Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ann Surg Oncol. 2018 Jun;25(6):1530-1535. doi: 10.1245/s10434-018-6411-z. Epub 2018 Mar 8.
Given the limited data, systemic treatment of male breast cancer has been extrapolated from female patients. The 21-gene recurrence score (RS) assay estimates the risk of distant recurrence and chemotherapy benefit in early-stage, ER+/HER2- female breast cancer. We assessed the association between RS and type of treatment in male breast cancer.
We identified male patients with ER+/HER2- breast cancer and available RS results treated at our institution in 2006-2016. We collected data on clinicopathologic features, treatment, and outcome. The Institutional Review Board approved the study.
The study cohort consists of 38 male breast cancer patients with a median age of 70 years. Median tumor size was 1.6 cm, and 81.6% (31) were node-negative. RS was low (≤ 17) in 26 (68.4%) cases, intermediate (18-30) in 9 (23.7%) cases, and high (≥ 31) in 3 (7.9%) cases, comparable to that in female patients at our institution. All patients underwent total mastectomy, and one received radiotherapy. Thirty-four (89.5%) patients received adjuvant endocrine therapy, mostly tamoxifen (81.6%; 31). Five (13.2%) patients with intermediate or high RS were treated with adjuvant chemotherapy. No locoregional recurrence was observed, and one patient developed distant recurrence (median follow-up 34 months).
The RS distribution in male breast cancers was similar to that in females treated at our institution. With limited follow-up, patients with low RS were spared chemotherapy and did not develop recurrence. Our results suggest that the RS may have a clinical utility in male breast cancer patients.
由于数据有限，男性乳腺癌的全身治疗是从女性患者中推断出来的。21 基因复发评分（RS）检测可预测早期 ER+/HER2-女性乳腺癌的远处复发风险和化疗获益。我们评估了 RS 与男性乳腺癌治疗类型之间的关系。
我们在 2006-2016 年间确定了在我院接受治疗的 ER+/HER2-乳腺癌且有可用 RS 结果的男性患者。我们收集了临床病理特征、治疗和结局的数据。机构审查委员会批准了该研究。
该研究队列包括 38 名中位年龄为 70 岁的男性乳腺癌患者。中位肿瘤大小为 1.6cm，81.6%（31 例）为淋巴结阴性。26 例（68.4%）的 RS 较低（≤17），9 例（23.7%）为中值（18-30），3 例（7.9%）为高值（≥31），与我院的女性患者相当。所有患者均接受了全乳房切除术，其中 1 例接受了放疗。34 例（89.5%）患者接受了辅助内分泌治疗，主要是他莫昔芬（81.6%；31 例）。5 例中值或高值 RS（13.2%）的患者接受了辅助化疗。未观察到局部区域复发，1 例患者出现远处复发（中位随访 34 个月）。
男性乳腺癌的 RS 分布与我院治疗的女性相似。在有限的随访中，RS 较低的患者避免了化疗且未发生复发。我们的结果表明，RS 可能对男性乳腺癌患者具有临床应用价值。
