*Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin 300060, China.
Jpn J Clin Oncol. 2013 Oct;43(10):954-63. doi: 10.1093/jjco/hyt116. Epub 2013 Aug 9.
The objective of the study was to compare disease-free survival and overall survival in a group of matched males and females with breast cancer, and to analyze possible treatment- and gender-related differences.
We retrospectively analyzed the data of 150 operable male breast cancer patients treated in our hospital from December 1980 to June 2012. Each male breast cancer patient recorded in the database was matched with two female breast cancer patients of equal stage. Prognosis in terms of disease-free survival and overall survival was evaluated.
The mean age at diagnosis was 58.6 ± 9.7 years for males and 57.2 ± 10.3 years for females. The median follow-up was 69 months for males and 81 months for females. Significant differences were identified for tumor location, hormone receptor status, molecular subtypes and hormone therapy between the two groups. Monofactorial analysis demonstrated that tumor size, lymph node state, American Joint Committee on Cancer stage, molecular subtypes and adjuvant chemotherapy treatment were prognostic factors in male breast cancer patients. The 5- and 10-year disease-free survival rates were 65.6 and 40.1% for males, and 74.9 and 51.5% for females, respectively. The 5- and 10-year overall survival rates were 72.9 and 53.9% for males, and 83.2 and 68.5% for females, respectively. There was significantly difference in disease-free survival and overall survival between the two matched groups (P = 0.002).
Male breast cancer patients had inferior outcome despite of equal stage in comparison with matched female breast cancer patients, which demonstrates that biological differences may contribute to the worse prognosis.
本研究旨在比较一组匹配的男性和女性乳腺癌患者的无病生存率和总生存率,并分析可能的治疗和性别相关差异。
我们回顾性分析了 1980 年 12 月至 2012 年 6 月期间在我院接受治疗的 150 例可手术男性乳腺癌患者的数据。数据库中记录的每位男性乳腺癌患者均与两名分期相等的女性乳腺癌患者相匹配。评估无病生存率和总生存率的预后。
男性诊断时的平均年龄为 58.6±9.7 岁,女性为 57.2±10.3 岁。男性的中位随访时间为 69 个月,女性为 81 个月。两组之间在肿瘤位置、激素受体状态、分子亚型和激素治疗方面存在显著差异。单因素分析表明,肿瘤大小、淋巴结状态、美国癌症联合委员会分期、分子亚型和辅助化疗治疗是男性乳腺癌患者的预后因素。男性患者的 5 年和 10 年无病生存率分别为 65.6%和 40.1%,女性分别为 74.9%和 51.5%。男性患者的 5 年和 10 年总生存率分别为 72.9%和 53.9%,女性分别为 83.2%和 68.5%。两组匹配患者在无病生存率和总生存率方面存在显著差异(P=0.002)。
尽管男性乳腺癌患者与匹配的女性乳腺癌患者处于相同的分期,但预后较差,这表明生物学差异可能导致预后更差。