Skip to main content

Advertisement

SpringerLink
Log in

A comparative analysis of males and females with breast cancer undergoing mastectomy using the American College of Surgeon’s National Surgical Quality Improvement Project (NSQIP)

  • Review
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Introduction

There is a paucity of literature comparing the postoperative outcomes of males and females with breast cancer who undergo mastectomy. The aim of this study is to evaluate the comorbidities and 30-day post-mastectomy complication rates among males and females.

Methods

We performed a retrospective analysis of breast cancer patients who underwent mastectomy from 2014 to 2016 using the American College of Surgeon's National Surgical Quality Improvement Project database. Data including patient demographics, comorbidities, and 30-day surgical and medical complications were collected. Statistical analysis included Chi-square and Fisher’s exact tests for categorical variables and Student T-tests for continuous variables. Statistical significance was defined as p < 0.05.

Results

A total of 15,167 patients were identified. There were 497 males (3.3%) and 14,670 females (96.7%). Age was significantly higher in females compared to males (63.5 vs. 57.6 years, p < 0.001). Body mass index (BMI) at time of surgery was also higher in males (30.0 vs. 29.3 kg/m2, p = 0.011). There was a higher prevalence of diabetes in males (20.1 vs. 16.5%, p = 0.032). Operative duration was significantly longer in females (114.9 vs. 95.0 min, p < 0.001). Median postoperative length of stay was also longer in females (1.2 vs. 0.8 days, p < 0.001). There were no significant differences in 30-day medical or surgical complication rates between the two sexes.

Conclusion

Our findings suggest that differences in age, BMI, and comorbidities between males and females do not significantly impact 30-day medical or surgical complications following total mastectomy for breast cancer. Further research is warranted to identify perioperative risk factors that influence post-mastectomy complication rates.

Level of evidence

3 (Retrospective cohort 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

Fig. 1

Similar content being viewed by others

References

  1. Sung H, Ferlay J, Siegel RL et al (2021) Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660

    Article  PubMed  Google Scholar 

  2. 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 

  3. 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 

  4. 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 

  5. Breast Cancer in Men. American Cancer Society. https://www.cancer.org/cancer/breast-cancer-in-men.html. Accessed 17 Feb 2022

  6. Bleyer A, Welch HG (2012) Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med 367(21):1998–2005. https://doi.org/10.1056/NEJMoa1206809

    Article  CAS  PubMed  Google Scholar 

  7. Fentiman IS, Fourquet A, Hortobagyi GN (2006) Male breast cancer. Lancet 367(9510):595–604. https://doi.org/10.1016/s0140-6736(06)68226-3

    Article  PubMed  Google Scholar 

  8. 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 

  9. Uslukaya Ö, Gümüş M, Gümüş H, Bozdağ Z, Türkoğlu A (2016) The management and outcomes of male breast cancer. J Breast Health 12(4):165–170. https://doi.org/10.5152/tjbh.2016.3073

    Article  PubMed  PubMed Central  Google Scholar 

  10. Thomas E (2010) Original research: Men's awareness and knowledge of male breast cancer. Am J Nurs 110(10):32–7, 39–40; quiz 41–2. https://doi.org/10.1097/01.NAJ.0000389672.93605.2f

  11. Tai YC, Domchek S, Parmigiani G, Chen S (2007) Breast cancer risk among male BRCA1 and BRCA2 mutation carriers. J Natl Cancer Inst 99(23):1811–1814. https://doi.org/10.1093/jnci/djm203

    Article  CAS  PubMed  Google Scholar 

  12. Nevanlinna H, Bartek J (2006) The CHEK2 gene and inherited breast cancer susceptibility. Oncogene 25(43):5912–5919. https://doi.org/10.1038/sj.onc.1209877

    Article  CAS  PubMed  Google Scholar 

  13. Brinton LA (2011) Breast cancer risk among patients with Klinefelter syndrome. Acta Paediatr 100(6):814–818. https://doi.org/10.1111/j.1651-2227.2010.02131.x

    Article  PubMed  PubMed Central  Google Scholar 

  14. Dimitrakakis C, Bondy C (2009) Androgens and the breast. Breast Cancer Res 11(5):212. https://doi.org/10.1186/bcr2413

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Thomas DB, Jimenez LM, McTiernan A et al (1992) Breast cancer in men: risk factors with hormonal implications. Am J Epidemiol 135(7):734–748. https://doi.org/10.1093/oxfordjournals.aje.a116360

    Article  CAS  PubMed  Google Scholar 

  16. Fogh S, Kachnic LA, Goldberg SI, Taghian AG, Powell SN, Hirsch AE (2013) Localized therapy for male breast cancer: functional advantages with comparable outcomes using breast conservation. Clin Breast Cancer 13(5):344–349. https://doi.org/10.1016/j.clbc.2013.05.004

    Article  PubMed  Google Scholar 

  17. Korde LA, Zujewski JA, Kamin L et al (2010) Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol 28(12):2114–2122. https://doi.org/10.1200/jco.2009.25.5729

    Article  PubMed  PubMed Central  Google Scholar 

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

    CAS  Google Scholar 

  19. 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 

  20. American Medical Association (2007) Surgery: integumentary system. CPT Assist Newslett 17(12):7

    Google Scholar 

  21. American Medical Association (2015) Coding brief: coding for breast surgery. CPT Assist Newslett 25(3):5–11

    Google Scholar 

  22. Coding brief: Coding for breast surery. American Medical Association. https://www.ama-assn.org/practice-management/cpt/cpt-coding-support-latest-guidance-and-best-practices

  23. Karlsson CT, Malmer B, Wiklund F, Grönberg H (2006) Breast cancer as a second primary in patients with prostate cancer–estrogen treatment or association with family history of cancer? J Urol 176(2):538–543. https://doi.org/10.1016/j.juro.2006.03.036

    Article  PubMed  Google Scholar 

  24. Swerdlow AJ, Schoemaker MJ, Higgins CD, Wright AF, Jacobs PA (2005) Cancer incidence and mortality in men with Klinefelter syndrome: a cohort study. J Natl Cancer Inst 97(16):1204–1210. https://doi.org/10.1093/jnci/dji240

    Article  PubMed  Google Scholar 

  25. Swerdlow AJ, Bruce C, Cooke R et al (2021) Obesity and BREAST CANCER RISK IN MEN: A National Case-Control Study in England and Wales. JNCI Cancer Spectr. https://doi.org/10.1093/jncics/pkab078

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rifkin WJ, Kantar RS, Cammarata MJ et al (2019) Impact of diabetes on 30-day complications in mastectomy and implant-based breast reconstruction. J Surg Res 235:148–159. https://doi.org/10.1016/j.jss.2018.09.063

    Article  PubMed  Google Scholar 

  27. Kapoor R, Kumar J, Abhishek, Singh SK (2012) Complications during surgery in chronic kidney disease patients. Clin Queries Nephrol 1(3):241–245. https://doi.org/10.1016/j.cqn.2012.06.008

    Article  Google Scholar 

  28. Butterworth J, James R, Prielipp R, Cerese J, Livingston J, Burnett D (2000) Female gender associates with increased duration of intubation and length of stay after coronary artery surgery. CABG Clinical Benchmarking Database Participants. Anesthesiology 92(2):414–424. https://doi.org/10.1097/00000542-200002000-00023

    Article  CAS  PubMed  Google Scholar 

  29. Olsen MA, Nickel KB, Fox IK et al (2015) Incidence of surgical site infection following mastectomy with and without immediate reconstruction using private insurer claims data. Infect Control Hosp Epidemiol 36(8):907–914. https://doi.org/10.1017/ice.2015.108

    Article  PubMed  PubMed Central  Google Scholar 

  30. Murphy BL, Glasgow AE, Habermann EB, Hieken TJ (2019) Returns to the operating room after breast surgery at a tertiary care medical center. Am J Surg 218(2):388–392. https://doi.org/10.1016/j.amjsurg.2019.02.026

    Article  PubMed  Google Scholar 

  31. Osman F, Saleh F, Jackson TD, Corrigan MA, Cil T (2013) Increased postoperative complications in bilateral mastectomy patients compared to unilateral mastectomy: an analysis of the NSQIP database. Ann Surg Oncol 20(10):3212–3217. https://doi.org/10.1245/s10434-013-3116-1

    Article  PubMed  Google Scholar 

Download references

Funding

The authors have no financial disclosures, commercial associations, or any other conditions posing a conflict of interest to report.

Author information

Authors and Affiliations

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

    Parhom Towfighi, Zoe K. Haffner, Nathan Aminpour & Areeg A. Abu El Hawa

  2. Department of Plastics and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC, 20007, USA

    Romina Deldar, Zoe K. Haffner & Kenneth L. Fan

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

    Olutayo Sogunro

  4. Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA

    Marc Boisvert

Authors
  1. Parhom Towfighi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Romina Deldar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zoe K. Haffner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nathan Aminpour
    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. Marc Boisvert
    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

Corresponding author

Correspondence to Kenneth L. Fan.

Ethics declarations

Conflict of interest

The authors declare they have no conflict of interest.

Additional information

Publisher's Note

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

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Towfighi, P., Deldar, R., Haffner, Z.K. et al. A comparative analysis of males and females with breast cancer undergoing mastectomy using the American College of Surgeon’s National Surgical Quality Improvement Project (NSQIP). Breast Cancer Res Treat 194, 201–206 (2022). https://doi.org/10.1007/s10549-022-06628-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-022-06628-x

Keywords

Search

Navigation