Treatment Of Female Breast Cancer Research Articles

Tamoxifen: An Investigative Review for Nano Dosage Forms and Hyphenated Techniques

Tamoxifen (TAM), a non-steroidal antiestrogen, has revolutionized female breast cancer treatment. The mechanism involves is to compete with 17β-estradiol (E2) at the receptor site and blocking the promotional role of E2 in breast cancer. Tam is a pioneering medicine because of its widespread usage in breast cancer treatment and chemoprevention, as well as research into novel selective estrogen receptor modulators (SERMs). In the vast majority of patients, TAM is cost-effective, life-saving, and free of significant adverse effects. In this context, this review presents several nanoformulations for selectively delivered lower dosages of TAM to breast tumors. Various TAM-containing nanosystems have been effectively created to deliver TAM to particular molecular targets with decreasing harmful effects. Following that, there is a summary of chromatographic techniques to quantify the drug in human biological samples. The quantification of the drug in different biological matrices is the major importance to assist the control of quality, efficacy, and safety.

Male Breast Cancer: Current Essentials & Review

Background: Breast cancer in male is a very rare condition but some of the reported case series had shown that its incidence is increasing over the last 25 years. The etiology of breast cancer in males differs from that of females in many ways. The literature lacks the prospective randomized evidences supporting the treatment of male breast cancer. Only retrospective evidences are available and all guidelines are extrapolated from the best available data of treatment of female breast cancer. Therefore, we have reviewed, compiled and tried to present the best available literature which highlights the treatment of male breast cancer .The reported incidence of breast cancer in men is around 1.2%-2% of all cancers in males and less than 1% of all breast cancers in both sexes. If it involves both breasts then it becomes an extremely uncommon condition which accounts for only 1% of all male breast cancer. Elderly males are most commonly diagnosed with breast cancer and they are approximately 5 to 10 years older than the women. The most common reason of breast cancer in males is excess of estrogen in the body and all conditions which leads to hyperestrogenism are responsible for increasing the risk of cancer.

China guideline for the screening and early detection of female breast cancer(2021, Beijing)

Breast cancer is the commonest malignant tumor among Chinese females, ranking first in terms of incidence of female cancers. Commissioned by the Disease Prevention and Control Bureau of National Health Commission of the People's Republic of China, the National Cancer Center formulated the Guideline for Screening and Early Diagnosis and Treatment of Female Breast Cancer in China according to WHO Handbook for Guideline Development. The methods on Cochrane China were referred to for the formulation of the system evaluation procedures. The GRADE methods for assessment, formulation and evaluation were adopted for the classification of evidence quality and recommendation strength, and the items were reported according to Reporting Items for Practice Guidelines in Healthcare. Based on the results of evaluation, the guideline gives evidence-based recommendations for the appropriate population and technical procedures for breast cancer screening and early diagnosis and treatment after comprehensive consideration of China's national conditions, the advantages and disadvantages of the evidence, the quality of the evidence, the economic cost of screening, the feedback of multidisciplinary clinical research respondents, and in-person expert consensus. It is aimed at regulating the practices of female breast cancer screening and early diagnosis and treatment and enhancing the effectiveness of the prevention and control of female breast cancer in China.

Female breast cancer treatment and survival in South Australia: Results from linked health data.

ObjectiveWe investigated treatment and survival by clinical and sociodemographic characteristics for service evaluation using linked data.MethodData on invasive female breast cancers (n = 13,494) from the South Australian Cancer Registry (2000–2014 diagnoses) were linked to hospital inpatient, radiotherapy and universal health insurance data. Treatments ≤12 months from diagnosis and survival were analysed, using adjusted odds ratios (aORs) from logistic regression, and adjusted sub‐hazard ratios (aSHRs) from competing risk regression.Results and conclusionFive‐year disease‐specific survival increased to 91% for 2010–2014. Most women had breast surgery (90%), systemic therapy (72%) and radiotherapy (60%). Less treatment applied for ages 80+ vs <50 years (aOR 0.10, 95% CI 0.05–0.20) and TNM stage IV vs stage I (aOR 0.13, 95% CI 0.08–0.22). Surgical treatment increased during the study period and strongly predicted higher survival. Compared with no surgery, aSHRs were 0.31 (95% CI 0.26–0.36) for women having breast‐conserving surgery, 0.49 (95% CI 0.41–0.57) for mastectomy and 0.42 (95% CI 0.33–0.52) when both surgery types were received. Patients aged 80+ years had lower survival and less treatment. More trial evidence is needed to optimise trade‐offs between benefits and harms in these older women. Survival differences were not found by residential remoteness and were marginal by socioeconomic status.

Thinking about the Treatment of Female Breast Cancer based on the Theory of "Kidney Qi-Tian Gui-Chong Ren-Uterus" Axis

Purpose: To explore the treatment of female breast cancer based on the "Kidney Qi-Tian Gui-Chong Ren-Uterus"axis theory. Method: Based on the physiological and emotional characteristics of women such as kidney, Chong Ren, and uterus, as well as the understanding of female breast cancer under the modern medical theory, the pathogenesis and treatment ideas of female breast cancer were discussed using the "Kidney Qi-Tian Gui-Chong Ren-Uterus" axis theory. Results: In the treatment of female breast cancer, attention should be paid to the regulation of Qi in the whole body, the regulation of Chong Ren, the strengthening of body resistance to eliminate pathogenic factors, and the regulation of emotions at the same time, so as to achieve the purposes of strengthening body resistance, resisting cancer, and improving the survival and prognosis of the patients.

Efficacy of neoadjuvant chemotherapy (NAC) in male breast cancer (MaBC) compared with female breast cancer (FBC): A National Cancer Database (NCDB) study.

587 Background: NAC is frequently used in the treatment of FBC. The efficacy of NAC in MaBC is unclear. Few studies have compared outcomes for MaBC and FBC after similar treatment. The aim of this study was to compare proportions of pathologic complete response (pCR) between MaBC and FBC according to tumor subtype (TS). Secondary aims were clinical response and overall survival (OS). Methods: We evaluated men and women with breast cancer treated with NAC between 2010 and 2016 with known hormone receptor (HR) status and human epidermal growth factor receptor 2 (HER2) status at NCDB centers. The proportion with pCR (ypT0/Tis ypN0) was compared for MaBC and FBC for each TS by Fisher’s exact test. Logistic regression evaluated odds of pCR. OS was estimated by Kaplan-Meier and compared by log-rank test. Results: Of 7,721 MaBC and 859,096 FBC patients, 385 MaBC (5%) and 68,065 FBC (7.9%) underwent NAC and were included in this study. Median age for MaBC was 58 years (y) (range 23-88) and for FBC was 53 y (range 18-90). Within each TS, there were no significant differences in the distribution of tumor grade between MaBC and FBC. Clinical stage in MaBC and FBC were: Stage I: 8% v 11%, Stage II: 54% v 59%, Stage III: 38% v 30%; respectively. Median time from initiation of NAC to surgery was 143 days in MaBC and 148 days in FBC. Compared with FBC, MaBC had a lower proportion of complete clinical response (18% v 31%) and a higher proportion of no clinical response (14% v 7%); p &lt; 0.001. Proportions and odds of pCR were numerically lower in MaBC compared with FBC for each TS and statistically significant for HR+/HER2- and HR+/HER2+ (table). pCR was associated with OS in both MaBC and FBC. Specifically, in MaBC who achieved pCR v not, 5 y OS was 90% v 64.7%; p = 0.02. In FBC who achieved pCR v not, 5 y OS was 91.9% v 75.3%; p &lt; 0.01. Among pts receiving NAC, MaBC had worse OS at 5 y than FBC (67.1% v 79.0%; p = 0.02). Conclusions: Men receiving NAC achieved lower proportions of pCR than women and had significantly worse OS. However, pCR is prognostic in both MaBC and FBC. Limitations include small sample sizes for HR-/HER2+ and triple-negative TS and lack of detailed regimen information. Nevertheless, our results suggest that, compared with FBC, MaBC may be intrinsically more resistant to NAC. [Table: see text]

Utilization of the Cancer Medications Enquiry Database (CanMED)-National Drug Codes (NDC): Assessment of Systemic Breast Cancer Treatment Patterns

Cancer Medications Enquiry Database (CanMED) is comprised of two interactive, nomenclature-specific databases within the Observational Research in Oncology Toolbox: CanMED-Healthcare Common Procedure Coding System (HCPCS) and CanMED-National Drug Code (NDC), described through this study. CanMED includes medications with a) a US Food and Drug Administration-approved cancer treatment or treatment-related symptom management indication, b) inclusion in treatment guidelines, or c) an orphan drug designation. To demonstrate the joint utility of CanMED, medication codes associated with female breast cancer treatment were identified and utilization patterns were assessed within Surveillance Epidemiology and End Results-Medicare (SEER) data. CanMED-NDC (11_2018 v.1.2.4) includes 6860 NDC codes: chemotherapy (1870), immunotherapy (164), hormone therapy (3074), and ancillary therapy (1752). Treatment patterns among stage I-IIIA (20701) and stage IIIB-IV (2381) breast cancer patients were accordant with guideline-recommended treatment by stage and molecular subtype. CanMED facilitates identification of medications from observational data (eg, claims and electronic health records), promoting more standardized and efficient treatment-related cancer research.

Breast Cancer Population Screening Program Results in Early Detection and Reduced Treatment and Health Care Costs for Medicaid.

The National Breast and Cervical Cancer Early Detection Program has increased access to screening services for low-income females since 1991; however, evaluation information from states implementing the program is sparse. This study evaluates the impact of the Missouri program, Show Me Healthy Women (SMHW), on early detection and treatment cost. To estimate breast cancer treatment and health care services costs by stage at diagnosis among Missouri's Medicaid beneficiaries and assess the SMHW program impact. Analyzed Missouri Medicaid claims linked with Missouri Cancer Registry data for cases diagnosed 2008-2012 (N = 1388) to obtain unadjusted and incremental costs of female breast cancer treatment and follow-up care at 6, 12, and 24 months following diagnosis. Noncancer controls (N = 3840) were matched on age, race, and disability to determine usual health care cost. Regression analyses estimated the impact of stage at diagnosis on expenditures and incremental cost. Show Me Healthy Women participants were compared with other breast cancer patients on stage at diagnosis. A comparison of SMHW participants to themselves had they not been enrolled in the program was analyzed to determine cost savings. Expenditures increased by stage at diagnosis from in situ to distant with unadjusted cost at 24 months ranging from $50 245 for in situ cancers to $152 431 for distant cancers. Incremental costs increased by stage at diagnosis from 6 months at $7346, $11 859, $21 501, and $20 235 for in situ, localized, regional, and distant breast cancers, respectively, to $9728, $17 056, $38 840, and $44 409 at 24 months. A significantly higher proportion of SMHW participants were diagnosed at an early stage resulting in lower unadjusted expenditures and cost savings. Although breast cancer treatment costs increased by stage at diagnosis, the population screening program's significant impact on early diagnosis resulted in important cost savings over time for Medicaid.

Risk factors and natural history of breast cancer in younger Chinese women.

To investigate the age differences in the risk factors, clinicopathological characteristics and patterns of treatment of female breast cancer patients. Seven thousand one hundred and fifty-two women with primary breast cancer from the Hong Kong Breast Cancer Registry were recruited after receiving patients' consent, they were asked to complete standardized questionnaires which captured their sociodemographic characteristics and risk factors associated with breast cancer development. Among them, clinicopathological data and patterns of treatment were further collected from medical records of 5523 patients with invasive breast cancers. Patients were divided into two groups according to the age at diagnosis: younger (< 40 years old) vs older patients (≥ 40 years old) for subsequent analyses. Analysis on the sociodemographic characteristics and exposure to risk factors were performed on 7152 women with primary breast cancer and the results revealed that younger patients were more likely to have unhealthy lifestyles; these include a lack of exercise (85.4% vs 73.2%, P < 0.001), having high stress in life (46.1% vs 35.5%, P < 0.001), having dairy/meat-rich diets (20.2% vs 12.9%, P < 0.001), having alcohol drinking habit (7.7% vs 5.2%, P = 0.002). Younger patients were also more likely to have hormone-related risk factors including nulliparity (43.3% vs 17.8%, P < 0.001) and an early age at menarche (20.7% vs 13.2%, P < 0.001). Analyses on clinicopathological characteristics and patterns of treatment were performed on 5523 women diagnosed with invasive breast cancer. The invasive tumours in younger patients showed more aggressive pathological features such as having a higher percentage of grade 3 histology (45.7% vs 36.5%, P < 0.001), having a higher proportion of tumours with lymphovascular invasion (39.6% vs 33.2%, P = 0.003), and having multifocal disease (15.7% vs 10.3%, P < 0.001); they received different patterns of treatment than their older counterparts. Younger patients in Hong Kong are more likely to encounter risk factors associated with breast cancer development and have more aggressive tumours than their older counterparts.

Localized Therapy for Male Breast Cancer: Functional Advantages With Comparable Outcomes Using Breast Conservation

BackgroundMale breast cancer (MBC) accounts for approximately 1% of all breast cancers. Given the rarity of this disease, treatment of MBC generally follows the same principles as treatment of female breast cancer. However, the traditional surgical approach for MBC is modified radical mastectomy (MRM) or total simple mastectomy (TSM) instead of breast conservation surgery (BCS). The purpose of this study was to examine the feasibility of BCS as an alternative to mastectomy for MBC with respect to musculoskeletal functionality and treatment outcome. Patients and MethodsA retrospective analysis was undertaken of all male patients with breast cancer who presented to Massachusetts General Hospital or Boston Medical Center for localized therapy from 1990 to 2003. Musculoskeletal functionality (tissue fibrosis, arm edema, and range of motion) and treatment outcome (local-regional control, disease-free survival, and overall survival) were evaluated. Functional/cosmetic outcomes were assessed by multidisciplinary review of patient follow-up visits and were scored as either “good-excellent” or “fair-poor” to account for subjectivity between different clinicians. ResultsForty-two patients in total were identified to undergo localized treatment. Thirty patients (71%) received MRM, 4 (10%) had TSM, and 8 (19%) underwent BCS. Actuarial overall 1-year fair-poor documented tissue fibrosis, arm edema, and decreased range of motion rates were 13%, 23%, and 27% for patients receiving MRM; 25%, 0%, and 50% for patients who underwent TSM; and 13%, 0%, and 0% for those undergoing BCS, respectively. Overall survival and disease-free survival were not statistically different between the groups. ConclusionsThese data suggest that breast conservation therapy may be considered a reasonable local treatment option for male patients presenting with breast cancer because it may offer functional advantages over mastectomy with comparable rates of local control and disease-free survival and overall survival.

Current status and progress of male breast cancer diagnosis and treatment

Male breast cancer is rare,it mainly caused by the interaction of the genetic factors,hormone levels,way of life,and the environment.Its clinical manifestations are indolent tumors.The diagnosis method includes clinical medical examination and imaging examination,and pathology examination.The treatment is in reference to the female breast cancer treatment model,including surgery,chemoradiotherapy and endocrine therapy.Tumor size and axillary lymph nodes involvement are independent predictors of overall survival. Key words: Breast neoplasms, male ; Therapy

Management of male breast cancer

The management of male breast cancer is still under discussion due to lack of information from prospective, randomized clinical trials and low incidence of this disease. Current management is based largely on extrapolation from data related to treatment of female breast cancer. Over the last two decades, several review articles have discussed mainly retrospective and anecdotal data related to hormonal and chemotherapy treatment modalities. In this review, we present the most recent information and future considerations related to the management of male breast cancer. In addition to the conventional treatment options we will discuss the possible role of targeted therapy. Establishing a national or global registry for male breast cancer will provide more precise information about the natural history of the disease and will facilitate the design and execution of prospective, randomized multicenter clinical trials.

Male Breast Cancer: Management and Follow-up Recommendations

National Comprehensive Cancer Network (NCCN) guidelines for female breast cancer treatment and surveillance are well established, but similar guidelines on male breast cancers are less recognized. As an NCCN institution, our objective was to examine practice patterns and follow-up for male breast cancer compared to established guidelines for female patients. After Institutional Review Board approval, a prospective breast database from 1990 to 2009 was queried for male patients. Medical records were examined for clinico-pathological factors and follow-up. The 5-year survival rates with 95% confidence intervals were estimated using Kaplan-Meier method and Greenwood formula. Of the 19,084 patients in the database, 73 (0.4%) were male patients; 62 had complete data. One patient had bilateral synchronous breast cancer. The median age was 68.8 years (range 29-85 years). The mean/median invasive tumor size was 2.2/1.6 cm (range 0.0-10.0 cm). All cases had mastectomy (29 with axillary node dissection, 23 with sentinel lymph node biopsy only, 11 with sentinel node biopsy followed by completion axillary dissection). Lymph node involvement occurred in 25/63 (39.7%). Based on NCCN guidelines, chemotherapy, hormonal therapy, and radiation are indicated in 34 cases, 62 cases, and 14 cases, respectively. Only 20/34 (59%) received chemotherapy, 51/62 (82%) received hormonal therapy, and 10/14 (71%) received post-mastectomy radiation. Median follow-up was 26.2 months (range: 1.6-230.9 months). The 5-year survival estimates for node positive and negative diseases were 68.5% and 87.5%, respectively (p = 0.3). Despite the rarity of male breast cancer, treatment options based on current female breast tumors produce comparable results to female breast cancer. Increased awareness and a national registry for patients could help improve outcomes and tailor treatment recommendations to the male variant.

Racial variation in breast cancer treatment among Department of Defense beneficiaries

Although the overall age-adjusted incidence rates for female breast cancer are higher among whites than blacks, mortality rates are higher among blacks. Many attribute this discrepancy to disparities in health care access and to blacks presenting with later stage disease. Within the Department of Defense (DoD) Military Health System, all beneficiaries have equal access to health care. The aim of this study was to determine whether female breast cancer treatment varied between white and black patients in the DoD system. The study data were drawn from the DoD cancer registry and medical claims databases. Study subjects included 2308 white and 391 black women diagnosed with breast cancer between 1998 and 2000. Multivariate logistic regression analyses that controlled for demographic factors, tumor characteristics, and comorbidities were used to assess racial differences in the receipt of surgery, chemotherapy, and hormonal therapy. There was no significant difference in surgery type, particularly when mastectomy was compared with breast-conserving surgery plus radiation (blacks vs whites: odds ratio [OR], 1.1; 95% confidence interval [CI], 0.8-1.5). Among those with local stage tumors, blacks were as likely as whites to receive chemotherapy (OR, 1.2; 95% CI, 0.9-1.7) and hormonal therapy (OR, 1.0; 95% CI, 0.6-1.4). Among those with regional stage tumors, blacks were significantly less likely than whites to receive chemotherapy (OR, 0.4; 95% CI, 0.2-0.7) and hormonal therapy (OR, 0.5; 95% CI, 0.3-0.8). Even within an equal access health care system, stage-related racial variations in breast cancer treatment are evident. Studies that identify driving factors behind these within-stage racial disparities are warranted.

Cell death induced by tamoxifen in human blood lymphocytes cultivated in vitro

Many chemotherapeutic agents with a potential against solid tumors or leukemia can cause lymphopenia. Tamoxifen (TAM) is a synthetic non-steroidal anti-estrogen drug employed in female breast cancer treatment. The present study investigated the capacity of TAM to induce cell death in human lymphocytes cultivated in vitro. Lymphocytes were obtained from young (25-30 years; n = 3) and elderly women (58-77 years; n = 3) and cultivated for 24 or 48h, with or without TAM (20 &micro;M). After the culture, cell viability, immunocytochemical response and ultrastructure were evaluated. TAM affected lymphocytes in a time- dependent manner, and cells obtained from elderly women were the most sensitive to TAM. Immunocytochemical analysis evidenced higher frequency of apoptosis in treated cells, and the ultrastructural study revealed autophagic vacuoles, differing from the controls. In summary, the treated lymphocytes were affected by TAM, leading to cell death by apoptosis and autophagy.

Male Breast Cancer

Diagnosis and treatment modalities for female breast cancer have developed spectacularly in recent years. Unfortunately, this is not the case for male breast cancer. Because the disease is so rare, controlled clinical trials have almost never been performed and treatment is based on findings in women or small series of men. Similarly, while breast cancer in women is diagnosed at an increasingly early stage, male breast cancer is usually diagnosed late, when the chances of cure are diminished. This article reviews what is currently known about male breast cancer, with an emphasis on areas where evidence-based data are scarce. While it is possible that some recent developments in female breast cancer treatment could be applicable to men, but the way forward is to increase awareness of the disease, and for treatment centers to pool patients for inclusion in randomized clinical trials.

Male breast cancer: follow-up recommendations after surgery.

Abstract Abstract #4130 Introduction: National Comprehensive Cancer Network (NCCN) guidelines for female breast cancer treatment and surveillance are well established, but data on male breast cancers are not collected. As an NCCN institution, our objective was to examine practice patterns and follow-up for male breast cancer.&amp;#x2028; Methods: After IRB approval, a prospective breast database from 1990-2008 was queried for male patients. Medical records were examined for traditional factors (TNM, receptor status, treatment, gynecomastia) and follow-up practices such as mammogram use. Survival analysis was performed using the Kaplan-Meier method with 95% confidence intervals (CI) generated for 5-yr estimates. The logrank test was used to compare node positive/negative cohorts.&amp;#x2028; Results: Of the 19,132 patients in the database, 71 (0.4%) were male; 64 had complete data. The median age for the 64 patients was 68.8yrs (range 29-85yrs). 89.1% presented with a palpable mass. 12.5% had gynecomastia in the cancer breast and 9.4% had contralateral gynecomastia. 18/64 (28.1%) had a familial history of breast, ovarian or colon cancer. One patient had bilateral synchronous breast cancer. Seven (10.9%) had previous prostate cancer and 4 (6.25%) had other synchronous cancers (2 papillary thyroid, 2 lung). Genetic testing was offered to all 64; 3 accepted. Two men had contralateral prophylactic mastectomy years later. The mean/median invasive tumor size was 2.0/1.6cm (range 0.0-10.0cm) and all but 2 tumors were ductal. 63 had a mastectomy (65.1% with axillary node dissection; 34.9% with sentinel lymph node biopsy). Lymph node involvement occurred in 25/64 (39.1%). Under NCCN guidelines, 49/64 (76.6%) should receive chemotherapy and chest wall radiation should be given to 27/64 (42.2%) based on tumor size and nodal status. Chemotherapy was offered to 50.0%; 35.9% received chemotherapy. Chest wall radiation was given in 59.3%. 63/64 were ER positive; 49 (77.8%) received hormone therapy. Follow-up annual mammograms were obtained in 27/64 (42.2%)[all BIRADs 1 or 2], not obtained in 28/64 (43.8%), and unknown in 9/64 (14.0%). Median follow-up was 26.1mos (range: 0.26-377.8mos). The 5-yr survival estimates and 95% CI for node positive and negative diseases were 75% (95% CI=46-90%) and 93% (95% CI=74-98%) respectively. For comparison, 5-yr survival rates from the NSABP B-04 trial were 60% in node-positive and 75% in node-negative disease. Four patients (6.3%) died of disease; 10 (15.6%) are alive with distant disease; 47 (73.4%) have no evidence of disease; and 3 (4.7%) are unknown or dead of other causes. There were 2 local recurrences (3.1%) [1 chest wall, 1 in-breast] and no metachronous contralateral breast cancer development. Conclusions: Male breast cancer is uncommon, as is contralateral breast cancer. Men were less likely to receive/accept chemotherapy/hormone therapy/genetic testing/annual mammograms and more likely to receive radiation based on NCCN guidelines, but survival compared to historic females was no worse. Creation of follow-up guidelines for males may be different than females. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4130.

Management of male breast cancer

The management of male breast cancer is still under discussion due to lack of information from prospective, randomized clinical trials and low incidence of this disease. Current management is based largely on extrapolation from data related to treatment of female breast cancer. Over the last two decades, several review articles have discussed mainly retrospective and anecdotal data related to hormonal and chemotherapy treatment modalities. In this review, we present the most recent information and future considerations related to the management of male breast cancer. In addition to the conventional treatment options we will discuss the possible role of targeted therapy. Establishing a national or global registry for male breast cancer will provide more precise information about the natural history of the disease and will facilitate the design and execution of prospective, randomized multicenter clinical trials.

Successful use of letrozole in male breast cancer: A case report and review of hormonal therapy for male breast cancer

Male breast cancer is an uncommon occurrence. Treatment of male breast cancer is typically extrapolated from data on the treatment of female breast cancer. Recently, aromatase inhibition has been proven as an effective therapy for female breast cancer, particularly in the setting of advanced cancers. The efficacy of aromatase inhibitors in males, however, has not been established. We report the successful treatment of a male with locally advanced breast cancer using the aromatase inhibitor letrozole.

An analysis of male and female breast cancer treatment and survival among demographically identical pairs of patients

Male breast cancer is rare, and there are no large comparative studies to guide treatment. We used National Cancer Data Base data on 4755 men and 624,174 women who had breast cancer (1985-1994) to identify equivalent groups of male and female breast cancer patients. For each man with breast cancer, the next woman treated at the same hospital was sought who matched the man's age (within 5 years), ethnicity, income category, and stage. We identified 3627 closely matched pairs of male and female patients with breast cancer. Men were more likely to be treated with mastectomy (modified radical, 65% of men versus 55.1% of women; radical, 2.5% of men versus 0.9% of women; simple, 7.6% of men versus 3.4% of women; P <.001), and more likely to receive radiation therapy after mastectomy (men, 29%; women, 11%; P <.001). Men treated with lumpectomy were less likely to receive radiation therapy (men, 54%; women, 68%; P <. 001). Men were also less likely to receive chemotherapy (26.7% of men versus 40.6% of women; P <. 001) after any surgical treatment. This large comparative study is the first to detail stage-specific differences in contemporary treatment strategies for highly comparable groups of men and women treated for breast cancer. Further studies of male breast cancer should focus on identifying prognostic factors and defining optimal therapy.