男性乳腺癌患者的临床病理分析及预后
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摘要
目的:探讨男性乳腺癌的发病特征及治疗情况,并分析其预后。方法:收集十堰市太和医院自2008年1月至2018年1月收治的10例男性乳腺癌患者的临床资料,分析其临床病理特征、远处转移率和5年生存率。结果:⑴10例男性乳腺癌患者的发病年龄为39～84岁,中位年龄为61.5岁;全部以乳腺肿物为首发症状,50%肿物位于乳晕区;⑵浸润性导管癌占70%,ER、PR、HER-2阳性率分别为100%、100%、25%;⑶2例行单纯乳腺肿块切除术,4例行乳腺癌改良根治术,3例行根治术,1例行单纯乳房切除术,5例接受化疗,4例接受放疗;⑷5年生存率为55.6%,其中Ⅰ期100%,Ⅱ期66.7%,Ⅲ期50%;各有33.3%、75%的患者出现局部复发和转移。结论:中国男性乳腺癌以无痛性乳晕区肿块为最常见的首发症状,病理类型多为浸润性导管癌,ER、PR阳性率高而HER-2阳性率低,治疗多以手术为主,配合放疗、化疗、内分泌治疗的综合治疗,预后较差。
Objective To explore the characteristics and treatment of male breast cancer,and to analyze its prognosis. Methods The clinical data of 10 male breast cancer patients admitted to Shiyan Taihe Hospital from January 2008 to January2018 were collected,and their clinicopathological features,distant metastasis rate and 5-year survival rate were analyzed.Results ⑴ The onset age of 10 male breast cancer patients ranged from 39 to 84 years old,with a median age of 61. 5 years. All the patients had breast tumor as the first symptom,and 50% of them were in the areola area. ⑵Invasive ductal carcinoma accounted for 70%,and the positive rates of ER,PR and Her-2 were 100%,100% and 25% respectively. ⑶2 patients were treated with simple lumpectomy,4 with modified radical mastectomy,3 with radical mastectomy,1 with simple mastectomy,5 with chemotherapy,4 with radiotherapy. ⑷the 5-year survival rate was 55.6%,including 100% in stageⅠ,66.7% in stage Ⅱ,50% in stage Ⅲ. The local recurrence and metastasis rate in stage Ⅱ and III were 33.3% and 75%respectively. Conclusion The most common first symptom of male breast cancer in China is the painless areolar mass. The pathological type is mostly invasive ductal carcinoma. ER and PR positive rates are high and HER-2 positive rates are low.Surgery is the main treatment combined with radiotherapy,chemotherapy and endocrine therapy. The prognosis is poor.
Objective To explore the characteristics and treatment of male breast cancer,and to analyze its prognosis. Methods The clinical data of 10 male breast cancer patients admitted to Shiyan Taihe Hospital from January 2008 to January2018 were collected,and their clinicopathological features,distant metastasis rate and 5-year survival rate were analyzed.Results ⑴ The onset age of 10 male breast cancer patients ranged from 39 to 84 years old,with a median age of 61. 5 years. All the patients had breast tumor as the first symptom,and 50% of them were in the areola area. ⑵Invasive ductal carcinoma accounted for 70%,and the positive rates of ER,PR and Her-2 were 100%,100% and 25% respectively. ⑶2 patients were treated with simple lumpectomy,4 with modified radical mastectomy,3 with radical mastectomy,1 with simple mastectomy,5 with chemotherapy,4 with radiotherapy. ⑷the 5-year survival rate was 55.6%,including 100% in stageⅠ,66.7% in stage Ⅱ,50% in stage Ⅲ. The local recurrence and metastasis rate in stage Ⅱ and III were 33.3% and 75%respectively. Conclusion The most common first symptom of male breast cancer in China is the painless areolar mass. The pathological type is mostly invasive ductal carcinoma. ER and PR positive rates are high and HER-2 positive rates are low.Surgery is the main treatment combined with radiotherapy,chemotherapy and endocrine therapy. The prognosis is poor.
引文
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[14] Senger JL,Adams ST,Kanthan R.Invasive lobular carcinoma of the male breast-a systematic review with an illustrative case study[J]. Breast Cancer(Dove Med Press),2017(9):337-345.
[15] Elmi M,Sequeira S,Azin A,et al. Evolving surgical treatment decisions for male breast cancer:an analysis of the National Surgical Quality Improvement Program(NSQIP)database[J].Breast Cancer Res Treat,2018,171(2):427-434.
[16] Ottini L. Male breast cancer:a rare disease that might uncover underlying pathways of breast cancer[J]. Nat Rev Cancer,2014,14(10):643.
[17] Eggemann H,Ignatov A,Smith BJ,et al.Adjuvant therapy with tamoxifen compared to aromatase inhibitors for257 male breast cancer patients[J]. Breast Cancer Res Treat,2013,137(2):465-470.
[18]周菲菲.影响男性乳腺癌预后的多因素分析:单中心72例临床资料总结[J].癌症,2010,29(2):196-201.
[19] Yu E,Suzuki H,Younus J,et al. The impact of postmastectomy radiation therapy on male breast cancer patients-a case series[J]. Int J Radiat Oncol Biol Phys,2012,82(2):696-700.
[2] Deb S,Jene N,Kconfab Investigators,et al. Genotypic and phenotypic analysis of familial male breast cancer shows under representation of the HER2 and basal subtypes in BRCA-associated carcinomas[J]. BMC Cancer,2012,12(1):510.
[3] Fouad TM,Barrera AMG,Reuben JM,et al.Inflammatory breast cancer:a proposed conceptual shift in the UICC-AJCC TNM staging system[J]. Lancet Oncol,2017(4):e228-e232.
[4] Doyen J,Italiano A,Largillier R,et al.Aromatase inhibition in male breast cancer patients:biological and clinical implications[J].Ann Oncol,2010,21(6):1 243.
[5] Vitkovski T,Marder GS,Filardi DA,et al.IgG4-related sclerosing disease of the breast in a male patient[J].Int J Surg Pathol,2017,25(8):711-715.
[6] Brinton LA,Cook MB,Mccormack V,et al. Anthropometric and hormonal risk factors for male breast cancer pooling project results[J]. Natl Cancer Inst,2014,106(5):117.
[7] Ruddy KJ,Winer EP.Male breast cancer:risk factors,biology,diagnosis,treatment,and survivorship[J]. Ann Oncol,2013,24(6):1 434-1 443.
[8] Taber KAJ,Morisy LR,Osbahr AJ,et al. Male breast cancer:risk factors,diagnosis and management(Review)[J].Oncol Rep,2010,24(5):1 115-1 120.
[9] Sousa B,Moser E,Cardoso F.An update on male breast cancer and future directions for research and treatment[J].Eur J Pharmacol,2013,717(1-3):71-83.
[10] Serdy KM,Leone JP,Dabbs DJ,et al.Male Breast Cancer[J].Am J Clin Pathol,2017,147(1):110-119.
[11] Weigelt B,Geyer FC,Reis-Filho JS.Histological types of breast cancer:how special are they?[J].Mol Oncol,2010,4(3):192-208.
[12] Leone JP,Leone J,Zwenger AO,et al.Prognostic significance of tumor subtypes in male breast cancer:a population-based study[J].Breast Cancer Res Treat,2015,152(3):601-609.
[13]郑克义,冯正勇,龚志涛,等.男性乳腺癌9例治疗体会[J].湖北医药学院学报,2015,34(5):483-485.
[14] Senger JL,Adams ST,Kanthan R.Invasive lobular carcinoma of the male breast-a systematic review with an illustrative case study[J]. Breast Cancer(Dove Med Press),2017(9):337-345.
[15] Elmi M,Sequeira S,Azin A,et al. Evolving surgical treatment decisions for male breast cancer:an analysis of the National Surgical Quality Improvement Program(NSQIP)database[J].Breast Cancer Res Treat,2018,171(2):427-434.
[16] Ottini L. Male breast cancer:a rare disease that might uncover underlying pathways of breast cancer[J]. Nat Rev Cancer,2014,14(10):643.
[17] Eggemann H,Ignatov A,Smith BJ,et al.Adjuvant therapy with tamoxifen compared to aromatase inhibitors for257 male breast cancer patients[J]. Breast Cancer Res Treat,2013,137(2):465-470.
[18]周菲菲.影响男性乳腺癌预后的多因素分析:单中心72例临床资料总结[J].癌症,2010,29(2):196-201.
[19] Yu E,Suzuki H,Younus J,et al. The impact of postmastectomy radiation therapy on male breast cancer patients-a case series[J]. Int J Radiat Oncol Biol Phys,2012,82(2):696-700.
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