| Objective: Breast Male breast cancer is infrequence disease. Now treatments of breast cancer are based on the molecular classification is widely applied on female breast cancer. At present, the association between molecular classification of MBC(male breast cancer) or clinical characteristics and prognosis is unclear. So, in this study, we focused on whether different molecular classification and clinical characteristics of MBC(male breast cancer) could influence prognosis or not.Methods:57 MBC patients was followed in this retrospective study from October 2000 to October 2015 at breast cancer center of the Fourth Hospital of Hebei Medical University(China). Follow-up contents included age, size of tumor, pathological classification, histological grades, TNM stages, blood vessel invasion, lymphatic metastasis, molecular classification, disease-free survival(DFS), overall survival(OS). The Kaplan-Meier test and long-rank was used to analyze statistical difference between different groups, such as the disease-free survival between sporadic breast cancer patients and healthy controls. P value under 0.05 was considered statistically significant. As to Multi factor analysis, Forward stepwise Cox proportional hazard model was used to compare the differences(P value of < 0.05 was considered statistically significant.). All of the statistical analysis was done with the SPSS version19.0 software package(SPSS Company, Chicago, IL).Results:1 General 1 clinical characteristics: 57 of all 59 the followed-up male patients' follow-up information was complete. All the patients had ipsilateral breast carcinoma and had surgical operation. Age ranged from 31 to 93. The median age and average age was 62 and 61 respectively. They were divided into three different groups. First group was patients who was 44 or under 44 years old which had 5 patients(8.77%). Second group was patients whose age ranged from 45 to 59, which had 19 patients(33.33%). Third group is patients who was up 60 years old(include 60 years old), which had 33 patients(57.90%). Tumor pT stage : pT1(?2cm), 33 patients(57.89%); pT2(>2, ?5cm), 21 patients(36.84%), pT3+pT4(>5cm or skin invasion), 3 patients(5.26%). Tumor pathological classification: there were 48 invasive ductal carcinomas(84.21%) and 9 other type carcinomas(15.79%). Molecular classification: Luminal A type, 19 patients(33.33%);Luminal B type, 36 patients(63.15%); HER-2 overexpression, 1 patient(1.75%), triple-negative, 1patient(1.75%). There were 14 patients(24.56%) who had blood vessel invasion and 43 patients(75.44%) who did not had blood vessel invasion. As to post surgery histopathology grades, there were 1 patient of grade?(1.75%), 42 patients of grade?(73.68%) and 14 patients of grade ?(24.56%). 31 patients(54.39%) had no lymphatic metastasis and 15 patients had 1-3 metastatic lymph nodes. 7(12.28%)patients had 4-9 metastatic lymph nodes while 4 patients(7.02%) had up to 10 metastatic lymph nodes. TNM stages: 17 patients of stage?(29.83%), and 26 patients of stage?(45.61%) while 14 patients of stage ?(24.56%). 6 of 57 patients had SLNB(sentinel lymph node biopsy excision of breast and the others had modified radical mastectomy. No patients had neoadjuvant chemotherapy and all patients who had metastatic lymph nodes accepted radiotherapy and according to immunohistochemistry, patients whose ER or PR receptor is positive accepted endocrine therapy but molecular targeted therapy did not work as a parameter in this study.2 following-up results: by the end of October 2015, 59 patients were followed-up and 2 of them were lost to follow-up. The median follow-up time was 46 months(Follow-up rate was 96.61%). At the endpoint, 43 of 57 patients were disease free and 14 of them had local recurrence or distant metastasis and 11 patients died because of breast cancer.3.1 DFS and clinical pathology3.1.1 By using long-rank text, different age groups and DFS had no statistically significant(X~2=3.229, P =0.199). DFS of first group(?44 years old) was 10-101 months and second group(45~59 years old) was 5-127 months and third group(?60 years old) was 2-136 months. Median follow-up time were 30, 40, 42 months respectively.3.1.2 By using long-rank text, different tumor pT stage groups and DFS had statistically significant(X~2=12.107, P =0.002). DFS of first group(pT1) was 3-136 months and second group(pT2) was 2-127 months and third group(pT3+ pT4) was18-61 months. Median follow-up time were 42, 32, 44 months respectively.3.1.3 By using long-rank text, different tumor histological grading groups and DFS had no statistically significant(X~2=3.864, P =0.145). DFS of first group(I grade) was 101 months and second group(II grade) was 3-136 months and third group(III grade) was 2-69 months. Median follow-up time were 101, 41, 31 months respectively.3.1.4 By using long-rank text, different lymphatic metastasis groups and DFS had statistically significant(X~2=17.630, P =0.001). DFS of first group(number of metastatic lymph nodes = 0) was 42 months and second group(number of metastatic lymph nodes: 1-3) was 6-136 months and third group(number of metastatic lymph nodes: 4-9) was 18-50 months and forth group(number of metastatic lymph nodes ? 10) was 2-29 months. Median follow-up time were 42, 51, 33, 11.5 months respectively.3.1.5 By using long-rank text, different blood vessel invasion groups and DFS had no statistically significant(X~2=2.463, P=0.117). DFS of first group(no blood vessel invasion) was 3-136 months and second group(blood vessel invasion) was 2-75 months. Median follow-up time were 28, 44 months respectively.3.1.6 By using long-rank text, different molecular classification groups and DFS had no statistically significant(X~2=4.464, P=0.035). DFS of first group(Luminal A) was 6-136 months and second group( not Luminal A) was 3 DFS?OS and clinical pathology(K-M text) 2-92 months. Median follow-up time were 65, 34.5 months respectively.3.1.7 By using long-rank text, different pathology groups and DFS had no statistically significant(X~2=2.495, P=0.114). DFS of first group(invasive ductal carcinomas) was 2-136 months and second group(other type of carcinomas) was 3-113 months. Median follow-up time were38, 67 months respectively.3.1.8 By using long-rank text, different TNM stage groups and DFS had statistically significant(X~2=14.155, P=0.001). DFS of first group(I stage) was 3-101 months and second group(II stage) was 6-136 months and third group(III stage)was 2-113 months. Median follow-up time were 46, 43, 31 months respectively.3.2 OS and clinical pathology3.2.1 By using long-rank text, different age groups and OS had no statistically significant(X~2=3.722, P =0.155). OS of first group(?44 years old) was 25-101 months and second group(45~59 years old) was 5-127 months and third group(?60 years old) was 2-136 months. Median follow-up time were 60, 55, 46 months respectively.3.2.2 By using long-rank text, different tumor pT stage groups and OS had statistically significant(X~2=8.604,P=0.014). OS of first group(pT1) was 3-136 months and second group(pT2) was 2-127 months and third group(pT3+ pT4) was46-61 months. Median follow-up time were 50, 39, 60 months respectively.3.2.3 By using long-rank text, different tumor histological grading groups and OS had no statistically significant(X~2=3.667, P=0.160). OS of first group(I grade) was 101 months and second group(II grade) was 3-136 months and third group(III grade) was 2-72 months. Median follow-up time were 101, 46.5, 48 months respectively.3.2.4 By using long-rank text, different lymphatic metastasis groups and OS had statistically significant(X~2=14.242, P=0.003). OS of first group(number of metastatic lymph nodes = 0) was 3-127 months and second group(number of metastatic lymph nodes:1-3) was 6-136 months and third group(number of metastatic lymph nodes :4-9) was 19-69 months and forth group(number of metastatic lymph nodes ? 10) was 2-50 months. Median follow-up time were 50, 59, 46, 19 months respectively.3.2.5 By using long-rank text, different blood vessel invasion groups and OS had no statistically significant(X~2=2.594, P =0.107). OS of first group(no blood vessel invasion) was 3-136 months and second group(blood vessel invasion) was 2-75 months. Median follow-up time were 51, 37.5 months respectively.3.2.6 By using long-rank text, different molecular classification groups and OS had no statistically significant(X~2=5.356, P=0.020). OS of first group(Luminal A) was 6-136 months and second group( not Luminal A) was 2-92 months. Median follow-up time were 67, 44.5 months respectively.3.2.7 By using long-rank text, different pathology groups and OS had no statistically significant(X~2=2.812, P =0.094). OS of first group(invasive ductal carcinomas) was 2-136 months and second group(other type of carcinomas) was 3-113 months. Median follow-up time were 48, 67 months respectively.3.2.8 By using long-rank text, different TNM stage groups and OS had statistically significant(X~2=11.510, P=0.003). OS of first group(I stage) was 3-101 months and second group(II stage) was 6-136 months and third group(III stage)was 2-113 months. Median follow-up time were 51.5, 43, 48 months respectively.4 DFS?OS and clinical pathology(Cox multi factor analysis)Size of tumor, number of metastatic lymph nodes, molecular classification, TNM stage were not independent risk factor of DFS and OS(P>0.05).Conclusion:1 Size of tumor, number of metastatic lymph nodes, molecular classification, TNM stage are associated with DFS of male breast cancer.2 Size of tumor, number of metastatic lymph nodes, molecular classification, TNM stage are associated with OS of male breast cancer.3 Size of tumor, number of metastatic lymph nodes, molecular classification, TNM stage were not independent risk factor of DFS and OS. |
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