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日本全国注册数据库中男性乳腺癌患者的临床病理特征。

Clinicopathological features of male patients with breast cancer based on a nationwide registry database in Japan.

机构信息

Department of Breast and Medical Oncology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

Department of Breast and Endocrine Surgery, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan.

出版信息

Breast Cancer. 2022 Nov;29(6):985-992. doi: 10.1007/s12282-022-01378-6. Epub 2022 Jun 22.

Abstract

BACKGROUND

Male breast cancer (MBC) is rare; however, its incidence is increasing. There have been no large-scale reports on the clinicopathological characteristics of MBC in Japan.

METHODS

We investigated patients diagnosed with breast cancer in the Japanese National Clinical Database (NCD) between January 2012 and December 2018.

RESULTS

A total of 594,316 cases of breast cancer, including 3780 MBC (0.6%) and 590,536 female breast cancer (FBC) (99.4%), were evaluated. The median age at MBC and FBC diagnosis was 71 (45-86, 5-95%) and 60 years (39-83) (p < 0.001), respectively. MBC cases had a higher clinical stage than FBC cases: 7.4 vs. 13.3% stage 0, 37.2 vs. 44.3% stage I, 25.6 vs. 23.9% stage IIA, 8.8 vs. 8.4% stage IIB, 1.9 vs. 2.4% stage IIIA, 10.1 vs. 3.3% stage IIIB, and 1.1 vs. 1.3% stage IIIC (p < 0.001). Breast-conserving surgery was more frequent in FBC (14.6 vs. 46.7%, p = 0.02). Axillary lymph node dissection was more frequent in MBC cases (32.9 vs. 25.2%, p < 0.001). Estrogen receptor(ER)-positive disease was observed in 95.6% of MBC and 85.3% of FBC cases (p < 0.001). The HER2-positive disease rates were 9.5% and 15.7%, respectively (p < 0.001). Comorbidities were more frequent in MBC (57.3 vs. 32.8%) (p < 0.001). Chemotherapy was less common in MBC, while endocrine therapy use was similar in ER-positive MBC and FBC. Perioperative radiation therapy was performed in 14.3% and 44.3% of cases.

CONCLUSION

Japanese MBC had an older age of onset, were more likely to be hormone receptor-positive disease, and received less perioperative chemotherapy than FBC.

摘要

背景

男性乳腺癌(MBC)较为罕见,但发病率呈上升趋势。目前尚无日本 MBC 临床病理特征的大规模报告。

方法

我们调查了 2012 年 1 月至 2018 年 12 月期间在日本国家临床数据库(NCD)中诊断为乳腺癌的患者。

结果

共评估了 594316 例乳腺癌病例,其中包括 3780 例 MBC(0.6%)和 590536 例女性乳腺癌(FBC)(99.4%)。MBC 和 FBC 诊断的中位年龄分别为 71 岁(45-86 岁,5-95 岁)和 60 岁(39-83 岁)(p<0.001)。MBC 病例的临床分期高于 FBC 病例:0 期为 7.4%比 13.3%,I 期为 37.2%比 44.3%,IIA 期为 25.6%比 23.9%,IIB 期为 8.8%比 8.4%,IIIA 期为 1.9%比 2.4%,IIIB 期为 10.1%比 3.3%,IIIC 期为 1.1%比 1.3%(p<0.001)。FBC 中保乳手术更为常见(14.6%比 46.7%,p=0.02)。MBC 病例腋窝淋巴结清扫更为常见(32.9%比 25.2%,p<0.001)。MBC 中雌激素受体(ER)阳性疾病占 95.6%,FBC 中占 85.3%(p<0.001)。HER2 阳性疾病率分别为 9.5%和 15.7%(p<0.001)。MBC 中合并症更为常见(57.3%比 32.8%)(p<0.001)。MBC 中化疗较少,而 ER 阳性 MBC 和 FBC 中内分泌治疗的使用相似。围手术期放疗在 14.3%和 44.3%的病例中进行。

结论

日本 MBC 的发病年龄较大,更可能为激素受体阳性疾病,且围手术期化疗少于 FBC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e246/9587939/4aa832e7d147/12282_2022_1378_Fig1_HTML.jpg

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