A study shows that men with breast cancer are not at increased risk for relapse after mastectomy compared to women with breast cancerr and therefore should be treated using the same guidelines as women.

Yes, men do develop breast cancer, but it is fairly rare. In most countries, about 1 of every 100 cases of breast cancer occur in men.

In women with breast cancer, post-mastectomy radiation is guided by specific indications such as tumor size. But in men with breast cancer, radiation is routinely given after mastectomy because the smaller male breast makes it harder for surgeons to leave a clear margin of healthy tissue when they remove the cancer, so men are thought to be at increased risk for cancer recurrence in the breast area.

The outcome of the current study “challenges the idea that males with breast cancer should be treated with more aggressive local therapy purely on the basis of sex,” said Dr. Graham Macdonald.

Macdonald, from the Aberdeen Royal Infirmary, UK, and Canadian colleagues, examined data on 4181 women and 60 men with invasive breast cancer who had undergone total mastectomy as primary therapy.

Men were almost 6 times more likely than women to have radiotherapy after mastectomy, even when other “confounding” factors were accounted for, the authors report in the Annals of Oncology, a medical journal.

Of note, gender was not a prognostic factor for recurrence, breast-cancer specific survival or overall survival. Local recurrence was significantly associated with tumor size and grade, involvement of the lymph nodes and the presence of vascular space invasion.

These findings, Macdonald concluded, should “reassure physicians involved in breast cancer care that the indications for post-mastectomyy radiotherapy should be the same for males and females.”

SOURCE: Annals of Oncology June 22, 2005.