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

Object : To investigate the clinical features,pathological features,treatment methods and prognostic factors of male breast cancer(MBC).Method:The clinical features,pathological features,treatment methods,and survival data of MBC patients admitted to First Affiliated Hospital of Nanchang University from May 1995 to April 2017 were retrospectively analyzed.Survival data of the collected patients were calculated using the Kaplan-Meier method,and the log-rank test(test level a=0.05)was used to investigate differences in survival.Result:In the 22 nd year of the first affiliated hospital of Nanchang University,31 cases of MBC were treated.These patients were aged 45-80 years old,18 cases were over 60 years old,and 13 cases were below the age of 60(median age = 67years).Clinical symptoms:Most of the first diagnosed symptoms are painless masses in the areola area.There were 4 patients with tumor diameter <2 cm,16 patients between 2-5CM,and 5 patients with >5 cm.There were 3 patients with the first diagnosis of nipple overflow or discharge,but a post areola mass was found during physical examination.3 cases patients with areola ulcers.Two patients were accompanied by pain and itching.In addition,6 patients had undergone surgery before entering our hospital and could not determine the size of the tumor.Among the 31 MBC patients,12 were pathologically diagnosed with MBC,but no further histopathologic classification was performed.Of the remaining 19 patients,14 were invasive ductal carcinoma,2 were carcinoma in situ,2 were mucinous adenocarcinoma,and infiltrated,Duct carcinoma with mucinous adenocarcinoma in 1case.Among the 31 patients,there were 17 patients with axillary lymph node metastases,13 patients with 1-3 axillary lymph node metastases,and 4 patients with >3 or more axillary lymph node metastases.Of the 31 patients,19 were performed ER/PR,18 were ER positive,and 18 were PR positive.18 cases were examined by Her-2,her-2(-,+,++)(her-2(++)patients who did not see amplification)in 14 patients,and 4 patients with her-2(+++).Among the 31 cases,15 cases wereexamined by Ki-67,of which 6 cases of less than 14%,9 cases of >14%.The 15 patients with known Ki-67 expression and Her-2 status were divided into the following types: Luminal A 5cases,LuminalB(Her-2(-))4 cases and LuminalB(Her-2(+))6 cases,and triple negative breast cancer 0 cases.Of the 31 patients,16 patients underwent modified radical mastectomy,6 patients underwent extended lumpectomy or simple mastectomy,1 patient underwent extended radical mastectomy,and 8 patients underwent no surgical treatment(4 of whom had distant disease.Metastasis,4 cases refused surgical treatment).There were 14 patients receiving adjuvant chemotherapy,13 patients receiving adjuvant endocrine therapy,and 6patients receiving postoperative adjuvant radiotherapy.The deadline for follow-up is April 15,2017.All follow-up information is fully recorded.During the follow-up period,4 people were lost.7 of them had recurrence or metastasis,of which 2 were locally recurrent,and 5 had distant metastasis.The shortest time for recurrence is 5 months after operation,the longest time is 46 months.The location of recurrence and metastasis is bone(2 cases),lung(2 cases)and liver(1cases).16 people died during the follow-up period,of which 11 patients died of breast cancer related diseases.Univariate analysis showed that Her-2(p=0.018<0.05)is closely associated with the overall survival time,Her-2(+ + +)indicates a worse prognosis.The high expression of Ki-67 may not be related to the prognosis of MBC(P=0.515).MBC postoperative radiotherapy may not affect the total survival time of MBC patients(p=0.167).Conclusion:The first symptoms of MBC usually is a lump or nipple discharge blood.The main pathological type of MBC was infiltrative ductal carcinoma,and the positive rate of ER and PR was high.The molecular typing is mainly LuminalA and Luminal B.At present,the treatment of MBC is mainly based on the treatment of FBC,mainly with surgery,adjuvant chemotherapy,endocrine therapy,targeted therapy,and radiotherapy.Her-2(+ + +)indicates a worse prognosis.The high expression of Ki-67 may not be related to the prognosis of MBC.MBC postoperative radiotherapy may have no effect on the total survival time of patients with MBC.