Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China.
BMC Cancer. 2021 May 8;21(1):523. doi: 10.1186/s12885-021-08267-9.
The purpose of this study was to explore clinicalpathology features, molecular features and outcome of male breast cancer patients who expressed ER, PR as well as HER-2, namely triple-positive male breast cancer (TP-MBC), and compared them with triple-positive female breast cancer patients (TP-FBC).
TP-MBC and TP-FBC from 2010 to 2017 were selected from the Surveillance, Epidemiology, and End Results database (SEER). Kaplan-Meier plotter and multivariable Cox regression model were applied to analyse the difference between TP-MBC and TP-FBC on cancer-specific survival (CSS) and overall survival (OS). Propensity score matched (PSM) analysis was used to ensure well-balanced characteristics. 7 cases TP-MBC and 174 cases TP-FBC patients with the genomic and clinical information were identified from the cohort of The Cancer Genome Atlas (TCGA) and the Memorial Sloan Kettering (MSK).
336 TP-MBC and 33,339 TP-FBC patients were taken into the study. The percentages of TP-MBC in MBC patients were higher than the rates of TP-FBC in FBC patients from 2010 to 2017 except 2012. Compared with TP-FBC, more TP-MBC were staged III (17.9% vs. 13.5%) or stage IV (11.0% vs. 6.9%). TP-MBC were more frequently to be older than 65-years-old (47.0% vs. 29.3%), Balck (15.2% vs. 10.8%), ductal carcinoma (91.7% vs. 84.4%) and metastases to lung (4.5% vs. 2.1%) or bone (8.6% vs. 4.7%). TP-MBC had worse OS and CSS than TP-FBC in all stages (P < 0.001). In multivariable prediction model of TPBC, male patients had a higher risk than female. Lastly, the worse OS (P < 0.001) and CSS (P = 0.013) were seen in the 1:3 PSM analysis between TP-MBC and TP-FBC. Genomic analysis revealed that TP-MBCs have some notable rare mutations, like ERBB2, ERBB3, RB1, CDK12, FGFR2, IDH1, AGO2, GATA3, and some of them are not discovered in TP-FBC.
TP-MBC had a worse survival than TP-FBC, and there were different genomic features between two groups. Current knowledge and treatment to TP-MBC maybe inadequate and remain to be explored.
本研究旨在探讨表达 ER、PR 及 HER-2 的男性乳腺癌患者（即三阳性男性乳腺癌，TP-MBC）的临床病理特征、分子特征和预后，并将其与三阳性女性乳腺癌患者（TP-FBC）进行比较。
从监测、流行病学和最终结果数据库（SEER）中选择 2010 年至 2017 年的 TP-MBC 和 TP-FBC。应用 Kaplan-Meier 绘图器和多变量 Cox 回归模型分析 TP-MBC 和 TP-FBC 在癌症特异性生存（CSS）和总生存（OS）方面的差异。采用倾向评分匹配（PSM）分析以确保特征均衡。从癌症基因组图谱（TCGA）和纪念斯隆凯特琳癌症中心（MSK）的队列中鉴定出 7 例 TP-MBC 和 174 例 TP-FBC 患者，这些患者具有基因组和临床信息。
研究纳入了 336 例 TP-MBC 和 33339 例 TP-FBC 患者。除 2012 年外，2010 年至 2017 年，MBC 患者中 TP-MBC 的比例高于 FBC 患者中 TP-FBC 的比例。与 TP-FBC 相比，更多的 TP-MBC 分期为 III 期（17.9% vs. 13.5%）或 IV 期（11.0% vs. 6.9%）。TP-MBC 更常发生在 65 岁以上（47.0% vs. 29.3%）、黑人（15.2% vs. 10.8%）、导管癌（91.7% vs. 84.4%）和肺转移（4.5% vs. 2.1%）或骨转移（8.6% vs. 4.7%）。在所有分期中，TP-MBC 的 OS 和 CSS 均较 TP-FBC 差（P<0.001）。在 TPBC 的多变量预测模型中，男性患者的风险高于女性。最后，在 TP-MBC 和 TP-FBC 之间进行 1:3 PSM 分析时，OS（P<0.001）和 CSS（P=0.013）均较差。基因组分析显示，TP-MBC 存在一些明显的罕见突变，如 ERBB2、ERBB3、RB1、CDK12、FGFR2、IDH1、AGO2、GATA3 等，其中一些在 TP-FBC 中并未发现。
TP-MBC 的生存情况较 TP-FBC 差，两组之间存在不同的基因组特征。目前对 TP-MBC 的认识和治疗可能不足，有待进一步探索。
