Abstract
Background
Although male breast cancer (MBC) is a rare disease, accounting for <1% of all breast
cancers, it has significant oncological, survival and psychosocial implications for
patients. The aim of this study is to assess the latest literature in the diagnosis,
management, oncological outcomes, and psychosocial impact of MBC.
Methods
A systematic literature review was conducted using the PRISMA guidelines (Moher et al.,
2009) [1] to explore the management of MBC, with particular focus on investigative
imaging, surgical management, oncological outcomes, survival, genetic screening and
psychosocial effects. Electronic databases were searched for randomised control trials,
cohort studies and case series involving more than 10 patients. Imaging and surgical
techniques, local and distant disease recurrence, survival, genetic screening and
psychosocial implications in the setting of MBC were assessed.
Results
The search criteria identified 199 articles, of which 59 met the inclusion criteria.
This included 39,529 patients, with a mean age of 64.5 years (55–71), and a mean follow-up
of 66.3 months (26.2–115). Mastectomy remains the most frequently used surgical technique,
with an average of 89.6%. Loco-regional and distant recurrence rate was 10.1% and
21.4% respectively. Disease-free survival (DFS) at 5 and 10 years was 66.8% and 54.5%
respectively. Disease-specific survival (DSS) at 5 and 10 years was 87.1% and 67.1%
respectively. Overall survival (OS) at 5 and 10 years was 72.7% and 50.7% respectively.
Genetic screening was conducted in 38.6% of patients of which 4.8% and 15.8% were
found to be BRCA1 and BRCA2 carriers respectively. Psychosocial studies were conducted
mainly using questionnaire and interview-based methodology focusing primarily on awareness
of breast cancer in men, support available and impact on gender identity.
Conclusions
This review demonstrates that men present with later stage disease with subsequent
impact on survival outcomes. There remains a paucity of high-level evidence and prospective
studies are required. There is a need for increasing awareness amongst the public
and health care professionals in order to improve outcomes and reduce stigma associated
with MBC.
Keywords
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Article info
Publication history
Published online: June 09, 2022
Accepted:
June 1,
2022
Received in revised form:
May 9,
2022
Received:
January 11,
2022
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
