The Role of Radiation Therapy in Addition to Lumpectomy and Hormone Therapy in Men 70 Years of Age and Older with Early Breast Cancer: A NCDB Analysis

Male Breast Cancer: Treatment Trends, Reported Outcomes, and Suggested Recommendations

“…Research shows that survival rates of MBC patients treated by BCS and RT are near equal if not better than patients treated by mastectomy [ 30 , 33 , 34 ]. In a study of 1777 MBC cases, where 17% of men had BCS and 40% had a radical or simple mastectomy, the five-year case-specific survival rate was equal amongst the treatment groups only if all mastectomy patients had stage I cancer and postsurgical radiation therapy [ 34 ].…”

“…However, the need for RT did not significantly impact the survival of patients treated by BCS, of whom only 46% received it [ 34 ]. Additionally, BCS treatment made no statistical difference in the overall survival of 752 men 70 years or older with stage I, ER+ cancer, treated with or without post-surgical RT compared to mastectomy [ 33 ]. Similarly, a 0.5% ten-year survival and 5.5% greater overall survival (OS) were reported in men ages 80 or older with stage IV MBC if treated by BCS rather than mastectomy [ 30 ].…”

“…Similarly, a 0.5% ten-year survival and 5.5% greater overall survival (OS) were reported in men ages 80 or older with stage IV MBC if treated by BCS rather than mastectomy [ 30 ]. The results reported by these studies suggest that using less invasive procedures is safe even in men of greater age and severity of cancer [ 30 , 33 ].…”

“…It has been 31 years since the National Institutes of Health (NIH) announced that the less invasive BCS followed by RT is an appropriate procedure with an equivalent survival rate to mastectomy used in treating early FBC [ 38 ]. Based on the FBC guideline recommendations and multiple study findings showing equal survival rates in those treated by BCS and mastectomy [ 11 , 28 , 30 , 33 ], qualified men should consider BCS along with postsurgical RT as a safe treatment option. Additionally, the authors suggest treating physicians should note the lack of postoperative therapy compliance and assist patients in making a well-informed decision when selecting their cancer treatment [ 36 ].…”

“…Although survival outcomes are similar between mastectomies and BCT [ 11 , 28 , 30 , 33 ], postoperative complications should be considered. These complications include infections, seromas with fluid collection surrounding the wound that can become a nexus for infection, and lymphedema [ 45 ].…”