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.
Breast Cancer. 2022 Nov;29(6):985-992. doi: 10.1007/s12282-022-01378-6. Epub 2022 Jun 22.
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.
We investigated patients diagnosed with breast cancer in the Japanese National Clinical Database (NCD) between January 2012 and December 2018.
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.
Japanese MBC had an older age of onset, were more likely to be hormone receptor-positive disease, and received less perioperative chemotherapy than FBC.
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。
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。
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。
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。