Ductal carcinoma in situ of the male breast. Analysis of 31 cases
Ductal carcinoma in situ of the male breast. Analysis of 31 cases
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DOI：
10.1016/s0959-8049(96)00436-4
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发表时间：
1997-01-01
影响因子：
8.4
通讯作者：
Velten, M
中科院分区：
文献类型：
--
作者：
Cutuli, B;Dilhuydy, JM;Velten, M
从1970年至1992年，31纯导管原位癌（DCIS）的男性乳腺癌治疗在19个法国地区癌症中心进行了审查。它们占同期男性治疗的所有乳腺癌的5%。中位年龄为58岁，但6例患者年龄小于40岁。TNM分类（UICC，1978）显示12例T0（仅通过血性乳头溢液发现），10例T1，5例T2和4例未分类肿瘤（Tx）。11例患者（35.5%）有临床男性乳房发育症，3例（10%）有乳腺癌家族史。乳腺肿块切除术6例，乳房切除术25例。19例行腋窝淋巴结清扫术。术后放疗6例。31处病变中有15处属于乳头状亚型，单纯或与筛状成分相关。12个测量病灶的大小从3到45 mm不等。所有淋巴结取样均为阴性。中位随访时间为83个月，4例患者（13%）分别在12、27、36和55个月时出现局部复发（LR）。其中3例患者最初接受了乳房肿瘤切除术。在1例病例中，LR仍在原位，但在其他3例病例中已浸润。3例进行了根治性挽救手术，但1例患者发生转移，30个月后死亡。最后一名患者接受了多次局部切除和他莫昔芬治疗。1例43岁患者发生对侧DCIS，另外3例发生异时性癌症。男性乳腺癌的病因和危险因素仍然未知。男性乳房发育，这意味着雄激素和雌激素之间的失衡，可能是一个诱发因素。与女性一样，男性乳腺DCIS预后良好。治疗方法以全乳切除术为主，不做腋窝淋巴结清扫。通常，第一个症状是血性乳头分泌物。发生的年龄比浸润性癌年轻，这表明DCIS是乳腺癌发展的第一步。(C)1997年爱思唯尔科学有限公司
From 1970 to 1992, 31 pure ductal carcinoma in situ (DCIS) of the male breast treated in 19 French Regional Cancer Centres were reviewed. They represent 5% of all breast cancers treated in men in the same period. The median age was 58 years, but 6 patients were younger than 40 years. TNM classification (UICC, 1978) showed 12 T0 (discovered only by bloody nipple discharge), 10 T1, 5 T2 and four unclassified tumours (Tx). 11 patients (35.5%) had clinical gynecomastia, and three (10%) had a family history of breast cancer. 6 patients underwent lumpectomy, and 25 mastectomy. Axillary dissection was performed in 19 cases. 6 cases received postoperative irradiation. 15 out of 31 lesions were of the papillary subtype, pure or associated with a cribriform component. The size of the 12 measured lesions varied from 3 to 45 mm. All lymph nodes sampled were negative. With a median follow-up of 83 months, 4 patients (13%) presented a local relapse (LR), respectively, at 12, 27, 36 and 55 months. 3 of these patients had been initially treated by lumpectomy. In one case LR was still in situ, but already infiltrating in the 3 others. Radical salvage surgery was performed in 3 cases, but one patient developed metastases and died 30 months later. The last patient was treated by multiple local excisions and tamoxifen. One 43-year-old patient developed a contralateral DCIS and three others developed a metachronous cancer. The aetiology and risk factors of male breast cancer remain unknown. Gynecomastia, which implies an imbalance between androgen and oestrogen, may be a predisposing factor. As in women, DCIS in the male breast has a good prognosis. Total mastectomy without axillary dissection is the basic treatment. Frequently, the first symptom is a bloody nipple discharge. The age of occurrence is younger than for infiltrating carcinoma, suggesting that DCIS is the first step in the development of breast cancer. (C) 1997 Elsevier Science Ltd.