title: Similarities and differences in the characteristics and primary treatment of breast cancer in men and women - a population based study (Sweden).
abstract: OBJECTIVE
  Male breast cancer (MBC) is an uncommon disease. In the absence of randomized studies, current guidelines are mainly based on data on the management of female breast cancer (FBC). In light of concerns regarding the quality and extent of management in men, the aim of the present study was to investigate whether there are differences in tumor characteristics, treatment and outcome in male compared with FBC patients.
  
  
  METHODS
  Cohorts of male and female breast cancer were retrospectively analyzed. All male patients diagnosed with invasive breast cancer between 1993 and 2007 were identified from the Regional Breast Cancer Register of the Uppsala-Örebro Region in Sweden. To increase the power of the study and obtain comparable cohorts we sampled four FBC patients (n = 396) for each MBC patient (n = 99) with similar age at diagnosis and time of diagnosis.
  
  
  RESULTS
  No differences were seen in stage at diagnosis between MBC and FBC. Men underwent mastectomy more often than women (92% vs. 44%, p < 0.001). Radiotherapy was delivered less often to MBC than FBC (44% vs. 56%, p = 0.034), but radiotherapy given after mastectomy (44% vs. 39%, p = 0.47) did not differ between the groups. No differences were found regarding adjuvant chemotherapy (16% vs. 21%; p = 0.31) or adjuvant endocrine therapy (59% vs. 52%, p = 0.24). Both overall survival (41% vs. 55%, p = 0.001) and relative survival (74% vs. 88%, p = 0.015) were inferior in MBC compared to FBC.
  
  
  CONCLUSIONS
  Concerns regarding less extensive treatment in MBC patients were not supported by this study. Although no differences in the stage of the disease or treatment intensity could be demonstrated, outcome was inferior in the male group.
authors.affiliation: Department of Radiology, Oncology and Radiation Science, Uppsala University Hospital, Sweden. cecilia.nilsson@ltv.se
authors.forename: Cecilia
authors.initials: C
authors.lastname: Nilsson
authors.forename: Marit
authors.initials: M
authors.lastname: Holmqvist
authors.forename: Leif
authors.initials: L
authors.lastname: Bergkvist
authors.forename: Ingrid
authors.initials: I
authors.lastname: Hedenfalk
authors.forename: Mats
authors.initials: M
authors.lastname: Lambe
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Fjällskog
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D018567:Breast Neoplasms, Male / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D013548:Sweden; D055815:Young Adult