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Background <p>Male breast cancer (MBC) is a rare malignancy with limited evidence-based treatment guidelines, particularly for early-stage disease in younger male patients. Therefore, further research is essential to define optimal therapeutic strategies and improve clinical outcomes.</p> Methods <p>Using SEER data (2000–2020), we conducted a retrospective cohort study of 4551 MBC patients who underwent breast-conserving surgery (BCS) or total mastectomy (TM), stratified by adjuvant radiotherapy (RT). Groups included BCS with RT (n = 285), BCS without RT (n = 291), TM with RT (n = 1048), and TM without RT (n = 2927). Multivariate Cox regression, Kaplan–Meier analysis, subgroup analysis, and propensity score matching (PSM) were used to assess breast cancer-specific survival (BCSS) and overall survival (OS).</p> Results <p>The maximum follow-up was 251&#xa0;months, with a median of 71.4&#xa0;months. The BCS rate was 12.7% (576/4551). Mean patient age was 65.1 ± 12.6&#xa0;years. In Cox multivariate analysis, with BCS with RT as the reference group, patients receiving BCS without RT, TM with RT, and TM without RT showed significantly higher mortality risks (all P &lt; .05). When TM without RT was used as the reference, BCS with RT remained associated with significantly better BCSS (HR: 0.19; 95% CI 0.08–0.48, P &lt; .001) and OS (HR: 0.48; 95% CI 0.32–0.71, P &lt; .001). Subgroup analyses (Figs.&#xa0;<InternalRef RefID="Fig3">3</InternalRef> &amp; <InternalRef RefID="Fig4">4</InternalRef>) consistently demonstrated survival advantages for BCS with RT, particularly in stage I–II and younger patients (&lt; 65&#xa0;years). Additionally, TM with RT improved survival compared to TM without RT in stages II–III (e.g., stage II OS, HR: 1.27, 95% CI 1.05–1.54). After propensity score matching, multimodal analysis shows that stage I-II MBC patients receiving BCS with RT had longer OS than those undergoing TM with or without RT (all P &lt; .05).</p> Conclusions <p>In patients younger than 65&#xa0;years or with stage I-II MBC, adjuvant RT following BCS is associated with a survival advantage. For stage II-III patients who underwent TM, adjuvant RT is linked to improved survival outcomes.</p>

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Radiotherapy and surgery for male breast cancer a population analysis of survival by age and stage

  • 期刊论文

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  • 发表日期：

    2026年4月6日

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  • ZeMing Wang,
  • YuFeng Zhang,
  • Jia Si,
  • YuRong Chen

摘要

Background

Male breast cancer (MBC) is a rare malignancy with limited evidence-based treatment guidelines, particularly for early-stage disease in younger male patients. Therefore, further research is essential to define optimal therapeutic strategies and improve clinical outcomes.

Methods

Using SEER data (2000–2020), we conducted a retrospective cohort study of 4551 MBC patients who underwent breast-conserving surgery (BCS) or total mastectomy (TM), stratified by adjuvant radiotherapy (RT). Groups included BCS with RT (n = 285), BCS without RT (n = 291), TM with RT (n = 1048), and TM without RT (n = 2927). Multivariate Cox regression, Kaplan–Meier analysis, subgroup analysis, and propensity score matching (PSM) were used to assess breast cancer-specific survival (BCSS) and overall survival (OS).

Results

The maximum follow-up was 251 months, with a median of 71.4 months. The BCS rate was 12.7% (576/4551). Mean patient age was 65.1 ± 12.6 years. In Cox multivariate analysis, with BCS with RT as the reference group, patients receiving BCS without RT, TM with RT, and TM without RT showed significantly higher mortality risks (all P < .05). When TM without RT was used as the reference, BCS with RT remained associated with significantly better BCSS (HR: 0.19; 95% CI 0.08–0.48, P < .001) and OS (HR: 0.48; 95% CI 0.32–0.71, P < .001). Subgroup analyses (Figs. 3 & 4) consistently demonstrated survival advantages for BCS with RT, particularly in stage I–II and younger patients (< 65 years). Additionally, TM with RT improved survival compared to TM without RT in stages II–III (e.g., stage II OS, HR: 1.27, 95% CI 1.05–1.54). After propensity score matching, multimodal analysis shows that stage I-II MBC patients receiving BCS with RT had longer OS than those undergoing TM with or without RT (all P < .05).

Conclusions

In patients younger than 65 years or with stage I-II MBC, adjuvant RT following BCS is associated with a survival advantage. For stage II-III patients who underwent TM, adjuvant RT is linked to improved survival outcomes.