男性乳腺癌40例临床分析

Male breast cancer: clinical analysis of 40 cases

目的探讨男性乳腺癌的发病特点、治疗方法和影响预后的因素。方法回顾性总结40例男性乳腺癌的临床特点及治疗方法。结果男性乳腺癌发病年龄偏晚,病程长,最常见的症状是无痛性的乳晕下肿块,确诊时腋淋巴结转移率为57.5%。ER(+)占85.7%,PR(+)占71.4%。术后辅以内分泌治疗、放疗和(或)化疗的患者5年生存率分别为70.6%和65.0%,与未行辅助治疗者5年生存率(22.0%)比较,差异有显著性。腋淋巴结阳性和阴性的患者5年生存率分别为43.5%和73.3%,二者比较差异亦有显著性。结论男性乳腺癌易发生腋淋巴结转移,预后差;且较女性患者的激素受体水平表达高。治疗上首选手术治疗,辅以内分泌治疗、放疗和(或)化疗能明显提高患者的生存率。腋淋巴结转移和术后积极的辅助治疗是影响预后的主要因素。

Objective To explore the clinical characteristics,treatment and factors effecting prognosis of male breast carcinoma, Method The clinical characteristics and treatment of 40 patients with male breast cancer were retrospectively reviewed. Results Onset of male breast cancer was at old age,course of disease was long. The most common symptom was painless subareolar lump. The axillary lymph node metastasis rate was 57.5% when diagnosed. 85.7% of male breast cancers expressed the estrogen receptor, and 71.4% expressed the progesterone receptor. 5-year overall survival rates were 70.6% and 65.0%, respec- tively,for the patients receiving hormonal therapy, radiation therapy and/or chemotherapy post-operatively and the differences were statistically significant as compared with the patients who did not receive adjuvant therapy（22.0% ）. 5-year overall survival rate were 43.5% and 73.3% ,respectively,for the patients with negative lymph node and positive node, the difference was also statistically significant. Conclusions Male breast cancer tends to involve axillary, lymph node, the prognosis was poorer and rate of hormone receptor ex- pression was higher than those in females. The treatment of first choice is operation. Patients who are treated with adjuvant hormonotherapy, radiotherapy and/or chemotherapy tend to have longer survival time. Lymph node involvement and post-operative systemic therapy are two important prognostic factors for male patients with breast cancer.