Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy.
Division of Breast Radiology, IRCSS, IEO European Institute of Oncology, 20141, Milan, Italy.
Breast Cancer Res Treat. 2024 Nov;208(1):29-40. doi: 10.1007/s10549-024-07380-0. Epub 2024 Jun 19.
To offer an extensive retrospective experience on the management of male breast cancer.
A multicenter retrospective observational cohort study was conducted, including male patients diagnosed with breast cancer (invasive or in situ) in 12 Italian breast units from January 1975 to December 2019. Patients aged 18 years or older were assessed for eligibility. Exclusion criteria were metastatic cancer at diagnosis, previous cancer(s), received neoadjuvant treatment, incomplete data on (neo) adjuvant treatment(s), and/or follow-up data. Data on radiological examinations, demographic characteristics, risk factors, histological features, receptor status, treatments, and follow-up were collected.
In a series of 671 male patients with breast cancer assessed for eligibility, 403 (28 in situ and 375 invasive neoplasms) were included in the study. All included patients underwent surgery. The median age at surgery was 63.8 years (IQR 56.1-72.1). In 68% of cases, patients underwent echography, and in 55.1%, a mammography. Most patients were ER and PR positive (63.8%), HER2 negative (80.4%), with high (≥ 20%) Ki67 values (61.3%), and luminal B subtype (51.1%). The 10-year overall survival was 73.6% (95% CI 67.0-79.1) for invasive breast cancer and 90% (95% CI 65.6-97.4) for in situ breast cancer. In patients with invasive breast cancer, at univariable analysis, having a G3 tumor (vs. G1), pT2/3/4 (vs. pT1), pN2/3 (vs. pN0), luminal B subtype with Ki67 ≥ 20% (vs. Luminal A), were significantly associated with a higher risk of death. In multivariable analyses, pT2/3/4 (vs. pT1) remained significantly associated with a higher risk of death (HR 3.14, 95% CI 1.83-5.39), and having a HER2 positive or a triple-negative subtype (vs. Luminal A) was also significantly associated with a higher risk of mortality (HR 4.76, 95% CI 1.26-18.1).
Male breast cancer is a rare disease, the better understanding of which is necessary for a more effective diagnostic and therapeutic approach.
提供对男性乳腺癌管理的广泛回顾性经验。
进行了一项多中心回顾性观察队列研究，纳入了 12 个意大利乳房单位从 1975 年 1 月至 2019 年 12 月期间诊断为乳腺癌（浸润性或原位）的男性患者。评估了年龄在 18 岁或以上的患者的资格。排除标准为诊断时转移性癌症、既往癌症、接受新辅助治疗、（新）辅助治疗数据不完整和/或随访数据不完整。收集了影像学检查、人口统计学特征、危险因素、组织学特征、受体状态、治疗和随访的数据。
在对 671 名符合条件的男性乳腺癌患者进行评估后，有 403 名（28 例原位和 375 例浸润性肿瘤）纳入了研究。所有纳入的患者均接受了手术。手术时的中位年龄为 63.8 岁（IQR 56.1-72.1）。在 68%的病例中，患者接受了超声检查，在 55.1%的病例中，接受了乳房 X 线摄影术。大多数患者的 ER 和 PR 阳性（63.8%），HER2 阴性（80.4%），Ki67 值较高（≥20%）（61.3%），并且为 luminal B 亚型（51.1%）。浸润性乳腺癌的 10 年总生存率为 73.6%（95%CI 67.0-79.1），原位乳腺癌为 90%（95%CI 65.6-97.4）。在浸润性乳腺癌患者中，单变量分析显示，G3 肿瘤（vs.G1）、pT2/3/4（vs.pT1）、pN2/3（vs.pN0）、Ki67≥20%的 luminal B 亚型（vs.luminal A）与更高的死亡风险显著相关。多变量分析显示，pT2/3/4（vs.pT1）仍与更高的死亡风险显著相关（HR 3.14，95%CI 1.83-5.39），HER2 阳性或三阴性亚型（vs.luminal A）也与更高的死亡率显著相关（HR 4.76，95%CI 1.26-18.1）。
男性乳腺癌是一种罕见的疾病，需要更深入地了解，以便采取更有效的诊断和治疗方法。
