Wick M R, Sayadi H, Ritter J H, Hill D A, Reddy V B, Gattuso P
Division of Surgical Pathology, Washington University Medical Center, St Louis, Missouri 63110, USA.
Am J Clin Pathol. 1999 Jan;111(1):59-69. doi: 10.1093/ajcp/111.1.59.
Male breast carcinoma (MBC) accounts for only 1% of total mammary carcinomas. Controversy exists about whether MBC differs clinically and pathologically from female breast carcinoma (FBC). We compared 10 archival cases with 75 stage-matched FBCs. Clinical data, histologic details, immunostains for mammary lineage markers, and results of several putative "prognostic" analyses were addressed, including DNA ploidy and expression of c-erbB-2 (neu) oncoprotein and p53 protein. Cumulative literature data on 2,530 MBCs were contrasted with information from 135 institutional cases of FBC. A statistically significant difference in grade 3 lesions at low stage persisted when MBCs of all stages were compared with similar FBCs. For stages I and IIA, 5-year survival was 60% and 86% for MBCs and FBCs, respectively (also statistically significant). This difference disappeared when all stages were compared. A similar number of MBCs and FBCs, regardless of stage, demonstrated DNA aneuploidy with or without synthesis of S-100 protein, gross cystic disease fluid protein-15, c-erbB-2 protein, and p53 protein. Hormone receptor positivity was more common in MBC than in FBC at high tumor stages. Low-stage MBC and FBC differ biologically; MBCs tend to manifest at a higher grade with lessened 5-year survival. However, aside from distinctions in hormone receptor proteins, broader comparison of MBC and FBC at stages IIB and higher shows no significant differences in 5-year survival or expression of breast cancer-associated gene products.
男性乳腺癌（MBC）仅占乳腺癌总数的1%。关于MBC在临床和病理上是否与女性乳腺癌（FBC）存在差异，目前存在争议。我们将10例存档病例与75例分期匹配的FBC进行了比较。研究涉及临床数据、组织学细节、乳腺谱系标志物的免疫染色，以及多项假定的“预后”分析结果，包括DNA倍体、c-erbB-2（neu）癌蛋白和p53蛋白的表达。将2530例MBC的累积文献数据与135例机构FBC病例的信息进行了对比。当将所有分期的MBC与相似分期的FBC进行比较时，低分期的3级病变存在统计学显著差异。对于I期和IIA期，MBC和FBC的5年生存率分别为60%和86%（也具有统计学显著性）。当比较所有分期时，这种差异消失。无论分期如何，MBC和FBC中显示DNA非整倍体且伴有或不伴有S-100蛋白、巨大囊肿病液体蛋白-15、c-erbB-2蛋白和p53蛋白合成的数量相似。在高肿瘤分期时，MBC中激素受体阳性比FBC更常见。低分期的MBC和FBC在生物学上存在差异；MBC往往表现为更高的分级，5年生存率降低。然而，除了激素受体蛋白的差异外，对IIB期及更高分期的MBC和FBC进行更广泛比较时，5年生存率或乳腺癌相关基因产物的表达没有显著差异。
