男性乳腺癌11例临床病理分析并文献复习

Clinicopathologic analyses of 11 male breast cancers and review of the literature

目的：分析男性乳腺癌临床病理特点、分子亚型特点。方法：收集本院2010年1月到2014年12月的男性乳腺癌病例,回顾并分析其临床病理特点和分子亚型,并复习相关文献。结果：男性乳腺癌患者11例,占同期乳腺癌患者0.92%,男性乳腺癌就诊年龄38-80岁,中位年龄61岁,左侧7例,右侧4例。其中9例为浸润性导管癌,2例为囊内乳头状癌,其中1例伴浸润癌成分。组织学分级Ⅱ级9例。Ⅲ级2例。确诊时伴淋巴结转移4例。免疫组织化学染色：ER均阳性;9例PR阳性;1例送检两次标本HER2检测分别为＋＋,＋＋＋,FISH检测无扩增,余均为阴性（0/＋）;Ki-67高表达（≥20%）4例,低表达（〈20%）7例。分子表型4例为Luminal A型,7例为Luminal B型。结论：男性乳腺癌少见,发病年龄较晚,临床分期较高,预后较差,加强对其认识,争取早期诊断和治疗是非常重要的。

Objective： To analyze the clinicopathologic characteristics and molecular subtype in male breast cancer （MBC）. Methods： The clinical features, histological features and molecular subtype of the cases from January 2010 to December 2014 were analyzed, and the related literatures were reviewed. Results： Eleven patients were diagnosed with MBC, accounting for 0.92% of all the breast cancer in the same term. The median age was 61 （range from 38-80）. Tumor is located in left side in 7 cases, right side in 4 cases. Nine cases were diagnosed as invasive ductal carcinoma while the others were diagnosed as encapsulated papillary carcinoma with adjacent invasive carcinoma in one case. Four patients had lymphatic metastasis when the tumor was diagnosed. Immunohistochemically, ER was positive in all the cases, while PR was positive in 9 cases. In one case Her-2 was diagnosed as ＋% ＋＋＋ but FISH showed no amplification, and other cases Her-2 were diagnosed as 0 or 1＋. Four cases were Luminal A type, while 7 were Luminal B type. Conclusion： MBC is a rare malignant neoplasm, and most patients are diagnosed older and at advanced clinical stage. It is important for both doctors and patients to be fully aware of this tumor for early diagnosis and treatment.