Faculty of Medicine, Minia University, Minia, Egypt; Online Research Club, Nagasaki, Japan.
Online Research Club, Nagasaki, Japan; Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Clin Breast Cancer. 2018 Dec;18(6):e1293-e1310. doi: 10.1016/j.clbc.2018.07.003. Epub 2018 Jul 7.
Male breast cancer (MBC) is usually diagnosed at late stages and therefore has a worse prognosis than female breast cancer (FBC). MBC is also more likely to have lymph node (LN) involvement than FBC.
We sought to determine the prognostic role of the examined lymph node (LN), negative LN (NLN), and positive LN counts and the LN ratio (LNR), defined as (positive LNs/ENLs), on the survival rate among MBC patients. We performed a large population-based study using the data from the Surveillance, Epidemiology, and End Results program.
Older age, black race, stage IV disease, ≤ 1 NLN, and a > 31.3% LNR were significantly associated with worse survival across all prediction models. Moreover, we demonstrated a decreased risk of mortality in MBC patients across the MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.998; P = .03) and 10-year MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.999; P = .04).
MBC has had an augmented incidence over the years. We found several independent predictors of MBC survival, including age, race, stage, NLNs, and the LNR. We strongly suggest adding the NLN count and/or LNR into the current staging system. Further studies are needed to provide information on the mechanisms underlying the association between the NLN count and MBC survival and the LNR and MBC survival.
男性乳腺癌（MBC）通常在晚期诊断，因此预后比女性乳腺癌（FBC）差。与 FBC 相比，MBC 更有可能发生淋巴结（LN）受累。
我们旨在确定检查的淋巴结（LN）、阴性淋巴结（NLN）、阳性淋巴结计数和淋巴结比（LNR）的预后作用，LNR 定义为（阳性 LNs/NLNs），以确定 MBC 患者的生存率。我们使用监测、流行病学和最终结果计划的数据进行了一项大型基于人群的研究。
所有预测模型中，年龄较大、黑种人、IV 期疾病、≤1NLN 和 LNR>31.3%与生存率降低显著相关。此外，我们在 MBC 特异性生存模型（风险比，0.98；95%置信区间，0.96-0.998；P=0.03）和 10 年 MBC 特异性生存模型（风险比，0.98；95%置信区间，0.96-0.999；P=0.04）中证明了 MBC 患者的死亡率降低。
近年来，MBC 的发病率有所增加。我们发现了几个与 MBC 生存相关的独立预测因素，包括年龄、种族、分期、NLN 和 LNR。我们强烈建议将 NLN 计数和/或 LNR 添加到当前的分期系统中。需要进一步的研究来提供关于 NLN 计数与 MBC 生存之间以及 LNR 与 MBC 生存之间关联的机制信息。
