Leone José Pablo, Leone Julieta, Zwenger Ariel Osvaldo, Iturbe Julián, Vallejo Carlos Teodoro, Leone Bernardo Amadeo
University of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, USA,
Breast Cancer Res Treat. 2015 Aug;152(3):601-9. doi: 10.1007/s10549-015-3488-y. Epub 2015 Jul 1.
Substantial controversy exists about the prognostic role of tumor subtypes in male breast cancer (MaBC). The aim of this study was to analyze the characteristics of each tumor subtype in MaBC and its association with prognosis compared with other factors. We evaluated MaBC patients between 2010 and 2012 with known estrogen receptor, progesterone receptor [together hormone receptor (HR)] status, and human epidermal growth factor receptor 2 (HER2) status reported to the Surveillance, Epidemiology, and End Results program. Patients were classified as: HR-positive/HER2-negative, HR-positive/HER2-positive, HR-negative/HER2-positive, and triple-negative (TN). Univariate and multivariate analyses determined the effect of each variable on overall survival (OS). We included 960 patients. Patient distribution was 84.9 % HR-positive/HER2-negative, 11.6 % HR-positive/HER2-positive, 0.6 % HR-negative/HER2-positive, and 2.9 % TN. TN patients were younger, had higher grade, presented with more advanced stage, were more likely to have mastectomy, and to die of breast cancer (all P < 0.05). Univariate analysis showed that HER2 positivity was associated with shorter OS (hazard ratio 1.90, P = 0.031) and TN patients had worse prognosis (hazard ratio 5.10, P = 0.0004). In multivariate analysis, older patients (hazard ratio 3.10, P = 0.032), those with stage IV (hazard ratio 16.27, P < 0.001) and those with TN tumors (hazard ratio 4.61, P = 0.002) had significantly worse OS. We observed significant differences in patient characteristics according to tumor subtype. HER2-positive and TN represented a small proportion of cases. In addition to age and stage, tumor subtype has clear influence on OS in MaBC.
关于肿瘤亚型在男性乳腺癌（MaBC）中的预后作用存在大量争议。本研究的目的是分析MaBC中各肿瘤亚型的特征及其与预后的关联，并与其他因素进行比较。我们评估了2010年至2012年间向监测、流行病学和最终结果计划报告了已知雌激素受体、孕激素受体[合称激素受体（HR）]状态以及人表皮生长因子受体2（HER2）状态的MaBC患者。患者被分为：HR阳性/HER2阴性、HR阳性/HER2阳性、HR阴性/HER2阳性和三阴性（TN）。单因素和多因素分析确定了每个变量对总生存期（OS）的影响。我们纳入了960例患者。患者分布情况为：84.9%为HR阳性/HER2阴性，11.6%为HR阳性/HER2阳性，0.6%为HR阴性/HER2阳性，2.9%为TN。TN患者更年轻，分级更高，分期更晚，更有可能接受乳房切除术，且更有可能死于乳腺癌（所有P<0.05）。单因素分析显示，HER2阳性与较短的OS相关（风险比1.90，P = 0.031），TN患者预后更差（风险比5.10，P = 0.0004）。在多因素分析中，年龄较大的患者（风险比3.10，P = 0.032）、IV期患者（风险比16.27，P<0.001）和TN肿瘤患者（风险比4.61，P = 0.002）的OS明显更差。我们观察到根据肿瘤亚型患者特征存在显著差异。HER2阳性和TN病例占比小。除年龄和分期外，肿瘤亚型对MaBC的OS有明显影响。
