Kidmas A T, Ugwu B T, Manasseh A N, Iya D, Opaluwa A S
Department of Surgery University Teaching hospital, P M. B. 2076, Jos, Nigeria.
West Afr J Med. 2005 Jan-Mar;24(1):36-40. doi: 10.4314/wajm.v24i1.28160.
Male breast malignancies are rare. Cancer of the male breast accounts for about 1% of all breast cancers. Poor level of awareness often results in late presentation and delayed diagnosis in our environment.
A retrospective study of all cases of male breast cancer (MBC) managed in Jos University Teaching Hospital over a 17-year period (January 1987-December 2003.)
A total of 302 cases of breast malignancies were managed over the study period. Twenty-six (8.6%) of these were males giving a male:female ratio of 1:10.6. The ages of the 26 MBC cases ranged from 12 years to 85 years, with a mean of 57.9 years and median age of 67 years. The right breast was affected in 15 and the left in 11. Mean duration of symptoms before presentation was 6 months with a range of 3 months to 4 years. All the patients had history of breast lumps, 21 (80.8%) of which were painless. Skin ulceration and axillary node enlargement were present in 19(73.1%) and 24(92.3%) respectively. Five (19.2%) were stage II; 15(57.7%) stage III and 6(23.1%) stage IV. There were 23 (88.5%) carcinomas, 2 (7.7%) fibrosarcomas and a case of Hodgkin's lymphoma. Invasive ductal carcinoma was the most common histological type in 20 (76.9%) of all breast malignancy and 20 (87.0%) of all breast carcinomas. Modified radical mastectomy (mastectomy with axillary clearance with or without division of the pectoralis minor muscle) was done in 10(38.5%) patients. Two of these were fibrosarcomas. Simple mastectomy was done in 13 (50%) as toilet procedures for advanced disease. The only case of Hodgkin's lymphoma had chemotherapy. Bilateral orchidectomy (BO), Tamoxifen, chemotherapy and radiotherapy were offered in 7(26.9%), 13(50%), 17(65.4%) and 7(26.9%) patients respectively. Wound infection was the most common complication in 14(53.8%) patients. There was no case of hospital mortality.
MBC accounts for 8.6% of all breast cancers in our centre. It affects elderly males. Late presentation with advanced disease and ulceration is a common feature in our environment.
男性乳腺恶性肿瘤较为罕见。男性乳腺癌约占所有乳腺癌的1%。在我们所处的环境中，人们对此病的认知水平较低，这常常导致就诊延迟和诊断延误。
对乔斯大学教学医院17年间（1987年1月至2003年12月）收治的所有男性乳腺癌（MBC）病例进行回顾性研究。
在研究期间共诊治了302例乳腺恶性肿瘤病例。其中26例（8.6%）为男性，男女比例为1:10.6。26例MBC患者的年龄在12岁至85岁之间，平均年龄为57.9岁，中位年龄为67岁。右侧乳房受累15例，左侧11例。就诊前症状的平均持续时间为6个月，范围为3个月至4年。所有患者均有乳腺肿块病史，其中21例（80.8%）无痛。皮肤溃疡和腋窝淋巴结肿大分别见于19例（73.1%）和24例（92.3%）。5例（19.2%）为Ⅱ期；15例（57.7%）为Ⅲ期，6例（23.1%）为Ⅳ期。有23例（88.5%）为癌，2例（7.7%）为纤维肉瘤，1例霍奇金淋巴瘤。浸润性导管癌是所有乳腺恶性肿瘤中最常见的组织学类型，在所有乳腺癌中占20例（76.9%），在所有癌中占20例（87.0%）。10例（38.5%）患者行改良根治性乳房切除术（切除乳房并清扫腋窝，可切除或不切除胸小肌）。其中2例为纤维肉瘤。13例（50%）行单纯乳房切除术作为晚期疾病的清理手术。唯一的霍奇金淋巴瘤病例接受了化疗。分别有7例（26.9%）、13例（50%）、17例（65.4%）和7例（26.9%）患者接受了双侧睾丸切除术（BO）、他莫昔芬、化疗和放疗。伤口感染是14例（53.8%）患者最常见的并发症。无医院死亡病例。
在我们中心，MBC占所有乳腺癌的8.6%。它影响老年男性。在我们所处的环境中，就诊延迟且伴有晚期疾病和溃疡是常见特征。
