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

Background. 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 equival ent groups of male and female breast cancer patients. Methods. For each man with breast canes 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 by matched pairs of male and female patients with breast cancer. Results. Men were more likely to be treated with mastectomy (modified radic al, 65% of men versus 55.1% of women; radical, 2.5% of men versus 0.9% of w omen; simple 7.6% of men versus 3.4% of women; P < .001), and more likely t o receive radiation therapy after mastectomy (men, 29%; women, 11%; P < .00 1). Men treated with lumpectomy were less likely to receive radiation thera py (men, 54%; women, 68%; P < .001). Men were also less likely to receive c hemotherapy (26.7% of men versus 40.6% of women; P < .001) after any surgic al treatment. Conclusions. This large comparative study is the first to detail stage-spec ific differences In contemporary treatment strategies or highly comparable groups of men and women treated for breast cancer Further studies of male b reast cancer should focus on identifying prognostic factors and defining op timal therapy.