Clinical Analysis And Literature Review Of 31 Cases Of Male Breast Cancer

Objective (s):Investigate the characteristics, treatment and prognosis of male breast cancer.Methods:Collected the 31 cases of male breast cancer of Yunnan Province Tumor Hospital from 2006.3 -2016.3. and retrospective analysis of the clinical characteristics, treatment method and prognosis of the patients, and the log rank test (a = 0.05 level test) and Cox regression model analysis of male breast cancer patients survival prognosis and independent prognostic factors. Into the analysis of reference include:age, tumor size, pathological type, lymph node metastasis, clinical stage, estrogen receptor, progesterone receptor, epidermal growth factor receptor 2, surgery, adjuvant chemotherapy, auxiliary radiotherapy, adjuvant endocrine therapy.Results:male breast cancer have a low incidence.10 years collected a total of 31 cases, the minimum age of 34 years old, biggest 81 year old, average age was 63.4 years old, Oriental female breast cancer patients with an average age of 45 to 55 years old, reminds the male patients with onset age is higher than that of female patients. The majority of the breast lump initial visits, which two people with nipple discharge,two people with nipple areola and ulceration,two people,with pain,and itching.16 people had the tumor resection in local hospital of male patients of the first time in our hospital clinic. Most of the primary tumor in the nipple and areola,10 patients have the tumor diameter more than 2cm. Among them,24 were invasive ductal carcinoma.3 person were mucinous adenocarcinoma,1 person were mucinous adenocarcinoma with infiltrating ductal carcinoma,1 person were invasive ductal carcinoma with lobular carcinoma,2 people were diagnosised carcinoma in situ (intraductal papillary tumor in situ carcinoma, Pagets disease), Tumor differentiation is characterized by low and medium differentiation. Axillary lymph node metastasis occurred in 11 people,25 people hormone receptor were positive,29 with ER positive and 5 with PR negative,20 HER2 negative patients, only 1 human patients with triple negative, because HER2 (2) in the majority of patients with loss of FISH detection and Ki-67, Therefore, it is impossible for all patients to luminal typing.31 patients in our hospital,24 underwent modified radical mastectomy, radical resection for 2 people,1 people mastectomy,2 people only mass resection,2 people without surgery.20 patients receiving chemotherapy,18 people have endocrine therapy, and 12 people had received chemotherapy and endocrine therapy at the same time,4 people had the radiotherapy after the postoperative. The 5 years overall survival rate of 31 patients was 88% and the5 years disease free survival rate was 78%. Because there are too few patients to be able to carry on the stage, therefore, it is unable to carry on the 5 year survival rate and the 5 year disease-free survival rate of the patients with different pathological stages of the specific analysis. During the follow-up period,5 were lost to follow-up, recurrence or metastasis occurred in 8, which 2 local recurrence,1 local recurrence combined with lung metastasis, shortest time of recurrence after operation may,7 years after surgery for the elderly, another 5 occurred distant metastasis, time after treatment for 1 month to 8 years, transfer including the main parts of the lungs (5 cases), bone (2 cases), brain (1 case). Univariate analysis showed that endocrine therapy (p< 0.05) is closely related with the survival time of patients, improve the prognosis of the patients. In addition, axillary lymph node metastasis (p< 0.05), progesterone receptor (p< 0.05), surgery (p < 0.05) and the patients with disease free survival are closely related, they are prognostic factors in patients with the disease free survival, but not the prognostic factors of overall survival. On univariate analysis are significant variables were evaluated by Cox regression analysis. The results show that Above factors are not affect male patients with breast cancer were independent prognostic factors for disease-free survival rate and Overall survival rate.In addition, because patients with different surgical methods, the patients with different surgical methods were analyzed, which showed no significant difference in modified radical mastectomy and radical surgery, and the rest of the operation because the number of patients is too small, can not be further analyzed.Conclusion(s):31 cases of male patients with breast tumor was the first most symptoms, most patients with tumors located in the areola area.It maybe relateto Patients with small breast, gland tissue is less, and which are mainly concentrated in the areola area. Infiltrating ductal carcinoma is the most common pathological type, ER, PR has a higher positive rate. For HER2 (2) are not detected by FISH, so not all of the known results. HER2 in the known results of the patients, with a high negative rate. Endocrine therapy and overall survival were closely related, significantly improve the prognosis of the patients. Patients with the disease free survival rate is closely correlated with axillary lymph node metastasis, progesterone receptor, way of operation.Effect of patients without disease the prognostic factors of survival is endocrine therapy,4 kinds of factors above are not affect prognosis independent factors. Currently on treatment for male breast cancer more according to the female breast cancer patients treated with standard, Mainly take a comprehensive treatment, including surgery, radiotherapy and chemotherapy, target to therapy and endocrine therapy. Tips received adjuvant systemic therapy (chemotherapy, endocrine therapy of male patients have a more significant survival advantage. Remember that in obtaining tumor tissue to improve the ER, PR, HER2, Ki-67, in guide subsequent endocrine and target to the treatment, there is significant.