The Role of Radiation Therapy in Addition to Lumpectomy and Hormone Therapy in Men 70 Years of Age and Older with Early Breast Cancer: A NCDB Analysis.
The Role of Radiation Therapy in Addition to Lumpectomy and Hormone Therapy in Men 70 Years of Age and Older with Early Breast Cancer: A NCDB Analysis.
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DOI：
10.1245/s10434-020-09242-7
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发表时间：
2021-05
影响因子：
3.7
通讯作者：
Sauder CAM
中科院分区：
文献类型：
--
作者：
Bateni SB;Perry LM;Zhao X;Arora M;Daly ME;Stewart SL;Bold RJ;Canter RJ;Sauder CAM
目前男性乳腺癌的治疗指南是由仅女性试验指导的，尽管数据表明性别之间存在明显的临床病理差异。我们试图评估肿瘤切除术后放射治疗（RT）是否与年龄≥ 70岁的I期雌激素受体（ER）阳性肿瘤男性患者的等效生存率相关，如癌症和白血病组B（CALGB）9343试验中的女性患者。我们对2004-2014年国家癌症数据库中752例I期、ER阳性、年龄≥70岁、接受激素治疗和手术（有或无RT）的男性乳腺癌患者进行了回顾性分析。根据手术和RT对患者进行分类（单纯乳房肿瘤切除术、乳房肿瘤切除术+RT和单纯乳房切除术）。多变量考克斯比例风险回归分析用于比较治疗组之间的总生存期。大多数患者接受了全乳房切除术，只有32.6%的患者接受了乳房肿块切除术。在接受肿瘤切除术的患者中，72.7%接受了辅助RT。在多变量分析中，单纯肿瘤切除术与肿瘤切除术联合RT相比，总生存率无统计学差异（aHR 0.72 [95%CI 0.38-1.37]，p=0.31），或当比较乳房肿瘤切除术（单独或与RT）和乳房切除术时（aHR 1.28 [95%CI 0.88-1.87]，p=0.20）。在这个全国样本中，ER阳性早期疾病的老年男性接受内分泌治疗，当比较单独的乳房肿瘤切除术与乳房肿瘤切除术+RT或乳房肿瘤切除术（单独或+RT）与乳房切除术时，总生存率没有显著差异。这些结果表明，不太积极的治疗可能是适当的男性乳腺癌患者的子集。
Current treatment guidelines for male breast cancer are guided by female-only trials despite data suggesting distinct clinicopathologic differences between sexes. We sought to evaluate if radiation therapy (RT) after lumpectomy was associated with equivalent survival among men ≥ 70 years of age with stage I, estrogen receptor (ER) positive tumors, as seen in women from the Cancer and Leukemia Group B (CALGB) 9343 trial. We performed a retrospective analysis of 752 stage I, ER-positive male breast cancer patients ≥70 years who were treated with hormone therapy and surgery, with or without RT, from the National Cancer Database between 2004–2014. Patients were categorized based on surgery and RT (lumpectomy alone, lumpectomy with RT, and mastectomy alone). Multivariable Cox proportional hazards regression analysis was used to compare overall survival between treatment groups. Most patients underwent total mastectomy, with only 32.6% treated with lumpectomy. Of those who underwent lumpectomy, 72.7% received adjuvant RT. In multivariate analysis, there was no statistical difference in overall survival when comparing lumpectomy alone to lumpectomy with RT (aHR 0.72 [95%CI 0.38–1.37], p=0.31), or when comparing lumpectomy (alone or with RT) and mastectomy (aHR 1.28 [95%CI 0.88–1.87], p=0.20). In this national sample of elderly men with ER-positive early-stage disease treated with endocrine therapy, there were no significant differences in overall survival when comparing lumpectomy alone to lumpectomy with RT, or lumpectomy (alone or with RT) to mastectomy. These results suggest that less aggressive treatment may be appropriate for a subset of male breast cancer patients.
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影响因子：
3.7
作者：
Cloyd, Jordan M.;Hernandez-Boussard, Tina;Wapnir, Irene L.
通讯作者：
Wapnir, Irene L.
影响因子：
45.3
作者：
Fisher, B;Bryant, J;Wolmark, N
通讯作者：
Wolmark, N
影响因子：
8.4
作者：
Cutuli, B;Lacroze, M;Berlie, J
通讯作者：
Berlie, J
影响因子：
45.3
作者：
Korde, Larissa A.;Zujewski, Jo Anne;Cardoso, Fatima
通讯作者：
Cardoso, Fatima
影响因子：
45.3
作者：
Bilimoria, Karl Y.;Bentrem, David J.;Ko, Clifford Y.
通讯作者：
Ko, Clifford Y.