Herman K, Lobaziewicz W, Skotnicki P, Fortuna J, Kusy T, Leśniak T
Department of Surgical Oncology, Cancer Center, Kraków, Poland.
Neoplasma. 2000;47(3):191-5.
Due to the low incidence of breast cancer in males there are not many reports in the literature. In this study we analyzed results of treatment in 65 breast cancer males, who had been treated in one institution. Radical surgery was performed in 45 patients. Lymph node metastases were found in 25 patients (55.5%), the tumor was usually moderately differentiated (21 pts - 46.7%). Median survival after radical surgery was 73 months compared to 38 months for nonsurgical patients (p < 0.0001). In the group of males after radical surgery the results of 5-, 10- and 15-year survival rates were 69.8, 59.7 and 31.3% respectively. Comparable analysis of two subgroups of patients with favorable (T1 or T2, N0, grade I or II) and unfavorable (T3 or N+ or grade III) prognostic factors was also performed. In the first subgroup the 5-, 10- and 15-year survival rates were 90, 77.4 and 62%, compared to 61.8, 23.1 and 23. 1% for the second subgroup. The multivariate analysis showed grading and node status as the strongest parameters influencing survival. Relative risk of death was over 3 times higher for nodal metastases and near 3 times higher for high grade carcinomas (p < 0.01), compared to patients without metastases and low grade of tumor. Similar analysis was performed when 45 males were compared to 500 selected women, with similar clinical parameters (age, node status, grading). Again, data indicated grading and lymph node status as the strongest prognostic factors. It was not unlikely, that gender had some influence on prognosis, when relative risk of death for males was over 1.5 times higher than for females, but this result was not clearly significant (p < 0.1 ). The question, whether male breast cancer prognosis is worse then in female remains open. Multiinstitutional prospective studies are needed in this area.
由于男性乳腺癌的发病率较低，文献中的报道并不多。在本研究中，我们分析了在同一机构接受治疗的65例男性乳腺癌患者的治疗结果。45例患者接受了根治性手术。25例患者（55.5%）发现有淋巴结转移，肿瘤通常为中度分化（21例 - 46.7%）。根治性手术后的中位生存期为73个月，而非手术患者为38个月（p < 0.0001）。在接受根治性手术的男性组中，5年、10年和15年生存率分别为69.8%、59.7%和31.3%。我们还对具有有利（T1或T2，N0，I级或II级）和不利（T3或N+或III级）预后因素的两个亚组患者进行了可比分析。在第一个亚组中，5年、10年和15年生存率分别为90%、77.4%和62%，而第二个亚组分别为61.8%、23.1%和23.1%。多因素分析显示分级和淋巴结状态是影响生存的最强参数。与无转移和低级别肿瘤的患者相比，淋巴结转移患者的死亡相对风险高出3倍以上，高级别癌患者高出近3倍（p < 0.01）。当将45例男性与500例具有相似临床参数（年龄、淋巴结状态、分级）的女性进行比较时，进行了类似的分析。同样，数据表明分级和淋巴结状态是最强的预后因素。当男性的死亡相对风险比女性高出1.5倍以上时，性别对预后可能有一定影响，但这一结果并不明显（p < 0.1）。男性乳腺癌的预后是否比女性更差这一问题仍然悬而未决。该领域需要多机构的前瞻性研究。
