Фактори прогнозу раку молочної залози у чоловіків

Abstract

168 consecutive male breast carcinomas were studied for size, category N, number of metastatic lymphonodes, histologic grade, histologic subtype, presence of carcinoma in situ, lymphovascular invasion, hormone receptor status. These findings were correlated with survival. Of the 168 carcinomas, 2 were noninvasive and 166 were invasive. In the invasive carcinomas, the median patient age was 56 years, and the median tumor size was 3,6 сm. The predominant histologic patterns were invasive ductal (45%) and mixed invasive ductal and cribriform (28%). Most tumors were of low histologic and nuclear grades (histologic grades: І, 21,5%; II, 53,7%; ІІІ, 15,7%). Of those surgically staged, 58 patients (51,3%) were lymph node positive and 55 patients ( 48, 7%) were node negative. Stage at presentation was higher than in women (0, І 0%; І, 17%; 2, 50%; З, І 3%; 4, 10%). The estrogen and progesterone receptor status was positive in 75% and 44% of tumors, respectively. Lymphatic vessel invasion (63%) was also more common than in women. True Paget's disease of the nipple was not seen; аІІ cases with nipple ulceration were the result of direct tumor extension to the epidermis. Survival analysis was limited bу the relatively small cohort size. Five- and І0-year adjusted overall survival rates for invasive tumors were 76 +/- 7% and 42 +/- 9%, respectively. Tumor size and number of metastatic lymphonodes involvement (Р < 0.05) and stage of disease (Р < 0.05) were significant predictors of adverse survival. Male breast carcinoma presents in an advanced stage with less favorable survival, despite low histologic grade, high estrogen receptor content, and small size. Anatomic factors may have been responsible for the poor survival outcome (і.е., paucity of breast tissue and close tumor proximity to skin and nipple, facilitating dermal lymphatic spread and early regional and distant metastasis).