Ciatto S, Iossa A, Bonardi R, Pacini P
Centro per lo Studio e la Prevenzione Oncologica, Firenze, Italy.
Tumori. 1990 Dec 31;76(6):555-8. doi: 10.1177/030089169007600608.
The authors report on a consecutive retrospective series of 150 male breast cancers. Clinical, diagnostic and therapeutic features are compared over time and with respect to a large consecutive series of female breast cancers. Both age at diagnosis and tumor stage were more advanced in males than in females. Poor alertness of both men and doctors for this infrequent disease may account for such a delay in diagnosis. The use of mammography increased over time and sonography or cytology were frequently and successfully employed in the last decade. Unfortunately no improvement of tumor stage at diagnosis was observed over time in the present series. A time trend was also evident for the type of surgical and postoperative treatment. Modified radical mastectomy and adjuvant chemo- or hormone therapy were increasingly adopted, although Halsted operation and postoperative radiotherapy were still common in the last decade due to the relatively high proportion of locally advanced T3-4 cancers. Both disease-free and overall survival were worse in men than in women, even after adjustment by stage at diagnosis. This study suggests that male breast cancer has a worse prognosis with respect to female breast cancer and provides no complete explanation of this finding, except for an intrinsic higher aggressivity. No evidence was found which may justify a different diagnostic or therapeutic approach with respect to female breast cancer.
作者报告了150例男性乳腺癌的连续回顾性系列病例。对其临床、诊断和治疗特征进行了时间上的比较,并与大量连续的女性乳腺癌系列病例进行了比较。男性的诊断年龄和肿瘤分期均比女性更晚。男性和医生对这种罕见疾病的警惕性不足可能是导致诊断延迟的原因。随着时间的推移,乳腺钼靶检查的使用有所增加,在过去十年中,超声检查或细胞学检查被频繁且成功地应用。不幸的是,在本系列病例中,未观察到随着时间推移诊断时肿瘤分期有改善。手术和术后治疗类型也存在明显的时间趋势。改良根治性乳房切除术和辅助化疗或激素治疗的应用越来越多,尽管由于局部晚期T3 - 4期癌症比例相对较高,哈氏手术和术后放疗在过去十年中仍然很常见。即使在根据诊断时的分期进行调整后,男性的无病生存率和总生存率仍低于女性。这项研究表明,男性乳腺癌的预后比女性乳腺癌更差,除了其内在的更高侵袭性外,没有对这一发现做出完整解释。未发现有证据表明相对于女性乳腺癌,需要采取不同的诊断或治疗方法。