15例男性乳腺癌患者临床特征及生存分析

Clinical features and survival analysis of 15 male breast cancer patients

目的探讨男性乳腺癌患者的临床特征、影响因素及生存情况。方法回顾性分析南京市江宁医院2002-01—2016-12间收治的15例男性乳腺癌患者的临床及回访资料,采用Kaplan-Meier模型分析男性乳腺癌生存情况。结果本组60岁以上患者有10例(66. 7%),60岁以下的有5例(33. 3%)。1例以腋窝肿块就诊,14例以乳房肿块就诊。60%肿块位于乳晕区。浸润性导管癌有14例(93. 3%),乳头状癌1例(16. 67%)。TNMⅠ～Ⅳ期的患者分别为4例、5例、5例和1例。15例患者激素受体均为阳性,其中分子分型为Luminal A型的7例(46. 7%)、Luminal B型8例(53. 3%)。14例患者接受了手术治疗(93. 3%),其中改良乳腺癌根治术12例(85. 8%)、1例行全乳切除加前哨淋巴结活检术,1例行传统乳腺癌根治术。术后11例实施化疗,7例给予放疗,所有患者均接受内分泌治疗。随访期间术前有肺转移的患者死于术后1. 5 a。接受乳腺癌根治术的患者出现复发和转移而死亡;其余患者中,共有5例复发,4例转移(其中2例死亡);还有2例死于原发性肺癌。结论男性乳腺癌患者发病年龄较晚,肿块多位于乳晕区,病理类型多为浸润性导管癌,淋巴结转移率较高,激素受体阳性者占绝大多数。手术为主要治疗方法,其中以改良乳腺癌根治术最为多见。内分泌治疗标准与女性乳腺癌相似。

Objective To explore the clinical features, influencing factors and survival of male breast cancer patients.Methods Retrospective analysis of clinical and follow-up data of 15 male breast cancer patients admitted to jiangning hospital in Nanjing from 2002 to 2016. Kaplan-meier model was used to analyze the survival of male breast cancer.Results In this group, 10 patients （66.7%） were more than 60 years old, and 5 patients （33.3%） were less than 60 years old. 14 patients come to hospital because of breast lump, while 1 patient come because of axillary lump. Most breast lumps （60%） were located around nipple areola region. Pathology analysis showed that 14 patients （93.3%） were invasive ductal carcinoma, 1 patient （16.67%） was papillary carcinoma. The number of TNM stage I to IV were 4, 5, 5 and 1, respectively. All patients were hormone receptor positive. 7 patients （46.7%） were Luminal A, 8 patients （53.3%） were Luminal B. Totally, 14 patients （93.3%） received surgery, among which 12 patients （85.8%） received modified radical mastectomy, 1 patient received mastectomy plus sentinel lymph node biopsy, and the other patient received radical mastectomy. After operation, 11 patients received chemotherapy, 7 patients received radiotherapy. All patients received endocrine therapy. During follow-up, 1 patient who diagnosed as breast cancer with lung metastasis, died 1.5 years after diagnosis. One patient who received radical mastectomy relapsed and died of metastasis. In the rest of patients, 5 patients relapsed, 4 developed distant metastasis （2 patients died）, and 2 other patients died of primary lung cancer.Conclusion Male breast cancer developed in elder age, and the lumps were mostly located near nipple areola. Infiltrating ductal carcinoma were more common. These patients have a higher rate of lymph node metastases, as well as a higher rate of positive hormone receptor. Operation was necessary, in which modified radical mastectomy were commonly used. Standard endocrine therapy of male breast cancer was similar to breast cancer of female.