Skip to main content

Advertisement

SpringerLink
Log in

Breast Reconstruction in Male Breast Cancer Patients: An analysis of trends using the NSQIP database

  • Original Paper
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Rates of breast reconstruction in males with breast cancer have yet to be defined. Despite extensive literature on breast reconstruction in females, a paucity of studies exists for male patients. The aim of this study is to assess the incidence and trends in breast reconstruction in males with breast cancer using the National Surgical Quality Improvement Project (NSQIP) database.

Methods

The 2005 to 2016 NSQIP database was queried to identify males with breast cancer who underwent partial or total mastectomy. Males who underwent post-mastectomy reconstruction were compared to those who did not. Primary outcomes included postoperative complications and mortality.

Results

A total of 1,167 males underwent breast surgery, of which 73 (6.3%) underwent reconstruction within 30 days. The majority of patients receiving reconstruction were Caucasian (74.0%) followed by African-American (11.0%), and Asian (5.5%). Asian males had the highest rate of post-mastectomy reconstruction (n = 4, 13.8%). Males who underwent reconstruction had higher rates of postoperative wound dehiscence compared to those who did not undergo reconstruction (2.7% vs. 0%, p = 0.004). The most common reconstructive procedure was implant-based reconstruction (n = 37, 50.7%). African-American males tended to have less implant-based reconstruction than Caucasian (p = 0.057) and Asian males (p = 0.019). African- American males tended to have more free flap reconstruction than Caucasian males (p = 0.034).

Conclusions

Post-mastectomy reconstruction is rarely performed in males with breast cancer. Most males undergo implant-based reconstruction, although racial differences exist. Further studies are warranted to assess long-term reconstruction and psychosocial outcomes in males who undergo breast reconstruction.

Level of evidence: Level III, Diagnostic study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

The authors confirm that the data supporting the findings of this study are available within the 2005-2016 NSQIP databases.

References

  1. Burga AM, Fadare O, Lininger RA, Tavassoli FA (2006) Invasive carcinomas of the male breast: a morphologic study of the distribution of histologic subtypes and metastatic patterns in 778 cases. Virchows Arch 449(5):507–512. https://doi.org/10.1007/s00428-006-0305-3

    Article  PubMed  PubMed Central  Google Scholar 

  2. Banys-Paluchowski M, Burandt E, Banys J et al. (2016) Male papillary breast cancer treated by wide resection and latissimus dorsi flap reconstruction: A case report and review of the literature. World J Clin Oncol 7(5):420–424. https://doi.org/10.5306/wjco.v7.i5.420

    Article  PubMed  PubMed Central  Google Scholar 

  3. White J, Kearins O, Dodwell D, Horgan K, Hanby AM, Speirs V (2011) Male breast carcinoma: increased awareness needed. Breast Cancer Res 13(5):219. https://doi.org/10.1186/bcr2930

    Article  PubMed  PubMed Central  Google Scholar 

  4. Czajka ML, Pfeifer C (2023) Breast cancer surgery. In: Statpearls [Internet]. Treasure Island (FL): Statpearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553076/

  5. Cuccolo NG, Kang CO, Boskey ER, et al. (2019) Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes. Plast Reconstruct Surg – Global Open 7(6):e2316. https://doi.org/10.1097/gox.0000000000002316

  6. Deldar R, Sayyed AA, Towfighi P et al. (2022) Postmastectomy Reconstruction in Male Breast Cancer. Breast J 2022:5482261. https://doi.org/10.1155/2022/5482261

    Article  PubMed  PubMed Central  Google Scholar 

  7. Danino A, Ichinose M, Yoshimoto S, Kuroki T, Servant JM (1998) External-internal oblique reverse blood supply musculocutaneous flap for chest wall reconstruction. Ann Plast Surg 41(4):430–433. https://doi.org/10.1097/00000637-199810000-00015

    Article  CAS  PubMed  Google Scholar 

  8. Di Benedetto G, Pierangeli M, Bertani A (1998) Carcinoma of the male breast: an underestimated killer. Plast Reconstr Surg 102(3):696–700. https://doi.org/10.1097/00006534-199809030-00012

    Article  PubMed  Google Scholar 

  9. Igun GO (2000) Rectus abdominis myocutaneous flap in reconstruction for advanced male breast cancer: case report. Cent Afr J Med 46(5):130–132

    CAS  PubMed  Google Scholar 

  10. Elshafiey MM, Zeeneldin AA, Elsebai HI et al (2011) Epidemiology and management of breast carcinoma in Egyptian males: experience of a single Cancer Institute. J Egypt Natl Canc Inst 23(3):115–122. https://doi.org/10.1016/j.jnci.2011.10.001

    Article  PubMed  Google Scholar 

  11. Nakao A, Saito S, Naomoto Y, Matsuoka J, Tanaka N (2002) Deltopectoral flap for reconstruction of male breast after radical mastectomy for cancer in a patient on hemodialysis. Anticancer Res 22(4):2477–2479

    PubMed  Google Scholar 

  12. Spear SL, Bowen DG (1998) Breast reconstruction in a male with a transverse rectus abdominis flap. Plast Reconstr Surg 102(5):1615–1617. https://doi.org/10.1097/00006534-199810000-00043

    Article  CAS  PubMed  Google Scholar 

  13. Schaverien MV, Scott JR, Doughty JC (2013) Male mastectomy: an oncoplastic solution to improve aesthetic appearance. J Plast Reconstr Aesthet Surg 66(12):1777–1779. https://doi.org/10.1016/j.bjps.2013.04.039

    Article  CAS  PubMed  Google Scholar 

  14. Al-Kalla T, Komorowska-Timek E (2014) Breast total male breast reconstruction with fat grafting. Plast Reconstr Surg Glob Open 2(11):e257. https://doi.org/10.1097/gox.0000000000000221

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bamba R, Krishnan NM, Youn R, Economides JM, Pittman TA (2018) The Use of Low-Profile Silicone Breast Implants in Male Breast Reconstruction. Plast Reconstr Surg 141(2):324e–325e. https://doi.org/10.1097/prs.0000000000004089

    Article  CAS  PubMed  Google Scholar 

  16. Kinne DW (1991) Management of male breast cancer. Oncology (Williston Park). 5(3):45–7 (discussion 47-8)

    CAS  PubMed  Google Scholar 

  17. Giordano SH, Buzdar AU, Hortobagyi GN (2002) Breast cancer in men. Ann Intern Med 137(8):678–687. https://doi.org/10.7326/0003-4819-137-8-200210150-00013

    Article  PubMed  Google Scholar 

  18. Robinson JD, Metoyer KP Jr, Bhayani N (2008) Breast cancer in men: a need for psychological intervention. J Clin Psychol Med Settings 15(2):134–139. https://doi.org/10.1007/s10880-008-9106-y

    Article  PubMed  Google Scholar 

  19. Qin Q, Tan Q, Lian B, Mo Q, Huang Z, Wei C (2018) Postoperative outcomes of breast reconstruction after mastectomy: A retrospective study. Medicine (Baltimore). 97(5):e9766. https://doi.org/10.1097/md.0000000000009766

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rubino C, Figus A, Lorettu L, Sechi G (2007) Post-mastectomy reconstruction: a comparative analysis on psychosocial and psychopathological outcomes. J Plast Reconstr Aesthet Surg 60(5):509–518. https://doi.org/10.1016/j.bjps.2006.06.013

    Article  PubMed  Google Scholar 

  21. Heneghan HM, Prichard RS, Lyons R et al (2011) Quality of life after immediate breast reconstruction and skin-sparing mastectomy - a comparison with patients undergoing breast conserving surgery. Eur J Surg Oncol 37(11):937–943. https://doi.org/10.1016/j.ejso.2011.08.126

    Article  CAS  PubMed  Google Scholar 

  22. Giunta G, Rossi M, Toia F, Rinaldi G, Cordova A (2017) Male breast cancer: Modified radical mastectomy or breast conservation surgery? A case report and review of the literature. Int J Surg Case Rep 30:89–92. https://doi.org/10.1016/j.ijscr.2016.11.030

    Article  PubMed  Google Scholar 

  23. Friedman S, Floyd C, Chrysopoulo M. Men can have breast reconstruction after mastectomy. Facing Our Risk of Cancer Empowered, Inc. Accessed February 17, 2022. https://www.facingourrisk.org/blog/men-can-have-breast-reconstruction-after-mastectomy

  24. Eck DL, Koonce SL, Goldberg RF et al (2012) Breast surgery outcomes as quality measures according to the NSQIP database. Ann Surg Oncol 19(10):3212–3217. https://doi.org/10.1245/s10434-012-2529-6

    Article  PubMed  Google Scholar 

  25. American Medical Association (2007) Surgery: Integumentary system. CPT Assistant Newsletter 17(12):7

    Google Scholar 

  26. American Medical Association (2015) Coding brief: Coding for breast surgery. CPT Assistant Newsletter 25(3):5–11

    Google Scholar 

  27. Platt J, Baxter N, Zhong T (2011) Breast reconstruction after mastectomy for breast cancer. CMAJ 183(18):2109–2116. https://doi.org/10.1503/cmaj.110513

    Article  PubMed  PubMed Central  Google Scholar 

  28. Co M, Lee A, Kwong A (2020) Delayed presentation, diagnosis, and psychosocial aspects of male breast cancer. Cancer Med 9(10):3305–3309. https://doi.org/10.1002/cam4.2953

    Article  PubMed  PubMed Central  Google Scholar 

  29. Brain K, Williams B, Iredale R, France L, Gray J (2006) Psychological distress in men with breast cancer. J Clin Oncol 24(1):95–101. https://doi.org/10.1200/jco.2006.10.064

    Article  PubMed  Google Scholar 

  30. Wolters U, Wolf T, Stützer H, Schröder T (1996) ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth 77(2):217–222. https://doi.org/10.1093/bja/77.2.217

    Article  CAS  PubMed  Google Scholar 

  31. Hackett NJ, De Oliveira GS, Jain UK, Kim JY (2015) ASA class is a reliable independent predictor of medical complications and mortality following surgery. Int J Surg 18:184–190. https://doi.org/10.1016/j.ijsu.2015.04.079

    Article  PubMed  Google Scholar 

  32. Angarita FA, Acuna SA, Cordeiro E et al (2018) Thirty-day postoperative morbidity and mortality in elderly women with breast cancer: an analysis of the NSQIP database. Breast Cancer Res Treat 170:373+

    Article  PubMed  Google Scholar 

  33. de Blacam C, Ogunleye AA, Momoh AO et al (2012) High body mass index and smoking predict morbidity in breast cancer surgery: a multivariate analysis of 26,988 patients from the national surgical quality improvement program database. Ann Surg 255(3):551–555. https://doi.org/10.1097/SLA.0b013e318246c294

    Article  PubMed  Google Scholar 

  34. El-Tamer MB, Ward BM, Schifftner T, Neumayer L, Khuri S, Henderson W (2007) Morbidity and mortality following breast cancer surgery in women: national benchmarks for standards of care. Ann Surg 245(5):665–671. https://doi.org/10.1097/01.sla.0000245833.48399.9a

    Article  PubMed  PubMed Central  Google Scholar 

  35. Epstein S, Tran BN, Cohen JB, Lin SJ, Singhal D, Lee BT (2018) Racial disparities in postmastectomy breast reconstruction: National trends in utilization from 2005 to 2014. Cancer 124(13):2774–2784. https://doi.org/10.1002/cncr.31395

    Article  PubMed  Google Scholar 

  36. Panchal H, Matros E (2017) Current Trends in Postmastectomy Breast Reconstruction. Plast Reconstr Surg. 140(5S Advances in Breast Reconstruction):7s–13s. https://doi.org/10.1097/prs.0000000000003941

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Alluri RK, Leland H, Heckmann N (2016) Surgical research using national databases. Ann Transl Med 4(20):393. https://doi.org/10.21037/atm.2016.10.49

    Article  PubMed  PubMed Central  Google Scholar 

  38. Yoon AP, Qi J, Brown DL et al (2018) Outcomes of immediate versus delayed breast reconstruction: Results of a multicenter prospective study. Breast 37:72–79. https://doi.org/10.1016/j.breast.2017.10.009

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Georgetown University School of Medicine, Washington, DC, USA

    Parhom Towfighi, Zoë K. Haffner, Adaah A. Sayyed, Areeg A. Abu El Hawa & Nathan Aminpour

  2. Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA

    Parhom Towfighi, Adaah A. Sayyed, Romina Deldar, Kenneth L. Fan & David H. Song

  3. Department of General Surgery, MedStar Georgetown University Hospital, Washington, DC, USA

    Olutayo Sogunro

Authors
  1. Parhom Towfighi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zoë K. Haffner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adaah A. Sayyed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Romina Deldar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Olutayo Sogunro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Areeg A. Abu El Hawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nathan Aminpour
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kenneth L. Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. David H. Song
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Parhom Towfighi.

Ethics declarations

Ethical approval

This study utilized a national database using human subject data, for which our institution received IRB, ethical approval, and informed consent prior to conducting this study.

Conflict of interest and financial disclosure statement

There are no financial disclosures, commercial associations, or any other conditions posing a conflict of interest to report for any of the above authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Towfighi, P., Haffner, Z.K., Sayyed, A.A. et al. Breast Reconstruction in Male Breast Cancer Patients: An analysis of trends using the NSQIP database. Eur J Plast Surg 46, 1113–1119 (2023). https://doi.org/10.1007/s00238-023-02091-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-023-02091-z

Keywords

Search

Navigation