Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Center for Breast Cancer, National Cancer Center, Goyang, Korea.
Cancer Res Treat. 2023 Jan;55(1):123-135. doi: 10.4143/crt.2021.1561. Epub 2022 Mar 24.
The treatment of male breast cancer (MBC) has been extrapolated from female breast cancer (FBC) because of its rarity despite their different clinicopathologic characteristics. We aimed to investigate the distribution of intrinsic subtypes based on immunohistochemistry, their clinical impact, and treatment pattern in clinical practice through a multicenter study in Korea.
We retrospectively analyzed clinical data of 248 MBC patients from 18 institutions across the country from January 1995 to July 2016.
The median age of MBC patients was 63 years (range, 25 to 102 years). Among 148 intrinsic subtype classified patients, 61 (41.2%), 44 (29.7%), 29 (19.5%), and 14 (9.5%) were luminal A, luminal B, human epidermal growth factor receptor 2, and triple-negative breast cancer, respectively. Luminal A subtype showed trends for superior survival compared to other subtypes. Most hormone receptor-positive patients (166 patients, 82.6%) received adjuvant endocrine treatment. Five-year completion of adjuvant endocrine treatment was associated with superior disease-free survival (DFS) in patients classified with an intrinsic subtype (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.04 to 0.49; p=0.002) and in all patients (HR, 0.16; 95% CI, 0.05 to 0.54; p=0.003).
Distribution of subtypes of MBC was similar to FBC and luminal type A was most common. Overall survival tended to be improved for luminal A subtype, although there was no statistical significance. Completion of adjuvant endocrine treatment was associated with prolonged DFS in intrinsic subtype classified patients. MBC patients tended to receive less treatment. MBC patients should receive standard treatment according to guidelines as FBC patients.
尽管男性乳腺癌（MBC）和女性乳腺癌（FBC）具有不同的临床病理特征，但由于其发病率较低，MBC 的治疗方法一直是从 FBC 中推断出来的。我们旨在通过在韩国的一项多中心研究，调查基于免疫组织化学的内在亚型分布、它们的临床影响以及在临床实践中的治疗模式。
我们回顾性分析了 1995 年 1 月至 2016 年 7 月期间全国 18 个机构的 248 例 MBC 患者的临床数据。
MBC 患者的中位年龄为 63 岁（范围为 25 至 102 岁）。在 148 例按内在亚型分类的患者中，61 例（41.2%）、44 例（29.7%）、29 例（19.5%）和 14 例（9.5%）分别为 luminal A、luminal B、人表皮生长因子受体 2 和三阴性乳腺癌。Luminal A 亚型的生存趋势优于其他亚型。大多数激素受体阳性患者（166 例，82.6%）接受了辅助内分泌治疗。按内在亚型分类的患者（风险比[HR]，0.15；95%置信区间[CI]，0.04 至 0.49；p=0.002）和所有患者（HR，0.16；95%CI，0.05 至 0.54；p=0.003）接受辅助内分泌治疗的 5 年完成率与无病生存（DFS）相关。
MBC 的亚型分布与 FBC 相似，Luminal A 型最常见。尽管没有统计学意义，但 luminal A 型的总体生存趋势有所改善。完成辅助内分泌治疗与内在亚型分类患者的 DFS 延长相关。MBC 患者的治疗倾向于较少。MBC 患者应根据指南接受标准治疗，如同 FBC 患者一样。
