23例男性乳腺癌的发病特征及预后  

Characteristics and prognosis of 23 cases of male breast cancer

作　　者：魏洪亮[1] 肖晶晶 樊菁[1] WEI Hongliang;XIAO Jingjing;FAN Jing(Department of Thyroid-Breast-Vascular Surgery, Xijing Hospital, the Fourth Military Medical University, Xi＇an 710032, China)

机构地区：[1]第四军医大学西京医院甲状腺乳腺血管外科,西安710032

出　　处：《临床肿瘤学杂志》2018年第3期228-233,共6页Chinese Clinical Oncology

摘　　要：目的探讨男性乳腺癌的发病特征及治疗情况,并分析影响其预后的因素。方法回顾分析本院2006年8月至2015年7月收治的23例男性乳腺癌的发病特征、治疗情况及预后,并选取同一时期收治的女性乳腺癌患者113例作为对照。采用Kaplan-Meier法计算患者的生存率,生存差异行Log-rank检验。结果 23例男性乳腺癌患者的发病年龄为36~84岁,中位年龄60岁;肿块大小2～5 cm者占60.9%,淋巴结转移者占34.7%,临床分期主要集中在Ⅱ期,激素受体阳性比例为95.7%,HER-2阳性占13.0%,组织学分类以浸润性导管癌为主,52.2%合并其他系统性疾病。男性乳腺癌患者中,21例行乳腺癌改良根治术,17例接受化疗,6例接受放疗,54.5%激素受体阳性患者接受了内分泌治疗。23例男性乳腺癌患者的中位生存时间为80.8个月,5年生存率和5年无病生存率分别为86.0%和75.3%;女性乳腺癌患者的5年生存率、5年无病生存率分别为78.1%、73.2%,差异均无统计学意义(P>0.05)。单因素分析结果显示,腋窝淋巴结转移、临床分期以及是否进行内分泌治疗是影响男性乳腺癌患者的预后因素(P<0.05)。结论与女性乳腺癌相比,男性乳腺癌发病年龄较大、合并症多、分期较晚,乳腺癌改良根治术是广为接受的术式;化疗、放疗对预后的改善不明显;绝大多数男性乳腺癌为激素受体阳性,能够从辅助内分泌治疗中获益。Objective To investigate the characteristics,treatment and prognosis of male breast cancer,and to analyze the prognostic factors for male breast cancer. Methods A total of 23 cases of male breast cancer in our hospital from August 2006 to July2015 were analyzed retrospectively,113 cases of female breast cancer treated in the same period were selected as control. We evaluated the patient＇s clinical data and treatment,and followed up the patient. The Kaplan-Meier method was employed to estimate the survival rate,and the Log-rank test was adopted to compare the survival between two groups. Results In this study,for male breast cancer,the median age 60 years（36-84）,the tumor size ranged 2～5 cm accounted for 60. 9%,patients with lymph node metastasis accounted for 34. 7%,clinical stage was mainly in phase Ⅱ,hormone receptor positive proportion was 95. 7%,HER-2 positive rate was13. 0%. The histological classification was mainly invasive ductal carcinoma,and 52. 2% associated with other systemic diseases. In male breast cancer patients,21 cases were treated with modified radical mastectomy,17 received chemotherapy,6 received radiotherapy,and 54. 5% of the hormone receptor positive patients were treated with endocrine therapy. The 5-year survival rate and the 5-year disease-free survival rates in male breast cancer were 86. 0% and 75. 3% respectively. The 5-year and 5-year disease-free survival rates of female breast cancer were 78. 1% and 73. 2%,respectively. There was no statistical difference between the two groups（ P〈0. 05）. Univariate analysis indicated that the axillary lymph nodestatus,clinical stage and endocrine therapy significantly affected the prognosis of the male patients with breast cancer（ P〈0. 05）. Conclusion Compared with female breast cancer,male breast cancer are usually associated with advanced age,more complications and late stage. Modified radical mastectomy is a widely accepted procedure. Chemotherapy and radiotherapy can＇t significantly improve the prognosis. Most of male

关 键 词：乳腺癌 男性 内分泌治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]