T1-T2 男性乳腺癌手术和生存趋势：国家癌症数据库研究。
Trends in surgery and survival for T1-T2 male breast cancer: A study from the National Cancer Database.
机构信息
Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Research in Surgical Outcomes and Effectiveness (UH-RISES), USA.
Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
出版信息
Am J Surg. 2023 Jan;225(1):75-83. doi: 10.1016/j.amjsurg.2022.09.043. Epub 2022 Sep 25.
BACKGROUND
Despite evidence that early-stage male breast cancer (MBC) can be treated the same as in females, we hypothesized that men undergo more extensive surgery.
METHODS
Patients with clinical T1-2 breast cancer were identified in the National Cancer Database 2004-2016. Trends in surgery type and overall survival were compared between sexes.
RESULTS
Of 9,782 males and 1,078,105 females, most were cN0 with AJCC stage I/II disease. Unilateral mastectomy was most common in men (67.1% vs. 24.1%, p < 0.001) and partial mastectomy in women (64.7% vs. 26.4%, p < 0.001), with no significant change over time. Over 1/3 of men received ALND in 2016. While overall survival was superior in females (HR 0.83, 95% CI 0.73-0.94, p = 0.003), partial mastectomy was associated with a 42% reduction in mortality risk for males (HR 0.58, 95% CI 0.4-0.8, p = 0.003).
CONCLUSIONS
De-escalation of surgery could be considered for MBC to improve survival and align with current standards of care.
背景
尽管有证据表明早期男性乳腺癌（MBC）可以与女性一样进行治疗，但我们假设男性会接受更广泛的手术。
方法
在 2004 年至 2016 年的国家癌症数据库中确定了临床 T1-2 期乳腺癌患者。比较了男女之间手术类型和总体生存率的趋势。
结果
在 9782 名男性和 1078105 名女性中，大多数患者为 cN0 期且 AJCC 分期为 I/II 期疾病。单侧乳房切除术在男性中最为常见（67.1% vs. 24.1%，p<0.001），部分乳房切除术在女性中最为常见（64.7% vs. 26.4%，p<0.001），且随着时间的推移没有明显变化。超过 1/3 的男性在 2016 年接受了 ALND。尽管女性的总体生存率更高（HR 0.83，95%CI 0.73-0.94，p=0.003），但部分乳房切除术可使男性的死亡率降低 42%（HR 0.58，95%CI 0.4-0.8，p=0.003）。
结论
可以考虑对 MBC 进行手术降级，以提高生存率并与当前的护理标准保持一致。
Zotero 插件