title: Is Breast Conserving Therapy a Safe Modality for Early-Stage Male Breast Cancer?
abstract: BACKGROUND
  Male breast cancer (MBC) is a rare disease and lacks data-based treatment guidelines. Most men are currently treated with modified radical mastectomy (MRM) or simple mastectomy (SM). We compared the oncologic treatment outcomes of early-stage MBC to determine whether breast conservation therapy (BCT) is appropriate.
  
  
  METHODS
  We searched the Surveillance, Epidemiology, and End Results database for MBC cases. That cohort was narrowed to cases of stage I-II, T1-T2N0 MBC with surgical and radiation therapy (RT) data available. The patients had undergone MRM, SM, or breast conservation surgery (BCS) with or without postoperative RT. We calculated the actuarial 5-year cause-specific survival (CSS).
  
  
  RESULTS
  We identified 6263 MBC cases and included 1777 men with stage I or II, T1-T2, node-negative disease, who had the required treatment information available. MRM without RT was the most common treatment (43%). Only 17% underwent BCS. Of the BCS patients, 46% received adjuvant RT to complete the traditional BCT. No deaths were recorded in the BCT group, regardless of stage, or in the 3 stage I surgical groups if the men had received RT. The actuarial 5-year CSS was 100% in each BCT group. MRM alone resulted in an actuarial 5-year CSS of 97.3% for stage 1% and 91.2% for stage 2.
  
  
  CONCLUSIONS
  The results from our study suggest that BCT for early-stage MBC yields comparable survival compared with more invasive treatment modalities (ie, MRM or SM alone). This could shift the treatment paradigm to less-invasive interventions and might have the added benefit of increased functional and psychological outcomes. Further prospective studies are needed to confirm our conclusions.
authors.affiliation: Department of Radiation Oncology, Georgia Regents University, Augusta, GA. Electronic address: dzaenger@gru.edu.
authors.forename: David
authors.initials: D
authors.lastname: Zaenger
authors.affiliation: Department of Radiation Oncology, Georgia Regents University, Augusta, GA.
authors.forename: Bryan M
authors.initials: BM
authors.lastname: Rabatic
authors.affiliation: Department of Radiation Oncology, Georgia Regents University, Augusta, GA.
authors.forename: Byron
authors.initials: B
authors.lastname: Dasher
authors.affiliation: Department of Radiation Oncology, Georgia Regents University, Augusta, GA.
authors.forename: Waleed F
authors.initials: WF
authors.lastname: Mourad
mesh_terms: D018567:Breast Neoplasms, Male / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015411:Mastectomy, Modified Radical / Q000379:methods*; D015412:Mastectomy, Segmental; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States / Q000453:epidemiology
keywords: Breast conservation therapy; Postoperative radiation therapy