Akosa Ab, Van Norden S, Tettey Y
Department of Pathology, University of Ghana Medical School, Accra, Ghana.
Ghana Med J. 2005 Mar;39(1):14-8. doi: 10.4314/gmj.v39i1.35976.
SummaryMale breast cancers are rare but have been found in higher proportions in Black Africans. Prognostic factors for breast cancers include tumour size, grade and stage, and hormone receptor status. The hormone receptor status is an invaluable guide in the use of adjuvant endocrine therapy, but none of the reports available in the literature from Africa showed any receptor work.This study was conducted to determine the grade, lymph node status and hormone receptor status of male breast cancers in Ghana.Nine archival cases of male breast cancers from the Pathology Department of Korle Bu Teaching Hospital were selected and studied on the basis of the presence of enough material for immunocytochemistry. Haematoxylin and Eosin (H & E) stained slides were reviewed and graded by Bloom and Richardson's criteria. Lymph node status was also assessed and sections were stained for oestrogen and progesterone receptors.Seven of the nine tumours were invasive ductal carcinomas and six of these were grade II, and one was grade III. Four cases had axillary lymph nodes removed at surgery and three were positive for metastases. Six (66%) of the cases were positive for oestrogen receptors with an H score ranging from 20 to 300. Using the criteria of McCarty et al, positivity for oestrogen receptor was reduced to 44%, which is lower than for Caucasians. We believe that this may be explained by the fact that in Ghana male breast cancers are seen a decade earlier. Only two cases were positive for progesterone receptor with an H score of 10 and 75. The two cases positive for progesterone receptors were also positive for oestrogen receptors.It is concluded that hormone receptor study is important in deciding on endocrine and adjuvant chemotherapy in male breast cancers and should be done routinely to help surgeons plan postoperative management of these patients. We recommend further research in this area.
摘要
男性乳腺癌较为罕见,但在非洲黑人中所占比例较高。乳腺癌的预后因素包括肿瘤大小、分级、分期以及激素受体状态。激素受体状态在辅助内分泌治疗的应用中是一项非常重要的指标,但非洲文献中尚无任何关于受体研究的报道。
本研究旨在确定加纳男性乳腺癌的分级、淋巴结状态及激素受体状态。
从科勒布教学医院病理科选取了9例男性乳腺癌存档病例,基于有足够材料进行免疫细胞化学检测进行研究。苏木精和伊红(H&E)染色切片按照布鲁姆和理查森标准进行复查和分级。同时评估淋巴结状态,并对切片进行雌激素和孕激素受体染色。
9个肿瘤中有7个为浸润性导管癌,其中6个为Ⅱ级,1个为Ⅲ级。4例患者在手术中切除了腋窝淋巴结,3例有转移阳性。6例(66%)雌激素受体阳性,H评分在20至300之间。按照麦卡蒂等人的标准,雌激素受体阳性率降至44%,低于白种人。我们认为这可能是因为在加纳男性乳腺癌的发病时间要早十年。只有2例孕激素受体阳性,H评分为10和75。这2例孕激素受体阳性的病例同时也是雌激素受体阳性。
结论是,激素受体研究对于男性乳腺癌内分泌及辅助化疗的决策很重要,应常规进行以帮助外科医生规划这些患者的术后管理。我们建议在该领域进一步开展研究。