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单中心经验下的男性乳腺癌:诊断、临床病理特征及治疗策略

Male breast cancer in a single-center experience: Diagnosis, clinicopathological features, and treatment strategies.

作者信息

Isik Deniz, Kinikoglu Oguzcan, Turkoglu Ezgi, Surmeli Heves, Buyukmurat Neslihan

机构信息

Department of Medical Oncology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkiye.

出版信息

North Clin Istanb. 2024 Oct 2;11(5):434-439. doi: 10.14744/nci.2024.32815. eCollection 2024.

Abstract

OBJECTIVE

Although breast cancer is the most common cancer type in women worldwide, it is a rare tumor in men, accounting for less than 1% of all male cancers. Therefore, the characteristics of the tumor, the management of the disease, and our overall survival data are quite limited.

METHODS

We retrospectively analyzed the data of 51 male patients diagnosed and treated for breast cancer, whose follow-up processes continue, at our hospital. We examined in detail the patients' age, comorbid diseases, history of concomitant malignancies, family history, stage of the disease, tumor size, lymph node status, estrogen receptor (ER)/progesterone receptor (PR) along with Human Epidermal Growth Factor Receptor-2 (HER-2) status. Additionally, we analyzed the type of surgery, history of radiotherapy, and chemotherapy and hormonal treatments in the adjuvant and metastatic periods.

RESULTS

In our study, where we determined a median survival time of 122 months (29-214), we found that the stage at diagnosis, Eastern Cooperative Oncology Group (ECOG) performance status, and discontinuation of adjuvant endocrine therapy significantly affected survival. While the median survival was not reached in stage 1 patients at diagnosis, the median survival times for stage 2, 3, and 4 patients were 118, 83, and 39 months, respectively. The differences between the groups were statistically significant (p=0.005). Similarly, the median survival was not reached for patients with an ECOG performance status of 0, but it was 84 months for those with a status of 1 and 98 months for those with a status of 2. The differences among these three groups were also statistically significant (p=0.001). The median survival was not reached for patients who completed adjuvant endocrine therapy, whereas it was 83 months for those who discontinued the therapy, with the difference being statistically significant (p=0.021). Besides these data, the presence of perineural invasion was found to be a factor close to statistical significance in terms of survival (p=0.066). Histological subgroups, grade, lymphovascular invasion, adjuvant chemotherapy, and Ki-67 were not significant parameters for survival.

CONCLUSION

Despite the differences in the stage at diagnosis, response to treatments, lower awareness of the disease, older age at diagnosis, and consequently, the increase in accompanying comorbid diseases, male breast cancer is managed according to studies and guideline recommendations for female breast cancer due to the lack of sufficient randomized studies. By presenting our clinical experience, we have emphasized the necessity for further studies in this field.

摘要

目的

尽管乳腺癌是全球女性中最常见的癌症类型,但在男性中却是一种罕见肿瘤,占所有男性癌症的比例不到1%。因此,肿瘤的特征、疾病的管理以及我们的总体生存数据相当有限。

方法

我们回顾性分析了我院51例诊断并接受乳腺癌治疗的男性患者的数据,这些患者的随访仍在继续。我们详细检查了患者的年龄、合并疾病、伴发恶性肿瘤病史、家族史、疾病分期、肿瘤大小、淋巴结状态、雌激素受体(ER)/孕激素受体(PR)以及人表皮生长因子受体2(HER-2)状态。此外,我们分析了手术类型、放疗史、辅助和转移期的化疗及激素治疗情况。

结果

在我们的研究中,我们确定中位生存时间为122个月(29 - 214个月),发现诊断时的分期、东部肿瘤协作组(ECOG)体能状态以及辅助内分泌治疗的中断对生存有显著影响。诊断时1期患者未达到中位生存时间,而2期、3期和4期患者的中位生存时间分别为118个月、83个月和39个月。组间差异具有统计学意义(p = 0.005)。同样,ECOG体能状态为0的患者未达到中位生存时间,而体能状态为1的患者为84个月,体能状态为2的患者为98个月。这三组之间的差异也具有统计学意义(p = 0.001)。完成辅助内分泌治疗的患者未达到中位生存时间,而中断治疗的患者为83个月,差异具有统计学意义(p = 0.021)。除了这些数据,发现神经周围浸润的存在在生存方面接近具有统计学意义(p = 0.066)。组织学亚组、分级、淋巴管浸润、辅助化疗和Ki-67不是生存的显著参数。

结论

尽管在诊断分期、对治疗的反应、对疾病的认识较低、诊断时年龄较大以及随之而来的伴发合并疾病增加等方面存在差异,但由于缺乏足够的随机研究,男性乳腺癌仍根据针对女性乳腺癌的研究和指南建议进行管理。通过展示我们的临床经验,我们强调了该领域进一步研究的必要性。

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