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男性乳腺癌的迟诊、诊断和社会心理方面。

Delayed presentation, diagnosis, and psychosocial aspects of male breast cancer.

机构信息

Division of Breast Surgery, The University of Hong Kong, Hong Kong.

Division of Breast Surgery, The University of Hong Kong Shenzhen Hospital, Shenzhen, China.

出版信息

Cancer Med. 2020 May;9(10):3305-3309. doi: 10.1002/cam4.2953. Epub 2020 Mar 13.

Abstract

INTRODUCTION

Male breast cancer is uncommon, delay in seeking medical attention often results in late presentation and poor prognosis.

METHODS

Retrospective review of a prospectively maintained database was performed. Patients who were still having regular follow-up were contacted for telephone interview.

RESULTS

In this study, 56 male breast cancer patients were treated in our center from January 1998 to December 2018, accounting for 0.88% of all breast cancers treated during the same period of time. Median age of onset was 61 years old (Range: 33-95). In this study, 6 (10.7%) patients presented with distant metastasis at the time of diagnosis and received palliative systemic treatment only. And, 50 patients were surgically treated and all had mastectomy. Axillary dissection was performed in 36 (72%) patients, while sentinel node biopsy was performed in 14 (28%) patients. Median tumor size was 23 mm (2-100 mm). A Majority were diagnosed with invasive carcinoma (NOS), while 38 (67.8%) patients were node positive.Here 36 (64.3%) patients were alive at the time of the study, 31 (86.1%) patients responded to the telephone interview. More than 90% of our patients expressed various degrees of embarrassment at the time of breast symptom onset. Similarly, more than 90% of these patients experienced embarrassment while waiting in the breast center with predominant female patients. Most patients (N = 26) were not aware that breast cancer can occur in men prior to the diagnosis. Median duration from symptoms to the first medical consultation was 12.4 months (1-120 months).

CONCLUSION

Male breast cancer is rare and patients usually present late, Lack of knowledge, public education, and embarrassment are the important related factors.

摘要

简介

男性乳腺癌较为罕见,就诊延迟往往导致就诊较晚和预后较差。

方法

对前瞻性维护的数据库进行回顾性分析。对仍在进行常规随访的患者进行电话访谈。

结果

本研究中,1998 年 1 月至 2018 年 12 月期间,我院共收治 56 例男性乳腺癌患者,占同期所有乳腺癌患者的 0.88%。发病中位年龄为 61 岁(范围:33-95 岁)。本研究中,6 例(10.7%)患者在诊断时即出现远处转移,仅接受姑息性全身治疗。50 例患者接受了手术治疗,均行乳房切除术。36 例(72%)患者行腋窝淋巴结清扫术,14 例(28%)患者行前哨淋巴结活检术。肿瘤大小中位数为 23mm(2-100mm)。大多数患者诊断为浸润性癌(NOS),38 例(67.8%)患者淋巴结阳性。截至研究时,36 例(64.3%)患者存活,31 例(86.1%)患者接受了电话访谈。我们的大多数患者在出现乳房症状时都表现出不同程度的尴尬。同样,在以女性为主的乳腺中心候诊时,超过 90%的患者感到尴尬。大多数患者(N=26)在诊断前不知道男性也可能患乳腺癌。从症状出现到首次就诊的中位时间为 12.4 个月(1-120 个月)。

结论

男性乳腺癌罕见,患者就诊通常较晚,缺乏相关知识、公众教育和尴尬是重要的相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98c9/7221437/dfce7c8eb146/CAM4-9-3305-g001.jpg

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