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Surgery for Men with Breast Cancer: Do the Same Data Still Apply?

Publication ,  Journal Article
Plichta, JK; Ren, Y; Marks, CE; Thomas, SM; Greenup, RA; Rosenberger, LH; Fayanju, OM; McDuff, SGR; Hwang, ES; Force, J
Published in: Ann Surg Oncol
November 2020

BACKGROUND: Men represent a small proportion of breast cancer diagnoses, and they are often excluded from clinical trials. Current treatments are largely extrapolated from evidence in women. We compare practice patterns between men and women with breast cancer following the publication of several landmark clinical trials in surgery. PATIENTS AND METHODS: Patients with invasive breast cancer (2004-2015) from the National Cancer Data Base were identified; subcohorts were created based on eligibility for NSABP-B06, CALGB 9343, and ACOSOG Z0011. Practice patterns were stratified by gender and compared. Cox proportional hazards regression analyses were utilized to estimate the association between OS and gender. RESULTS: Of the 1,664,746 patients identified, 99% were women and 1% were men. Among NSABP-B06 eligible men, mastectomy rates did not change (consistently ~ 80%), and their adjusted OS was minimally worse compared with women (HR 1.19, 95% CI 1.11-1.28). Following publication of CALGB 9343, omission of radiation after lumpectomy was less likely in men and lagged behind that of women, despite similar OS (male HR 0.92, 95% CI 0.59-1.44). Application of ACOSOG Z0011 findings resulted in deescalation of axillary surgery for men and women with comparable OS (male HR 0.69, 95% CI 0.33-1.45). CONCLUSIONS: Uptake of clinical trial results for men with breast cancer often mirrors that for women, despite exclusion from these studies. Furthermore, when study findings were applied to eligible patients, men and women demonstrated similar survival. Observational studies can help inform the potential application of study findings to this unique population and improve patient enrollment in clinical trials.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

November 2020

Volume

27

Issue

12

Start / End Page

4720 / 4729

Location

United States

Related Subject Headings

  • Sentinel Lymph Node Biopsy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Mastectomy, Segmental
  • Mastectomy
  • Male
  • Lymph Node Excision
  • Humans
  • Breast Neoplasms, Male
 

Citation

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Plichta, J. K., Ren, Y., Marks, C. E., Thomas, S. M., Greenup, R. A., Rosenberger, L. H., … Force, J. (2020). Surgery for Men with Breast Cancer: Do the Same Data Still Apply? Ann Surg Oncol, 27(12), 4720–4729. https://doi.org/10.1245/s10434-020-08901-z
Plichta, Jennifer K., Yi Ren, Caitlin E. Marks, Samantha M. Thomas, Rachel A. Greenup, Laura H. Rosenberger, Oluwadamilola M. Fayanju, Susan G. R. McDuff, E Shelley Hwang, and Jeremy Force. “Surgery for Men with Breast Cancer: Do the Same Data Still Apply?Ann Surg Oncol 27, no. 12 (November 2020): 4720–29. https://doi.org/10.1245/s10434-020-08901-z.
Plichta JK, Ren Y, Marks CE, Thomas SM, Greenup RA, Rosenberger LH, et al. Surgery for Men with Breast Cancer: Do the Same Data Still Apply? Ann Surg Oncol. 2020 Nov;27(12):4720–9.
Plichta, Jennifer K., et al. “Surgery for Men with Breast Cancer: Do the Same Data Still Apply?Ann Surg Oncol, vol. 27, no. 12, Nov. 2020, pp. 4720–29. Pubmed, doi:10.1245/s10434-020-08901-z.
Plichta JK, Ren Y, Marks CE, Thomas SM, Greenup RA, Rosenberger LH, Fayanju OM, McDuff SGR, Hwang ES, Force J. Surgery for Men with Breast Cancer: Do the Same Data Still Apply? Ann Surg Oncol. 2020 Nov;27(12):4720–4729.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

November 2020

Volume

27

Issue

12

Start / End Page

4720 / 4729

Location

United States

Related Subject Headings

  • Sentinel Lymph Node Biopsy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Mastectomy, Segmental
  • Mastectomy
  • Male
  • Lymph Node Excision
  • Humans
  • Breast Neoplasms, Male