Howard University College of Medicine, Washington, District of Columbia.
J Surg Res. 2013 Dec;185(2):e71-6. doi: 10.1016/j.jss.2013.05.043. Epub 2013 Jun 3.
Lobular carcinoma of the male breast is rare. We sought to investigate the clinical characteristics, treatment, and outcomes of men and women with lobular breast cancer, using a population-based database.
We reviewed the Surveillance, Epidemiology, and End Results database 1988-2008 and identified patients with a lobular breast cancer diagnosis (invasive lobular carcinoma [ILC] and lobular carcinoma in situ [LCIS]) using the "International Classification of Diseases for Oncology, Third Edition" codes. Bivariate analyses compared the male and female patients on demographics, clinical characteristics, and treatment modalities. Multivariate logistic regression analysis determined the risk-adjusted likelihood of receiving treatment. Survival analysis was done and hazard ratios were obtained using Cox proportional models.
Overall, 133,339 patients were identified, including 133,168 women (99.9%) and 171 men (0.1%). Most had ILC (82.08%). The median age was 66 ± 20 y for the men and 61 ± 21 y for the women. The men with ILC were more likely to have poorly differentiated tumors (26.45% versus 15.61%; P < 0.001) and stage IV disease (9.03% versus 4.18%; P = 0.005) than were the women. The cancer-specific 5-year survival rates for ILC were 82.9% for the men and 91.9% for the women. Adjusted survival was better for patients with ILC receiving surgery plus radiotherapy than patients receiving neither (hazard ratio 0.52, 95% confidence interval 0.49-0.56). Women with ILC had a 55% increased odds of receiving surgery plus radiotherapy compared with men (odds ratio 1.55, 95% confidence interval 1.08-2.22).
ILC presents at a higher grade and stage in men. The difference in disease characteristics and survival rates suggests that the treatment of men with lobular breast cancer should be adjusted to improve their outcomes.
男性乳腺癌中的小叶癌较为罕见。我们旨在通过基于人群的数据库，研究男性和女性小叶乳腺癌患者的临床特征、治疗方法和结局。
我们回顾了 1988 年至 2008 年期间的监测、流行病学和最终结果数据库，并使用“国际肿瘤疾病分类，第三版”代码确定了小叶乳腺癌（浸润性小叶癌[ILC]和小叶原位癌[LCIS]）的患者。双变量分析比较了男性和女性患者的人口统计学、临床特征和治疗方式。多变量逻辑回归分析确定了接受治疗的风险调整可能性。进行生存分析并使用 Cox 比例模型获得危险比。
共有 133339 例患者被确定，其中包括 133168 名女性（99.9%）和 171 名男性（0.1%）。大多数患者为 ILC（82.08%）。男性的中位年龄为 66±20 岁，女性为 61±21 岁。男性 ILC 患者更有可能患有低分化肿瘤（26.45%比 15.61%；P<0.001）和 IV 期疾病（9.03%比 4.18%；P=0.005）。ILC 的癌症特异性 5 年生存率，男性为 82.9%，女性为 91.9%。与未接受手术联合放疗的患者相比，接受手术联合放疗的 ILC 患者的调整后生存情况更好（危险比 0.52，95%置信区间 0.49-0.56）。与男性相比，ILC 女性患者接受手术联合放疗的可能性增加了 55%（优势比 1.55，95%置信区间 1.08-2.22）。
男性的 ILC 呈现出更高的分级和分期。疾病特征和生存率的差异表明，男性小叶乳腺癌的治疗应进行调整，以改善其结局。
