The Grapevine

The Angelina Jolie Effect: Prophylactic Surgeries Nearly Double In Men With Breast Cancer

Breast Cancer In Men
Breast cancer in men is rare, but surgeries associated with it are rising. The Shared Experience (CC BY-NC-ND 2.0)

Breast cancer is often associated with women, and rightfully so — about one in eight women will develop invasive breast cancer in her lifetime, while the risk for men is only around one in 1,000. Though women still vastly outnumber men in terms of being diagnosed (men account for only about one percent of all cases in the United States) there have recently been some changes in trends concerning the disease. The number of men with breast cancer who undergo surgery to remove the unaffected breast has risen aggressively, according to a new study by American Cancer Society and Dana Farber Cancer Institute researchers.

Though breast cancer is relatively common in women, the use of contralateral prophylactic mastectomy (CPM) surgery to remove the unaffected breast has increased. The percentage of women undergoing the surgery with invasive breast cancer in one breast increased from 2.2 percent in 1998 to 11 percent in 2011. This increase occurred even though there is no solid evidence the procedure has a survival benefit, and experts acknowledge that there are costs and possible complications.

Researchers wished to explore whether the same increase occurred in men. A team led by Dr. Ahmedin Jemal, vice president of surveillance and health services research at the American Cancer Society, examined the treatments of 6332 men who underwent breast cancer surgery for cancer limited to one breast. They took nationwide data from the North American Association of Central Cancer Registries (NAACCR) for the study.

The researchers saw that the rates of CPM among men almost doubled between the years of 2004 and 2011. There was an increase from three percent to 5.6 percent — a relative increase of 86.7 percent. The procedure was more common in privately insured, white, younger patients. The same demographic factors were associated with more surgery in women as well.

The study did not, however, have the data to examine if the surgery in men is associated with genetic testing, family history, magnetic resonance imagining, or fear of contralateral breast cancer, all of which were linked to the surgery in women.

"The increase in the rate of this costly, serious procedure with no evidence of survival benefit comes, paradoxically, at a time of greater emphasis on quality and value in cancer care," Jemal said. "Health care providers should be aware that the increase we've seen in removal of the unaffected breast is not limited to women, and doctors should carefully discuss with their male patients the benefits, harms, and costs of this surgery to help patients make informed decisions about their treatments."

Source: Jemal A, Lin C, DeSantis C, Sineshaw H, Freedman R. Temporal Trends in and Factors Associated With Contralateral Prophylactic Mastectomy among US Men with Breast Cancer. JAMA Surgery. 2015.

Loading...