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Prophylactic surgery doubles for men with breast cancer

The rates have risen for men the same as women, although researchers are unsure how effective the surgery is for them.

By Stephen Feller

ATLANTA, Sept. 2 (UPI) -- The number of men who choose to undergo contralateral prophylactic mastectomy, or CPM, as part of treatment for breast cancer has increased at a rate similar to that of women with breast cancer, despite lack of proof it increases their chances for surviving the disease.

While some socioeconomic factors are the same for men and women who choose CPM -- they are often younger, white and have private health insurance -- many of the other reasons which statistically support women's decision could not be determined in men.

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"The increase in the rate of this costly, serious procedure with no evidence of survival benefit [for men] comes, paradoxically, at a time of greater emphasis on quality and value in cancer care," said Dr. Ahmedin Jemal, vice president of surveillance and health services research at the American Cancer Society, in a press release.

Using data from the North American Association of Central Cancer Registries, researchers at the American Cancer Society and the Dana Farber Cancer Institute data on 6,332 men who had surgery between 2004 and 2011 for cancer in one breast. They found that the rate of CPM among these male patients increased from 3 percent in 2004 to 5.6 percent in 2011, an increase of 86 percent.

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While the increase among women was larger, patients choosing CPM increased from 2.2 percent in 1998 to 11 percent in 2011, there were more reasons for them to consider it an option. The surgery is often connected to genetic testing, family history, MRIs or a general fear of developing contralateral breast cancer. Researchers reported that data was not available on these areas for men, so they were not able to explore these links.

Breast cancer in men is rare, representing about 1 percent of diagnoses in the United States.

"Health care providers should be aware that the increase we've seen in removal of the unaffected breast is not limited to women," Jemal said, "and doctors should carefully discuss with their male patients the benefits, harms, and costs of this surgery to help patients make informed decisions about their treatments."

The study is published in JAMA Surgery.

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