Comparison of short-term surgical outcomes between men and women with breast cancer: a retrospective study using nationwide inpatient data in Japan

Breast Cancer Research and Treatment (2021)Cite this article

Abstract

Purpose

Although long-term survival is similar between men and women, little is known about the short-term outcomes following breast cancer surgery in men. This study was performed to compare postoperative outcomes adjusted for background factors between men and women with breast cancer using a Japanese nationwide inpatient database.

Methods

This study included 2126 men and 363,468 women who underwent surgery for stage 0–III breast cancer from July 2010 to March 2017. We generated a 1:4 matched-pair cohort matched for age, institution, and fiscal year at admission. We then conducted multivariable regression analyses to compare postoperative complications, 30-day readmission, duration of anesthesia, length of hospitalization, and total hospitalization costs between the sexes.

Results

Men were older, more likely to have comorbidities and advanced cancer, and more likely to undergo total mastectomy and axillary dissection than women. There were no significant differences in postoperative complications between the sexes, but men showed a lower risk of 30-day readmission (odds ratio 0.74; 95% confidence interval [CI] 0.57–0.95), shorter duration of anesthesia (difference − 22.0 min; 95% CI − 2.1 to − 0.5), shorter length of hospitalization (difference − 1.3 days; 95% CI − 2.1 to − 0.5), and lower total hospitalization costs (difference − 506 US dollars; 95% CI − 668 to − 334) than women.

Conclusions

The matched-pair cohort analyses revealed no significant differences in postoperative complications between men and women with breast cancer. However, men showed better outcomes than women in terms of 30-day readmission, duration of anesthesia, length of hospitalization, and total hospitalization costs.

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (19AA2007 and 20AA2005) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907).

Author information

Affiliations

  1. Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Takaaki Konishi, Masahiko Tanabe & Yasuyuki Seto

  2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Takaaki Konishi, Michimasa Fujiogi, Kojiro Morita, Hiroki Matsui & Hideo Yasunaga

  3. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA

    Michimasa Fujiogi

  4. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Nobuaki Michihata

  5. Department of Health Services, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan

    Kojiro Morita

  6. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Kiyohide Fushimi

  7. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Yasuyuki Seto

Authors
  1. Takaaki Konishi
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  2. Michimasa Fujiogi
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  3. Nobuaki Michihata
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  4. Kojiro Morita
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  6. Kiyohide Fushimi
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  8. Yasuyuki Seto
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  9. Hideo Yasunaga
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Corresponding author

Correspondence to Takaaki Konishi.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Study approval was obtained from the Institutional Review Board at The University of Tokyo.

Informed consent

The need for informed consent in the current study was waived because of the anonymous nature of the patient database.

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Cite this article

Konishi, T., Fujiogi, M., Michihata, N. et al. Comparison of short-term surgical outcomes between men and women with breast cancer: a retrospective study using nationwide inpatient data in Japan. Breast Cancer Res Treat (2021). https://doi.org/10.1007/s10549-020-06069-4

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Keywords

  • Male breast cancer
  • Mastectomy
  • Postoperative outcomes
  • Sex differences