| Background and Objective Male breast cancer is a rare malignant tumor,accounting for less than 1.0% of all breast cancers,which is much lower than female breast cancer.Similar to female breast cancer,it has been found that the incidence of male breast cancer has increased in recent years.Due to the low incidence of male breast cancer and scattered cases,it is difficult to carry out prospective control studies,so the diagnosis and treatment of male breast cancer mostly refer to the guidelines for postmenopausal women.There are many similarities in the pathological features of male and Postmenopausal women breast cancer,but male breast cancer also has many characteristics of its own.It has been reported abroad that there are some differences between male breast cancer patients and female breast cancer patients in the clinical characteristics such as age of onset and expression of sex hormone receptor.It is unreasonable to follow the treatment of female breast cancer completely.So the therapeutic effect of male breast cancer is not very ideal.Coupled with the lack of awareness of the risk of breast cancer,male breast cancer patients can not be diagnosed in time and delay the disease to a certain extent.At present,most of the studies about male breast cancer at home and abroad are small sample studies in the form of case reports and the therapeutic effect is poor and the research is insufficient.Therefore,it is urgent to conduct a large sample retrospective and prospective study in order to better guide clinical diagnosis and treatment and improve the therapeutic effect of patients.A large number of data have shown that there are significant regional differences in the incidence,lymph node metastasis and mortality of female breast cancer so far.There is a lack of related reports of male breast cancer due to rarity,but as far as Henan Province is concerned,Henan Province is a populous province,whose environment,diet,living habits and so on are quite different from other provinces,so the situation is more complex and severe.Therefore,the results of male breast cancer research based on Henan Province may be more valuable for the diagnosis and treatment of male breast cancer in Henan Province.But there is a relative lack of relevant data on male breast cancer in Henan Province.Therefore,focusing on Henan Province,this paper aimed to explore the differences of clinical features between male and female breast cancer patients in Henan Province.The factors affecting the prognosis of male invasive ductal carcinoma were analyzed in order to provide some reference value for the diagnosis and treatment of male breast cancer in Henan Province.Methods A total of 106 male breast cancer patients in Henan Province who met the inclusion and exclusion criteria in the first affiliated Hospital of Zhengzhou University from January 2000 to December 2019 were collected,including 98 cases of invasive ductal carcinoma.At the same time,1060 female breast cancer patients who met the inclusion and exclusion criteria were randomly selected from the breast cancer case database established by the Department of Breast surgery of the First Affiliated Hospital of Zhengzhou University.Our aim is to compare male breast cancer with female breast cancer patients and to explore the differences of clinical characteristics between them.The matched data of male and female breast cancer patients were matched by PSM’s method according to the proportion of 1:2.The matching conditions were age,histological type,tumor size,histological grade,TNM stage,ER status,PR status,Her-2 status and treatment information.There was no significant difference in clinicopathological variables between male and female breast cancer patients except gender,and then the total survival time was obtained by follow-up of matched female breast cancer patients.Our aim is to compare the survival difference between male breast cancer and female breast cancer.Using the statistics package SPSS 23.0(IBM Corp.),the prognostic factors of 98 male patients with invasive ductal carcinoma were analyzed.Cox proportional hazard model was used in univariate and multivariate analysis,and the risk ratio(HR)was calculated and analyzed.A p value <0.05 was considered statistically significant.Results A total of 1166 patients were included in this study,including 106 males and 1060 females.The data before PSM was used to compare the clinicopathological features of male and female patients with breast cancer without comparing the survival differences between the two groups.The PSM was used to match the male breast cancer with the female breast cancer at 1:2,so that there was no significant difference in clinicopathological variables except for gender.Then the survival differences between the two groups were compared.Before matching,the age of male patients was between 29 and 93 years old,and the median diagnostic age was 67 years old,while the age range of female patients was between 25 and 96 years old,and the median diagnostic age was 59 years old.Compared with female breast cancer patients,male breast cancer patients were older at onset(P<0.001);The proportion of invasive ductal carcinoma was higher(P< 0.001);The largest diameter of tumor between 2~5cm was more common(P < 0.001);The number of patients with TNM stage Ⅲ and IV stage was higher than that of female patients(P=0.040);There were more positive expressions of ER and PR(P=0.001;P=0.014).The proportion of Her-2 positive expression was lower (P=0.001).The proportion of Luminal type was larger and that of Her-2 overexpression type and triple negative type was lower(P<0.001).There was no significant difference in histological grade(P > 0.05).After matching,the total survival time of male breast cancer patients was 1~193 months,and the median survival time was 75 months.The total survival time of female breast cancer patients was 3~213 months,and the median survival time was 89 months.There was no significant difference in prognosis between male and female breast cancer patients after adjusting confounding factors(P>0.05).Univariate analysis of 98 patients with invasive ductal carcinoma showed that age,tumor size,TNM stage,ER,molecular classification,operation and chemotherapy were the factors affecting the prognosis of male patients with invasive ductal carcinoma.Multivariate analysis showed that age,TNM stage,molecular classification and chemotherapy were independent prognostic factors.Conclusions 1.Compared with female breast cancer patients,male breast cancer patients in Henan Province are older and more in advanced stage.The invasive ductal carcinoma is the main histopathological type;The largest diameter of tumor between 2~5cm is more common than female;The positive rate of ER and PR is higher;The negative expression of Her-2 is more common;The proportion of Luminal type is higher than that of female,and histological grading has no obvious difference with that of female breast cancer.After removing confounding factors,the prognosis is the same as that of female breast cancer.2.The age,TNM stage,molecular classification and chemotherapy are independent factors affecting the prognosis of patients with invasive ductal carcinoma in Henan Province.3.There are differences in clinical characteristics between male breast cancer and female breast cancer in Henan Province.The treatment of male breast cancer should not refer to female breast cancer guidelines completely.4.Early detection,early diagnosis,early treatment and regular reexamination are the key to improve the survival rate of male patients with breast cancer. |
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