Understanding Male Breast Cancer in the Community Setting.
Journal of clinical oncology(2011)
摘要
e16526 Background: Male breast cancer (BC) affects <1% of the male population and accounts for <1% of the breast cancer cases diagnosed in the United States annually. An estimated 1,970 male patients were diagnosed in 2010, with 390 dying. Although male and female breast cancer patients share disease characteristics, they differ in stage at diagnosis and hormone receptor status, therefore, initial treatment choices. Limited research has been conducted due to the rarity of the disease. Methods: Male patients with invasive and noninvasive BC identified within the US Oncology iKnowMed (iKM) database between January 2006 and January 2010 were included. Patterns of diagnosis and treatment were characterized by the median age; distribution of stage and grade; estrogen receptor (ER), progesterone receptor (PR), HER2neu status; and treatment characteristics of the neoadjuvant and adjuvant chemotherapy prescribed. Results: Of the 146 patients identified within the iKM database, the median age at diagnosis was 62 years. The distribution by stage was 15% stage I, 29% IIa, 13% IIb, 7% IIIa, 9% IIIb, 5% IIIc, and 16% IV, with 6% of patients missing staging information. Consistent with published literature, hormone receptor positivity was higher than seen in women; 88% ER+, 72% PR+, but Her2neu status was lower; only 10% positive. The majority of patients with early-stage disease received neoadjuvant/adjuvant therapy: 71% stage I, 60% Ia, 69% IIa, 63% IIb, 80% IIIa, 77% IIIb, 75% IIIc, and 13% stage IV. Conclusions: In our study, the median age at diagnosis was 62 years, which is less than the previously characterized age of 67. Similar to other studies, the overwhelming majority of patients were positive for ER, and Her2neu amplification was lower than among women. While the majority of patients (54%) presented with stage I and II disease, a high percentage of patients had advanced-stage disease. Chemotherapy utilization was high among all stages of disease. (Jemal A, et al. CA Cancer J Clin 2010;60: 277-300; Giordano SH, et al. Cancer 2004;101: 51-57; Gomez-Raposo et al. Cancer Treat Rev 2010;36: 451-457; Korde LA, et al. JCO 2010;28: 2114-2122.)
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