Breast conserving surgery and mastectomy for the surgical management of early stages breast cancer in men: systematic review
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Abstract
Objective: breast cancer in men is an underestimated diagnosis, and the treatment of choice is mastectomy. Different surgical techniques have been described, including breast-conserving surgery compared to simple mastectomy. However, the real effectiveness of these techniques is still unknown, considering the least number of complications. The present study aims to evaluate the effectiveness of these 2 techniques through a systematic review of the literature.
Methods: a systematic literature review was performed up to November 2022, following Cochrane’s Prisma methodology. We evaluated the best evidence available on the effectiveness of breast-conserving surgery when it is compared with traditional mastectomy. Secondary evaluated outcomes were overall survival and disease-free survival.
Results: out of 1054 initial studies, 7 met the criteria for selection and analysis. Both techniques showed adequate effectiveness, there was no statistical significance in breast cancer-specific survival, at 5 and 10 years, and overall survival between these 2 techniques. However, worse cosmetic and functional outcomes were evidenced in mastectomy.
Conclusions: breast conservative surgery is an option that should be considered in men with breast cancer, since in terms of disease-free survival and overall survival there is no statistical difference compared to mastectomy and it may have better cosmetic outcomes. The role of adjuvant radiotherapy is the subject of additional new studies.
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