Li Wei-Ping, Gao Hong-Fei, Ji Fei, Zhu Teng, Cheng Min-Yi, Yang Mei, Yang Ci-Qiu, Zhang Liu-Lu, Li Jie-Qing, Zhang Jun-Sheng, Wang Kun
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Breast Cancer, Cancer Centre, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Ther Adv Med Oncol. 2020 Sep 20;12:1758835920958358. doi: 10.1177/1758835920958358. eCollection 2020.
Male breast cancer is an uncommon disease. The benefit of adjuvant chemotherapy in the treatment of male breast cancer patients has not been determined. The aim of this study was to explore the value of adjuvant chemotherapy in men with stage I-III breast cancer, and we hypothesized that some male patients may safely skip adjuvant chemotherapy.
Male breast cancer patients between 2010 and 2015 from the Surveillance Epidemiology and End Results database were included. Univariate and multivariate Cox analyses were used to analyse the factors associated with survival. The propensity score matching method was adopted to balance baseline characteristics. Kaplan-Meier curves were used to evaluate the impacts of adjuvant chemotherapy on survival. The primary endpoint was survival.
We enrolled 514 patients for this study, including 257 patients treated with chemotherapy and 257 patients without. There was a significant difference in overall survival (OS) but not in breast cancer-specific survival (BCSS) between the two groups ( < 0.001 for OS and = 0.128 for BCSS, respectively). Compared with the non-chemotherapy group, the chemotherapy group had a higher 4-year OS rate (97.5% 95.2%, < 0.001), while 4-year BCSS was similar (98% 98.8%, = 0.128). The chemotherapy group had longer OS than the non-chemotherapy group among HR+, HER2-, tumour size >2 cm, lymph node-positive male breast cancer patients ( < 0.05). Regardless of tumour size, there were no differences in OS or BCSS between the chemotherapy and non-chemotherapy cohorts for lymph node-negative patients (OS: > 0.05, BCSS: > 0.05). Adjuvant chemotherapy showed no significant effects on both OS and BCSS in patients with stage I (OS: = 0.100, BCSS: = 0.858) and stage IIA breast cancer (OS: > 0.05, BCSS: > 0.05).
For stage I and stage IIA patients, adjuvant chemotherapy could not improve OS and BCSS. Therefore, adjuvant chemotherapy might be skipped for stage I and stage IIA male breast cancer patients.
男性乳腺癌是一种罕见疾病。辅助化疗在男性乳腺癌患者治疗中的益处尚未确定。本研究的目的是探讨辅助化疗在Ⅰ - Ⅲ期男性乳腺癌患者中的价值，并且我们推测部分男性患者可能可安全地跳过辅助化疗。
纳入2010年至2015年监测、流行病学与最终结果数据库中的男性乳腺癌患者。采用单因素和多因素Cox分析来分析与生存相关的因素。采用倾向评分匹配法平衡基线特征。采用Kaplan - Meier曲线评估辅助化疗对生存的影响。主要终点为生存。
本研究共纳入514例患者，其中257例接受化疗，257例未接受化疗。两组的总生存期（OS）存在显著差异，但乳腺癌特异性生存期（BCSS）无显著差异（OS：<0.001，BCSS：=0.128）。与未化疗组相比，化疗组的4年OS率更高（97.5%对95.2%，<0.001），而4年BCSS相似（98%对98.8%，=0.128）。在HR +、HER2 -、肿瘤大小>2 cm、淋巴结阳性的男性乳腺癌患者中，化疗组的OS长于未化疗组（<0.05）。无论肿瘤大小如何，淋巴结阴性患者的化疗组和未化疗组在OS或BCSS方面均无差异（OS：>0.05，BCSS：>0.05）。辅助化疗在Ⅰ期（OS：=0.100，BCSS：=0.858）和ⅡA期乳腺癌患者中对OS和BCSS均无显著影响（OS：>0.05，BCSS：>0.05）。
对于Ⅰ期和ⅡA期患者，辅助化疗不能改善OS和BCSS。因此，Ⅰ期和ⅡA期男性乳腺癌患者可能可跳过辅助化疗。
