男性乳腺癌超声及临床病理学表现

Ultrasonic and clinico-pathological features of male breast cancer

目的观察男性乳腺癌超声及临床病理学表现。方法纳入30例男性乳腺癌患者,观察其超声及临床病理学表现;根据有无淋巴结转移分为阳性组和阴性组并进行比较。结果24例表现为单侧乳腺乳头周围无痛性肿物(24/30,80.00%),可伴腋下肿物、乳晕及周围皮肤红肿破溃或乳头溢液;病理类型以浸润性导管癌(IDC)为主(22/30,73.33%)。30例中,28例超声检出乳腺病灶(28/30,93.33%),多表现为形态不规则(25/28,89.29%)的低回声(24/28,85.71%)肿物,边缘多不光整(22/28,78.57%),内部回声多不均(22/28,78.57%),血流多较丰富,少见钙化(5/28,17.86%)或后方回声衰减(2/28,7.14%)。超声检出16例腋窝或锁骨上、下淋巴结肿大,均经病理证实为淋巴结转移(阳性组);12例未见淋巴结肿大(阴性组);组间仅乳腺肿物最大径差异有统计学意义(P<0.05)。雌激素受体(ER)和孕激素受体(PR)阳性率均为95.65%(22/23)。结论男性乳腺癌临床多表现为单侧乳腺乳头周围无痛性肿物;超声多呈形态不规则的低回声肿物,边缘多不光整,内部回声不均,血流多较丰富;病理类型以IDC为主,ER、PR阳性率高而人表皮生长因子受体2(HER-2)阳性率甚低,过半呈Ki-67高表达。

Objective To observe the ultrasonic and clinic-pathological features of male breast cancer.Methods A total of 30 male patients with breast cancer were enrolled,and the clinical,ultrasonic and pathological features were observed.According to the presence of metastatic lymph nodes,the patients were divided into positive group and negative group.Results Single painless palpable sub-areolar mass(24/30,80.00%)was the most common presentation of male breast cancer,others symptoms included axillary mass,areola and surrounding skin redness,swelling and rupture or nipple discharge.Invasive ductal carcinoma(IDC)was the main pathological type(22/30,73.33%).Ultrasound detected breast lesions in 28 cases(28/30,93.33%),most present as hypoechoic(24/28,85.71%)masses with irregular shape(25/28,89.29%),irregular edge(22/28,78.57%)and heterogeneous internal echo(22/28,78.57%),rare with calcification(5/28,17.86%)or posterior echo attenuation(2/28,7.14%).The blood flow of male breast cancer was rather abundant.Axillary or supraclavicular lymph node enlargement were detected in 16 cases and were pathologically confirmed as metastatic lymph nodes(positive group),while in 12 cases were not found(negative group).Only the maximum diameters of breast cancers were statistically different between groups(P<0.05).The positive rate of estrogen receptor(ER)and progesterone receptor(PR)was both 95.65%(22/23).Conclusion Most of male breast cancer present as painless mass around the unilateral breast papilla,with ultrasonic features of irregular hypoechoic masses with irregular edges,uneven internal echo and abundant blood flow.IDC was the main pathological type of male breast cancer,with high positive rate of ER and PR but rather low positive rate of human epidermal growth factor receptor-2(HER-2),while more than half with high expression of Ki-67.