancer: A systematic literature review [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-19-06.