Postmastectomy Reconstruction in Male Breast Cancer

Abstract

Introduction. Less than 1% of all breast cancers are diagnosed in males. In females, postmastectomy breast reconstruction is associated with increased patient satisfaction. However, there is a paucity of literature describing reconstructive options for postmastectomy deformity in the male chest. The purpose of this systematic review was to evaluate postmastectomy reconstruction outcomes in males with breast cancer. Methods. A systematic review was performed in accordance with PRISMA guidelines. Ovid MEDLINE, Embase, Cochrane, and Web of Science were queried for records pertaining to the study question using medical subject heading (MeSH) terms such as “male breast cancer,” “mastectomy,” and “reconstruction.” No limitations were placed on the year of publication, country of origin, or study size. Study characteristics and patient demographics were collected. Primary outcomes of interest included postoperative complications, recurrence rate, and mortality rate. Results. A total of 11 articles examining 29 male patients with breast cancer who underwent postmastectomy reconstruction were included for analysis. Literature was most commonly available in the form of case reports. The average age was 59.6 +/−11.4 years. Reconstruction methods included fat grafting (n = 1, 3.4%), silicone implants (n = 1, 3.4%), and autologous chest wall reconstruction with local flaps (n = 26, 89.7%). Postoperative complications occurred in two patients (6.8%), including partial nipple necrosis (n = 1) and hypertrophic scarring (n = 1). Of the studies reporting patient satisfaction, all patients were pleased with the aesthetic appearance of their chest. Conclusion. This systematic review revealed the limited availability of research regarding postmastectomy chest reconstruction in males with breast cancer. Nevertheless, the evidence available suggests that reconstruction can restore a patient’s body image and, thus, should be regularly considered and discussed with male patients. Larger studies are warranted to further shed light on this population.

An Update on the General Features of Breast Cancer in Male Patients—A Literature Review

“…A study by Deldar [ 78 ] looks at the aspects of postmastectomy reconstruction in male breast cancer and concludes that there is limited availability of research on chest reconstruction after mastectomy in male breast cancer patients.…”

The 5-Factor Modified Frailty Index as a Predictor of Post-operative Complications in Males Undergoing Mastectomy

“…Male breast reconstruction after mastectomy is rare, and data is scarce on this subject. 32 Despite federal law mandating that physicians discuss breast reconstruction with all patients undergoing mastectomy, this is rarely done with males compared to females. 33 Given that postoperative complications following reconstruction was similar between frailty cohorts, we advocate that surgeons should offer breast reconstruction to all males undergoing mastectomy as post-mastectomy reconstruction is associated with increased quality of life in both males and females.…”

Imaging of the Reconstructed Breast

“…Although scarce, there are reports at the literature regarding postmastectomy breast reconstruction in men. Autologous reconstruction is the most common method with local flaps followed by the TRAM flap and there is a single report of fat grafting for chest symmetry [112,113].…”