Guinee V F, Olsson H, Moller T, Shallenberger R C, van den Blink J W, Peter Z, Durand M, Dische S, Cleton F J, Zewuster R
Department of Patient Studies, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Cancer. 1993 Jan 1;71(1):154-61. doi: 10.1002/1097-0142(19930101)71:1<154::aid-cncr2820710125>3.0.co;2-#.
Because of the relative rarity of breast cancer in males, data have not been sufficient to support a definitive analysis of pertinent prognostic factors. Remarkably, no studies of male patients with breast cancer have presented survival information based on the number of histologically positive axillary nodes, the most sensitive single indicator of prognosis in women with breast cancer.
In this study, the clinical course of breast cancer was documented for 335 male patients registered from 1965 through 1986. For patients to be eligible, diagnoses had to be made within 3 months of registration and the patients had to have histologic confirmation and receive part or all of their initial treatment at 1 of 11 cancer centers participating in the International Patient Data Exchange System.
The survival rate at 10 years was 84% for patients with histologically negative nodes, 44% for those with one to three positive nodes, and 14% for the group with four or more histologically positive nodes. The survival rates at 5 years were 90%, 73%, and 55%, respectively. In a multivariable analysis, the risk of death due to breast cancer for a patient with four or more histologically positive nodes was 6.75 times that of a patient with negative nodes.
The findings of the authors indicate the following: (1) The number of histologically positive axillary nodes and, to a lesser degree, tumor diameter are significant prognostic factors for breast cancer in male patients. (2) The prognosis of breast cancer is the same in male and female patients when compared on the basis of the number of histologically positive nodes.
由于男性乳腺癌相对罕见，尚无足够数据支持对相关预后因素进行确定性分析。值得注意的是，尚无针对男性乳腺癌患者的研究基于腋窝淋巴结组织学阳性数目（这是女性乳腺癌预后最敏感的单一指标）给出生存信息。
本研究记录了1965年至1986年登记的335例男性乳腺癌患者的临床病程。符合条件的患者，诊断必须在登记后3个月内做出，且患者必须有组织学确诊，并在参与国际患者数据交换系统的11家癌症中心之一接受部分或全部初始治疗。
腋窝淋巴结组织学阴性的患者10年生存率为84%，1至3个阳性淋巴结的患者为44%，4个或更多组织学阳性淋巴结的患者为14%。5年生存率分别为90%、73%和55%。在多变量分析中，腋窝淋巴结组织学阳性数目为4个或更多的患者死于乳腺癌的风险是阴性患者的6.75倍。
作者的研究结果表明：（1）腋窝淋巴结组织学阳性数目以及在较小程度上肿瘤直径是男性乳腺癌患者的重要预后因素。（2）基于腋窝淋巴结组织学阳性数目进行比较时，男性和女性乳腺癌患者的预后相同。
