Vermeulen Marijn A, Slaets Leen, Cardoso Fatima, Giordano Sharon H, Tryfonidis Konstantinos, van Diest Paul J, Dijkstra Nizet H, Schröder Carolien P, van Asperen Christi J, Linderholm Barbro, Benstead Kim, Foekens Renee, Martens John W M, Bartlett John M S, van Deurzen Carolien H M
Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
EORTC Headquarters, Brussels, Belgium.
Eur J Cancer. 2017 Sep;82:219-227. doi: 10.1016/j.ejca.2017.01.034. Epub 2017 Mar 11.
Several prognostic histological features have been established in female breast cancer (BC), but it is unknown whether these can be extrapolated to male BC patients. The aim of this study was to evaluate the prognostic value of several histological features in a large series of male BC.
Central pathology review was performed for 1483 male BCs collected through part 1 of the European Organisation for Research and Treatment of Cancer (EORTC) International Male BC Program. Pathology review included histological subtype, grade, mitotic activity index (MAI), presence of a fibrotic focus and density of tumour-infiltrating lymphocytes (TILs). These features were correlated with clinical outcome. The relationship between these features and surrogate molecular subtypes using immunohistochemistry was also assessed.
Median follow-up for overall survival (OS) was 7.1 years. Overall histological grade was not significantly associated with OS (p = 0.129). MAI, the presence of a fibrotic focus and a low TIL density however were correlated with unfavourable OS (p = 0.023, p = 0.004 and p = 0.011, respectively). BC subtype correlated with TIL density (p = 0.015), as we observed a higher density for human epidermal growth factor receptor type 2 (HER2) positive BC compared to luminal HER2-negative subtype. No association was observed between subtype and fibrotic focus.
Histologic grade was not significantly correlated with clinical outcome in this series, unlike what is seen in female patients. These results contribute to our understanding of male BC and indicate the importance of further research on the optimisation of risk stratification and treatment decisions for male BC patients.
在女性乳腺癌（BC）中已确定了几种预后组织学特征，但尚不清楚这些特征是否可外推至男性BC患者。本研究的目的是评估一系列男性BC中几种组织学特征的预后价值。
对通过欧洲癌症研究与治疗组织（EORTC）国际男性BC项目第1部分收集的1483例男性BC进行中心病理学复查。病理学复查包括组织学亚型、分级、有丝分裂活性指数（MAI）、纤维化灶的存在以及肿瘤浸润淋巴细胞（TILs）密度。这些特征与临床结局相关。还评估了这些特征与使用免疫组织化学的替代分子亚型之间的关系。
总生存期（OS）的中位随访时间为7.1年。总体组织学分级与OS无显著相关性（p = 0.129）。然而，MAI、纤维化灶的存在和低TIL密度与不良OS相关（分别为p = 0.023、p = 0.004和p = 0.011）。BC亚型与TIL密度相关（p = 0.015），因为我们观察到与管腔HER2阴性亚型相比，人表皮生长因子受体2（HER2）阳性BC的密度更高。未观察到亚型与纤维化灶之间的关联。
与女性患者不同，在本系列中组织学分级与临床结局无显著相关性。这些结果有助于我们对男性BC的理解，并表明进一步研究优化男性BC患者的风险分层和治疗决策的重要性。
