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Impact of adding preoperative magnetic resonance imaging to ultrasound on male breast cancer survival: a matched analysis with female breast cancer
Jeongmin Lee1 , Ka Eun Kim1,2 , Myoung Kyoung Kim1 , Haejung Kim1 , Eun Sook Ko1 , Eun Young Ko1 , Boo-Kyung Han1 , Ji Soo Choi1,3
1Department of Radiology, Samsung Medical Center , Seoul, Korea
2Department of Radiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Korea
3Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
Corresponding Author: Ji Soo Choi ,Tel: 010-8818-3843, Fax: 02-3410-6368, Email: jisoo.choi@samsung.com
Received: July 14, 2024;  Accepted: September 21, 2024.  Published online: September 23, 2024.
ABSTRACT
Purpose:
To investigate whether adding magnetic resonance imaging (MRI) to ultrasound (US) in preoperative evaluation is associated with survival outcomes of male breast cancer patients compared to female patients in matched analysis and to evaluate clinicopathological prognostic factors.
Methods:
Between January 2005 and December 2020, 93 male and 28,191 female patients who underwent breast surgery were screened, and exact matching analysis was performed for age, pathologic T and N stages, and molecular subtypes. Clinicopathological characteristics and preoperative imaging methods of the matched cohorts were reviewed. Disease-free survival (DFS) and overall survival (OS) were assessed through Kaplan-Meier analysis, and Cox proportional hazards regression analysis was performed to identify prognostic factors.
Results:
A total of 328 breast cancer patients (61 men and 267 women) were included in the matched analysis. Male patients had worse DFS (10-year DFS, 70.6% vs. 89.2%, P=0.001) and OS (10-year OS, 64.4% vs. 96.3%, P<0.001) compared to female patients. Pathologic index cancer size (HR 2.013, 95% CI 1.063-3.810, P=0.032) was associated with worse DFS, whereas there were no significant factors associated with OS. Adding MRI to US for preoperative evaluation was not associated with DFS (hazard ratio [HR] 1.117, 95% CI 0.223–5.583, P=0.893) or OS (HR 1.529, 95% CI 0.300–7.781, P=0.609) in male patients.
Conclusion:
Adding breast MRI to US for preoperative evaluation was not associated with survival outcomes in male breast cancer, and the pathologic index cancer size was associated with worse DFS.
Keywords: Breast neoplasms; Male; Malignancy; Survival; Magnetic resonance imaging
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