Male Breast Cancer in Hong Kong: 15-Year Experience from a Tertiary Institution
JCH Chow, RKC Ngan
Hong Kong J Radiol 2015;18:119-24
DOI: 10.12809/hkjr1515320
Objective: Male breast cancer (MBC) is a rare disease entity and few data are available for the Chinese population. This study aimed to report MBC data from a single institution in Hong Kong to supplement existing evidence of this disease in our local population.
Methods: Patients with histologically confirmed MBC treated between July 1997 and February 2012 were retrospectively identified from an institutional patient database. Clinical, pathological, treatment, and survival data were collected and subsequently analysed.
Results: Within the captioned period, 52 cases of MBC were identified. The median age was 63 years, with evenly distributed tumour laterality. The majority of patients had invasive ductal carcinoma (84.6%), most of which were histologically grade II (50.0%). Almost all patients demonstrated hormone receptor positivity (oestrogen receptor–positive 98.0%, progesterone receptor–positive 96.0%), and HER2 amplification rate was 25.0%. Patients tended to present at an early stage of disease: approximately 85% presented as a T1 or T2 tumour, and 56.1% had axillary nodal involvement. Surgery with curative intent was performed in 48 patients, with 13 (27.1%) received adjuvant chemotherapy, and 35 (72.9%) underwent adjuvant radiotherapy. Almost all hormone receptor–positive patients received adjuvant tamoxifen. The median time to tamoxifen discontinuation was 60 months (range, 2-61 months). Discontinuation rate before 60 months was 15.9%. For those who underwent radical surgery, none developed loco-regional recurrence, and 5- and 10-year disease-free survival was 89.6% and 85.1%, respectively. The median overall survival for the entire population was 14.3 years.
Conclusion: Our single-institutional data indicate that a good long-term survival outcome can be achieved in MBC following a treatment protocol similar to that established for females with breast cancer. Prospective data will be helpful to further evaluate optimal treatment strategies as well as treatment tolerance for MBC in the Asian population.
中文摘要
香港的男性乳腺癌：一所提供第三層醫療服務的醫院的15年經驗
周重行、顏繼昌
目的：男性乳腺癌是一種罕見的疾病，華籍人口中有關男性乳腺癌的數據廖廖可數。本研究通過報導本港一所醫療機構中男性乳腺癌的數據，旨在加深瞭解本地人口中此症的現況。
方法：回顧研究數據資料庫中於1997年7月至2012年2月期間經組織學證實患有乳腺癌的男性病例。收集和分析患者的臨床、病理、治療和生存數據。
結果：研究期間共有52例男性乳腺癌。患者平均年齡63歲，左右兩邊的腫瘤病例數量相若。大多數病例為浸潤性導管癌（84.6%），其中又以組織學II級居多（50.0%）。幾乎所有患者屬激素受體陽性（ER+ 98.0%，PR+ 96.0%），HER2擴增率為25.0%。患者多在疾病早期階段接受治療：約85%的病例屬T1或T2腫瘤，56.1%的患者腋窩淋巴結受累。48例接受了根治性手術，13例（27.1%）接受了輔助化療，35例（72.9%）接受了輔助放療。幾乎所有激素受體陽性的患者接受了他莫昔芬輔助治療。他莫昔芬停藥時間的中位時間為60個月（介乎2-61個月）。60個月前停藥的比率為15.9%。接受根治性手術的患者中無局部復發的病例，其5年和10年無病生存率分別為89.6%和85.1%。所有患者的總生存中位時間為14.3年。
結論：這單一機構的數據表明，根據針對女性乳腺癌的類似治療方案來處理男性乳腺癌能得到良好的長期生存結果。前瞻性數據將有助進一步評估亞洲男性乳腺癌的最佳治療策略及耐受性。