Castaneda Carlos A, Castillo Miluska, Bernabe Luis A, Sanchez Joselyn, Torres Ebert, Suarez Nancy, Tello Katherine, Fuentes Hugo, Dunstan Jorge, De La Cruz Miguel, Cotrina Jose Manuel, Abugattas Julio, Guerra Henry, Gomez Henry L
Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15067, Peru.
Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
World J Clin Oncol. 2021 Oct 24;12(10):926-934. doi: 10.5306/wjco.v12.i10.926.
Breast cancer (BC) frequency in males is extremely low and tumor features vary from its female counterpart. Breast cancer clinical and pathological features differ by race in women. Tumor infiltrating lymphocyte (TIL) levels, mismatch repair (MMR) protein loss, androgen receptor (AR) expression, and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC. There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC.
To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population.
This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018. Standard pathological features, TIL levels, MMR proteins, AR immunohistochemistry staining, and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material. Percentage of AR and estrogen receptor (ER) positive cells was additionally calculated by software after slide scanning. Statistical analyses included association tests, intraclass correlation test and Kaplan Meier overall survival curves.
The median age was 63 years and most cases were ER-positive (85.7%), HER2 negative (87.2%), Luminal-A phenotype (60%) and clinical stage II (41.5%) among our male breast tumors. Median TIL was 10% and higher levels tended to be associated with Luminal-B phenotype and higher grade. AR-positive was found in 85.3% and was correlated with ER (intraclass index of 0.835, < 0.001). Loss of MMR proteins was found in 15.4% and PIK3CA mutation (H1047R) in 14.3% (belonged to the Luminal-A phenotype). Loss of MMR proteins was associated with AR-negative ( = 0.018) but not with ER ( = 0.43) or TIL ( = 0.84). Early stages ( < 0.001) and lower grade ( = 0.006) were associated with longer overall survival. ER status, phenotype, AR status, TIL level, MMR protein loss nor PIK3CA mutation was not associated with survival ( > 0.05).
Male BC is usually ER and AR positive, and Luminal-A. MMR loss and PIK3CA mutations are infrequent. Stage and grade predicted overall survival in our South American country population.
男性乳腺癌（BC）的发病率极低，其肿瘤特征与女性乳腺癌不同。女性乳腺癌的临床和病理特征因种族而异。肿瘤浸润淋巴细胞（TIL）水平、错配修复（MMR）蛋白缺失、雄激素受体（AR）表达和PIK3CA基因突变是女性乳腺癌生物治疗反应的预测生物标志物。关于非白种人男性BC的临床和病理特征以及预测生物标志物的信息有限。
研究秘鲁男性BC肿瘤的临床病理特征、生物标志物及其预后价值。
本研究观察了2004年1月至2018年6月在单一机构诊断的54例秘鲁浸润性BC男性患者。对有可用石蜡材料的病例前瞻性评估标准病理特征、TIL水平、MMR蛋白、AR免疫组化染色和PIK3CA基因突变。玻片扫描后通过软件额外计算AR和雌激素受体（ER）阳性细胞的百分比。统计分析包括关联检验、组内相关检验和Kaplan-Meier总生存曲线。
我们的男性乳腺肿瘤中位年龄为63岁，大多数病例为ER阳性（85.7%）、HER2阴性（87.2%）、Luminal-A表型（60%）和临床II期（41.5%）。中位TIL为10%，较高水平往往与Luminal-B表型和更高分级相关。85.3%的病例AR阳性，且与ER相关（组内指数为0.835，P<0.001）。15.4%的病例存在MMR蛋白缺失，14.3%的病例存在PIK3CA突变（H1047R）（属于Luminal-A表型）。MMR蛋白缺失与AR阴性相关（P=0.018），但与ER（P=0.43）或TIL（P=0.84）无关。早期（P<0.001）和低分级（P=0.006）与更长的总生存期相关。ER状态、表型、AR状态、TIL水平、MMR蛋白缺失和PIK3CA突变均与生存无关（P>0.05）。
男性BC通常为ER和AR阳性，且为Luminal-A型。MMR缺失和PIK3CA突变不常见。在我们这个南美国家人群中，分期和分级可预测总生存期。
