Yoney Adnan, Kucuk Ahmet, Alan Omur, Unsal Mustafa
Okmeydani Training and Research Hospital, Istanbul, Turkey.
Hematol Oncol Stem Cell Ther. 2008 Apr-Jun;1(2):98-105. doi: 10.1016/s1658-3876(08)50041-0.
Optimal management if male breast cancer (MBC) is not clearly established and treatment guidelines are scarce. We evaluated our own results in the treatment of male breast cancer patients with respect to local control (LC), overall survival (OS) and possible prognostic factors for survival.
Thirty-nine patients with MBC were retrospectively studied to evaluate the results in this type of tumor; 94.8% had invasive ductal carcinoma (IDC), 2.6% invasive papillary carcinoma (IPC) and 2.6% invasive lobuler carcinoma (ILC). The distribution according to stage was 12.8%, 46.2%, 30.7% and 10.3% in Stages I, II, III and IV, respectively; 7.7% underwent radiotherapy (RT)+/-hormonotherapy (HT), 22.8% had chemotherapy (CT), 61.8% had chemoradiotherapy (CRT)+/-HT and 7.7% had HT in addition to surgery.
The distant metastases rate was 36% and the local recurrence rate was 5%. All the local recurrences and the distant metastases had occurred after the first two years. The 2-year disease free survival (DFS) and OS rates were 87.2% and 89.7%, respectively, and the 5-year DFS and OS rates were 65.8% and 80.1%, respectively. In a univariate analysis for OS, statistical significance was found for lymph node metastases (P=.00001), stage (P=.0098) and age (P=.03), while presence of RT in the treatment modality (P=.6849), and tumor size (P=.4439) demonstrated no significance. The presence of lymph node metastases significantly impaired OS (P=.004) and DFS (P=.014) in the multivariate analysis.
Postoperative radiotherapy was important in the management of MBC to improve LC resulting in one local failure, but did not improve OS and DFS. The presence of lymph node metastases significantly impaired OS and DFS.
男性乳腺癌（MBC）的最佳治疗方案尚未明确确立，且治疗指南稀缺。我们评估了自己在男性乳腺癌患者治疗方面关于局部控制（LC）、总生存期（OS）以及可能的生存预后因素的结果。
对39例男性乳腺癌患者进行回顾性研究，以评估此类肿瘤的治疗结果；94.8%为浸润性导管癌（IDC），2.6%为浸润性乳头状癌（IPC），2.6%为浸润性小叶癌（ILC）。根据分期的分布情况为：I期占12.8%，II期占46.2%，III期占30.7%，IV期占10.3%；7.7%接受了放疗（RT）±激素治疗（HT），22.8%接受了化疗（CT），61.8%接受了放化疗（CRT）±HT，7.7%除手术外还接受了HT。
远处转移率为36%，局部复发率为5%。所有局部复发和远处转移均发生在头两年之后。2年无病生存率（DFS）和OS率分别为87.2%和89.7%，5年DFS和OS率分别为65.8%和80.1%。在OS的单因素分析中，发现淋巴结转移（P = 0.00001）、分期（P = 0.0098）和年龄（P = 0.03）具有统计学意义，而治疗方式中放疗的存在（P = 0.6849）以及肿瘤大小（P = 0.4439）无显著意义。在多因素分析中，淋巴结转移的存在显著损害了OS（P = 0.004）和DFS（P = 0.014）。
术后放疗对男性乳腺癌的治疗很重要，可改善LC，仅导致1例局部失败，但未改善OS和DFS。淋巴结转移的存在显著损害了OS和DFS。
