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Nationwide Analysis of Locoregional Management for Ductal Carcinoma In Situ in Males: An NCDB Analysis of the Surgical Approach to DCIS in Males

  • Breast Oncology
  • Published:
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Abstract

Background

Limited data exist regarding the optimal locoregional approach for males with ductal carcinoma in situ (DCIS). This study examined trends in management and survival for males with DCIS.

Methods

The National Cancer Database (NCDB) was queried for males with a diagnosis of DCIS from 2006 to 2017. Patients were categorized by locoregional management. Continuous variables were evaluated by Kruskal-Wallis and categorical variables by chi-square or Fisher’s exact test. Univariable and multivariable logistic regressions were performed to evaluate for predictors of patients receiving partial mastectomy (PM) with radiation. Survival was analyzed by Kaplan–Meier.

Results

Between 2006 and 2017, 711 males with DCIS were identified. Most received mastectomy alone (57.1%). No change was observed in management approach from 2006 to 2017. Patients who underwent mastectomy alone were mostly hormone-positive (95.9% were estrogen-positive, 90.9% were progesterone-positive), although this cohort was least likely to receive hormone therapy (17.2%). Among those who underwent PM with radiation, only 61% of those who were hormone-positive received hormone therapy. Univariable analysis demonstrated that those of black race had lower odds of receiving PM with radiation (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.36–0.84), which persisted in the multivariable analysis with control for age and tumor size (OR, 0.32; 95% CI, 0.15–0.67). Overall survival did not differ significantly between the four treatment methods (p = 0.08).

Conclusions

The management approach to male DCIS did not change from 2006 to 2017. Survival did not differ between treatment methods. Demographic and clinicopathologic features, including race, may influence locoregional treatments received, and further studies are needed to further understand this.

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Authors and Affiliations

  1. Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Michela M. Carter MD, Jenna N. Whitrock MD, Catherine G. Pratt MD, Elizabeth A. Shaughnessy MD, PhD, Alicia A. Heelan MD, MS & Jaime D. Lewis MD

  2. Division of Surgical Oncology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Elizabeth A. Shaughnessy MD, PhD, Alicia A. Heelan MD, MS & Jaime D. Lewis MD

  3. Department of Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Teresa M. Meier MD & Michelle F. Barrord MD

  4. Department of Radiation Oncology, Kettering Health Cancer Center, Kettering, OH, USA

    Michelle F. Barrord MD

  5. Division of Research and Biostatistics, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Dennis J. Hanseman PhD

  6. Division of Surgical Oncology, Department of Surgery, Loyola University Chicago’s Stritch School of Medicine, Maywood, IL, USA

    Chantal R. Reyna MD

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  1. Michela M. Carter MD
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Correspondence to Michela M. Carter MD.

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Disclosure

Chantal Reyna has been a consultant for Agenda and Elucent Medical in the past 24 months. Agreements terminated in December 2022. Alicia Heelan is a consultant for Elucent Medical.

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Carter, M.M., Whitrock, J.N., Pratt, C.G. et al. Nationwide Analysis of Locoregional Management for Ductal Carcinoma In Situ in Males: An NCDB Analysis of the Surgical Approach to DCIS in Males. Ann Surg Oncol 31, 1599–1607 (2024). https://doi.org/10.1245/s10434-023-14579-w

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