男性乳腺癌临床特征及诊治：附35例报告

背景与目的 男性乳腺癌是一种非常罕见的疾病，一般确诊时分期较晚，预后差。目前其治疗上多参照女性乳腺癌。笔者通过对男性乳腺癌的病例的回顾分析，探讨该病临床特点及诊治。方法 回顾分析大连医科大学附属第二医院于2003年3月—2019年6月收治的35例男性乳腺癌患者的临床特点、病理特征、治疗及随访情况。结果 全组患者就诊时均无远处转移，中位年龄65岁，主要临床表现为无痛性乳房肿块，所有患者均接受了手术治疗，仅2例（5.7%）患者接受了部分乳腺切除术，其余均接受全乳房切除术或更大范围的手术。18例（51.4%）接受了辅助化疗，4例（11.4%）接受了辅助放疗，17例（48.6%）接受了辅助内分泌治疗。30例（85.7%）术后病理诊断为浸润性导管癌。全组均获得随访，5年总生存率83.4%。结论 加强对男性乳腺癌的认识，做到早期诊断，并进行以手术为主的综合治疗非常重要。男性乳腺癌的诊治仍有待进一步研究和规范。

Clinical features and diagnosis and treatment of male breast cancer: a report of 35 cases

Background and Aims Male breast cancer is a considerably rare disease, and usually diagnosed at an advanced stage with a dismal prognosis. Currently, its treatment generally follows that for female breast cancer. Here, the authors discuss the clinical characteristics as well as the diagnosis and treatment of this disease through a retrospective analysis of male breast cancer cases.Methods The clinical features, pathological manifestations, treatment and follow-up of 35 male breast cancer patients admitted in the Second Affiliated Hospital of Dalian Medical University from March 2003 to June 2019 were retrospectively analyzed.Results In the entire group of patients, no distant metastasis was found at admission, the median age was 65 years, and the main clinical manifestation was painless breast mass. All patients received surgical treatment. Only two patients (5.7%) had partial mastectomy, and the remaining cases underwent total mastectomy or more extensive surgery. Eighteen patients (51.4%) received adjuvant chemotherapy, 4 patients (11.4%) received adjuvant radiotherapy, and 17 patients (48.6%) received adjuvant endocrine therapy. Thirty cases (85.7%) were pathologically diagnosed as invasive ductal carcinoma. Follow-up was obtained in all patients, and the 5-year overall survival rate was 83.4%.Conclusion Strengthening the knowledge about male breast cancer, so as to achieve early diagnosis and perform comprehensive treatment based on surgery is particularly important. The diagnosis and treatment of this disease still need further improved and standardized.