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Study: Mastectomy May Be Overused—For Men

November 6, 2013
Written by: , Filed in: Breast Imaging
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Looks matter for guys too. So men who get breast cancer shouldn’t routinely be treated with mastectomy.

So says Rachel Rabinovitch, MD, professor of radiation oncology at the University of Colorado Hospital in Aurora and primary investigator for studies conducted by the hospital’s Radiation Therapy Oncology Group. Most recently, she was senior author of a study, published in the November 15 issue of International Journal of Radiation Oncology*Biology*Physics, that examines male breast cancer in the United States.

Almost 90 percent of the time, it’s treated with mastectomy, the study found. Dr. Rabinovitch said that needs to be rethought:

Traditionally, breast conservation is not even considered for men with breast cancer. But in a world in which a man’s appearance is increasingly important and where it is common for men to be seen without a shirt in the gym or on the beach, mastectomy can have overlooked psycho-sexual impacts on men, just as in women.

Dr. Rabinovitch was quoted in a University of Colorado Cancer Center news release.

For the study, the researchers mined the Surveillance, Epidemiology, and End Results (SEER) Program database of the National Cancer Institute. They examined all primary invasive breast cancer cases diagnosed from 1973 through 2008—718,587 in women and 4,276 in men.

“The study demonstrates that, just as in women, men with early stage breast cancer have the same outcome with a mastectomy or a lumpectomy followed by radiation,” Dr. Rabinovitch said. However, 87.4 percent of men had mastectomies, compared with 38.3 percent of women. Receiving breast-conserving surgery were 52.6 percent of women but only 12.6 percent of men.

“I think these findings point to new areas of research and should push clinicians to consider the advantages of breast-conserving therapy with their patients,” Dr. Rabinovitch said. “It’s a new conversation. Surgeons and oncologists shouldn’t assume that men are fine with a mastectomy.”

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A surprising factor has a big impact on whether women in the United States receive mammograms: citizenship. For details, see our Facebook page.

Related CME seminar (up to 15 AMA PRA Category 1 credits™): New Horizons in Breast Imaging

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