Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2013 May 1;119(9):1611-7. doi: 10.1002/cncr.27905. Epub 2013 Jan 22.
Breast cancer occurs rarely in men. To the authors' knowledge, no population-based estimates of the incidence of human epidermal growth factor receptor 2 (HER2)-positive breast cancer or of the distribution of breast cancer subtypes among male breast cancer patients have been published to date. Therefore, the objective of the current study was to explore breast tumor subtype distribution by race/ethnicity among men in the large, ethnically diverse population of California.
This study included men who were diagnosed with invasive breast cancer between 2005 and 2009 with known estrogen receptor (ER) and progesterone receptor (PR) (together, hormone receptor [HR]) status and HER2 status reported to the California Cancer Registry. Among the men with HR-positive tumors, survival probabilities between groups were compared using log-rank tests.
Six hundred six patients were included. The median age at diagnosis was 68 years. Four hundred ninety-four men (81.5%) had HR-positive tumors (defined as ER-positive and/or PR-positive and HER2-negative). Ninety men (14.9%) had HER2-positive tumors, and 22 (3.6%) had triple receptor-negative (TN) tumors. Among the patients with HR-positive tumors, non-Hispanic black men and Hispanic men were more likely to have PR-negative tumors than non-Hispanic white men. No statistically significant differences in survival were observed according to tumor subtype (P = .08). Differences in survival according to race/ethnicity were observed among all patients (P = .087) and among those with HR-positive tumors (P = .0170), and non-Hispanic black men had poorer outcomes.
In this large, representative cohort of men with breast cancer, the distribution of tumor subtypes was different from that reported for women and varied by patient race/ethnicity. Non-Hispanic black men were more likely to have TN tumors and ER-positive/PR-negative tumors than white men.
男性乳腺癌的发病率较低。据作者所知,目前尚未有基于人群的男性乳腺癌患者人表皮生长因子受体 2(HER2)阳性乳腺癌发病率或乳腺癌亚型分布的报告。因此,本研究的目的是探讨加利福尼亚州这个大的、种族多样化的人群中男性乳腺癌的肿瘤亚型分布与种族/族裔的关系。
本研究纳入了 2005 年至 2009 年间诊断为浸润性乳腺癌且已知雌激素受体(ER)和孕激素受体(PR)(统称激素受体[HR])状态和 HER2 状态的男性患者,这些数据均报告给了加利福尼亚癌症登记处。在 HR 阳性肿瘤患者中,使用对数秩检验比较组间的生存概率。
共纳入 606 例患者。中位诊断年龄为 68 岁。494 例(81.5%)男性患者的肿瘤为 HR 阳性(定义为 ER 阳性和/或 PR 阳性且 HER2 阴性)。90 例(14.9%)男性患者的肿瘤为 HER2 阳性,22 例(3.6%)患者的肿瘤为三阴性(TN)。在 HR 阳性肿瘤患者中,非西班牙裔黑人男性和西班牙裔男性的 PR 阴性肿瘤发生率高于非西班牙裔白人男性。根据肿瘤亚型,未观察到生存差异有统计学意义(P=0.08)。在所有患者(P=0.087)和 HR 阳性肿瘤患者(P=0.0170)中均观察到生存差异与种族/族裔有关,非西班牙裔黑人男性的结局较差。
在本项大型、具有代表性的男性乳腺癌队列研究中,肿瘤亚型的分布与女性报道的不同,且因患者种族/族裔而异。非西班牙裔黑人男性发生 TN 肿瘤和 ER 阳性/PR 阴性肿瘤的可能性高于白人男性。