Saving the Male Breast: A Systematic Literature Review of Breast-Conservation Surgery for Male Breast Cancer

Background

Male breast cancer (MBC) management is extrapolated from female BC. Mastectomy remains the most frequently used surgical procedure for male breast cancer (MBC). We performed a literature review to assess the use of breast-conservation (BCS) in MBC as well as outcomes following BCS.

Methods

A systematic literature was performed, and articles screened to identify studies that measured overall survival (OS), disease-free survival (DFS), or local recurrence (LR) in patients undergoing BCS. Weighted averages based on study size were performed for LR, DFS, and 5-year OS.

Results

Eight studies met the inclusion criteria with male breast surgery cases, and 859 (14.7%) underwent BCS. The mean follow-up time was 53 months, and mean age was 62.6 years, with stage II as the most common presentation. Two studies reported that 50–71.4% of patients underwent sentinel lymph node biopsy, and four studies reported axillary lymph node dissection in 14.3–100%. Five studies reported on adjuvant radiation therapy in 12.0–100% of 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 116 patients, with a weighted average of 9.9%. Three studies reported on DFS in 14 patients, with a weighted average 85.6%. Two studies report OS in 143 patients with a weighted average of 84.4%.

Conclusions

Breast conservation may be considered a safe alternative in the surgical treatment of MBC. Future research should focus on better standardization of local therapy for MBC and improved reporting of outcomes.