Preventive Breast Cancer Surgery on the Rise in Men

Research from the American Cancer Society and Dana Farber Cancer Institute has found a sharp rise in the number of men with breast cancer who are having their cancer-free breast removed as well. This mirrors a trend seen among women in the US for the past 20 years. The trends have occurred despite a lack of evidence that the extra surgery helps either men or women live longer.

The study, published online September 2, 2015 in JAMA Surgery, looked at the treatment of more than 6,000 men with breast cancer. The data came from the North American Association of Central Cancer Registries (NAACCR). These men had been diagnosed with cancer in one breast and undergone surgery between 2004 and 2011. During this time, the percentage of men who also had their other breast removed (known as a bilateral mastectomy) rose from 3% to 5.6%. Although the researchers could not pinpoint the cause of the increase, the procedure was more common in men who were younger, white, and had private medical insurance.

These factors are also linked to more surgery in women. The percentage of women with invasive breast cancer in one breast having the other breast also removed increased from about 2.2% in 1998 to 11% in 2011.

“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,” said lead researcher Ahmedin Jemal, DVM, PhD, vice president of surveillance and health services research at the American Cancer Society. “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.”

Breast cancer is not common in men. About 2,350 new cases of invasive breast cancer are predicted to be diagnosed among men in the US in 2015. Because of this, routine screening mammograms are not recommended for men. Men should report any changes in their chest wall to their doctors. Signs to report include a lump or swelling, skin dimpling or puckering, the nipple turning inward, redness or scaling of the nipple or breast skin, or discharge from the nipple.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Temporal Trends in and Factors Associated With Contralateral Prophylactic Mastectomy among US Men with Breast Cancer. Published online Sept 2, 2015 in JAMA Surgery. First author Ahmedin Jemal, DVM, PhD, American Cancer Society, Atlanta Ga.

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