Gender-Based Differences in Mental Health Outcomes Following Breast Surgery: Insights from Epic Cosmos.

The study identified 232,138 patients with nononcologic breast diagnoses, of whom 30,521 (13.15%) underwent breast surgery.

• Retrospective data from 2010 to 2020 were queried from Cosmos, a national deidentified database from the Epic electronic health record.
• Conditions included gynecomastia, breast hypertrophy or macromastia, and asymmetry.
• Patients were divided into male and female cohorts.
• Primary outcomes compared rates of anxiety, depression, and suicidality in those who did or did not receive breast surgery.

Female patients who underwent breast surgery demonstrated significantly lower rates of mental health diagnoses compared with female nonsurgical patients.

• Mental health diagnoses were significantly lower for female surgical patients compared with female nonsurgical patients.
• This finding applied across anxiety, depression, and suicidality outcomes.
• The pattern suggests a potential psychosocial benefit of breast surgery for female patients.

Male patients who underwent breast surgery experienced higher rates of anxiety compared with male nonsurgical patients.

• Anxiety rates were 24.3% in male surgical patients versus 19.9% in male nonsurgical patients.
• This difference was statistically significant (P < 0.001).
• This was opposite to the trend observed in female patients.

Male patients who underwent breast surgery experienced higher rates of depression compared with male nonsurgical patients.

• Depression rates were 22.4% in male surgical patients versus 19.7% in male nonsurgical patients.
• This difference was statistically significant (P = 0.003).
• This represented an opposite trend compared with female surgical patients.

Male patients who underwent breast surgery experienced higher rates of self-harm compared with male nonsurgical patients.

• Self-harm rates were 2.7% in male surgical patients versus 1.6% in male nonsurgical patients.
• This difference was statistically significant (P < 0.001).
• This was identified as among the most notable findings in the male cohort.

The heightened mental health risk in males who underwent breast surgery was most notably identified in the preoperative period.

• A concerning trend was identified in which males who underwent surgery were more likely to suffer from mental health conditions.
• The elevated risk was described as most notable in the preoperative period.
• The authors suggest enhanced gender-specific counseling may help address this heightened risk.

The study concluded that breast surgery is experienced differently among genders as demonstrated by the mental health outcomes.

• Female and male patients showed opposite trends in mental health outcomes following breast surgery.
• Enhanced gender-specific counseling was recommended, particularly for males.
• The study highlights the interplay of breast surgery, mental health conditions, and gender in nononcologic breast conditions.