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埃及男性乳腺癌:患者的激素概况、治疗及疗效

Egyptian male breast carcinoma: patients' hormonal profile, management and outcome

摘要Objective: Male breast cancer (MBC) represents < 1% of all breast cancers. Hormone receptors and Her-2/neu status are established prognostic factors in female breast cancer but not yet studied enough in male breast cancer. The aim of the study was to verify the clinico-pathologic profile of male patients with breast cancer including analysis of hormone receptors and Her-2/neu state and its impact on survival rate. Methods: This is a retrospective study carried on a total of 123 male patients presented to the National Cancer Institute (NCI), Cairo University, Egypt - with breast carcinoma from January 1999 to December 2009. Results: The patients had a median age of 58 (ranged from 29-92) years. About 39.8% of the patients presented with T4 lesion. At presentation, 12.2% of the cases had metastasis with bone represented 86.7% of metastatic sites. About 92.7% of patients were subjected to modified radical mastectomy and radical mastectomy. Invasive duct carcinoma reported in 91.1%, and 76.4% of the patients had grade II pathology. Hormone profile was reported in 74% of the patients with 71.4% positive ER and 69.2% positive PR. Among 57 cases tested for Her-2/neu, 10.5% were positive. Luminal A was the most common subtype detected in male breast carcinoma patients constituting 66.7%. Comparison with female patients with breast carcinoma revealed some differences regarding stage, hormone profile, Her-2/neu status and breast cancer subtypes. Chemotherapy as adjuvant, neo-adjuvant and metastatic was given for 73.1%, 17.3% and 9.6% of the cases, with 83% of them had an anthracyclin-containing regimen. Sixty-nine patients received radiation treatment, 65.2% and 34.8% of them with adjuvant and palliative aim, respectively. Dose of adjuvant radiotherapy had a median value of 4410 (3400-5000) cGy. Adjuvant hormonal treatment (Tamoxafin) was given for 47 patients all of them with ER and/or PR positive for a median period of 33.5 (4-60) months. The 5-year overall survival (OS), loco-regional control (LRC), metastasis-free survival (MFS) rates were 63%, 68%, and 62%, respectively. Axillary lymph node metastasis and advanced tumor stage significantly worsen all survival rates. While, higher grade was associated with a poor overall survival, this was not reflected on LRC and MFS rates. Adjuvant radiotherapy and chemotherapy had significantly improved all survival rates. Conclusion: Some gender differences were detected regarding stage, hormone profile, Her-2 state, and tumor subtypes.

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分类号 R73
栏目名称 Original Articles
DOI 10.1007/s10330-011-0918-0
发布时间 2012-02-24
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