CAJ | 학술논문

目的：回顾性分析了内蒙古医科大学附属医院1997年至2011年收治的24例男性乳腺癌的临床资料，探讨其临床特点、治疗及预后。方法采用以手术为主，化疗、放疗及内分泌治疗为辅的综合治疗。23例行手术治疗，经典乳癌根治术2例。乳癌改良根治术20例，为MBC的主要术式。术后根据肿瘤大小、临床分期、腋淋巴结转移数目及激素受体表达，术后辅助化疗10例。21例激素受体阳性的患者，口服三苯氧胺治疗。行术后放射治疗6例。结果临床特点：发病年龄偏高，本组发病年龄60～83岁，中位年龄69.5岁。发病率低，本院同期收治3821例女性乳腺癌患者，MBC占0.63%。典型的临床表现为：乳晕区质硬的无痛性肿块，可伴有乳头溢液、乳头凹陷等表现。病理组织学特点：导管浸润癌占87.5%。腋淋巴结转移率高：淋巴结转移率为68.2%。肿瘤激素受体表达率高：激素受体表达率达79.1～87.5%。内分泌治疗三苯氧胺成为一线的内分泌治疗药物。芳香化酶抑制剂的疗效，需更多的大样本的临床研究的证明。术后放疗可明显改善局部控制率。术后辅助化疗降低了腋淋巴结阳性患者的死亡风险。接受术后辅助化疗的占43.4%，其患者5年生存率>70%。因患者年龄偏大，70岁以上占39.1%。术后辅助化疗受年龄限制因素的影响较明显。70岁以上的患者，在激素受体阳性的情况下，以手术及术后内分泌治疗为主。术后5年总体生存率为52.2%，略低于文献报道。Ⅱ期、Ⅲ期占79.2%，是术后5年生存率偏低的主要原因。发病年龄偏高，常合并有其它疾病。有4例在3年内因心脑血管意外死亡，也是本组术后5年生存率偏低的非肿瘤性原因。结论以手术为主，化疗、放疗及内分泌治疗为辅的综合治疗。乳癌改良根治术为主要术式。三苯氧胺成为一线的内分泌治疗药物。术后辅助化疗受年龄限制因素的影响较明显。70岁以上的患者，在激素受体阳性的情况下，以手术及内分泌治疗为主。目的：迴顧性分析瞭內矇古醫科大學附屬醫院1997年至2011年收治的24例男性乳腺癌的臨床資料，探討其臨床特點、治療及預後。方法採用以手術為主，化療、放療及內分泌治療為輔的綜閤治療。23例行手術治療，經典乳癌根治術2例。乳癌改良根治術20例，為MBC的主要術式。術後根據腫瘤大小、臨床分期、腋淋巴結轉移數目及激素受體錶達，術後輔助化療10例。21例激素受體暘性的患者，口服三苯氧胺治療。行術後放射治療6例。結果臨床特點：髮病年齡偏高，本組髮病年齡60～83歲，中位年齡69.5歲。髮病率低，本院同期收治3821例女性乳腺癌患者，MBC佔0.63%。典型的臨床錶現為：乳暈區質硬的無痛性腫塊，可伴有乳頭溢液、乳頭凹陷等錶現。病理組織學特點：導管浸潤癌佔87.5%。腋淋巴結轉移率高：淋巴結轉移率為68.2%。腫瘤激素受體錶達率高：激素受體錶達率達79.1～87.5%。內分泌治療三苯氧胺成為一線的內分泌治療藥物。芳香化酶抑製劑的療效，需更多的大樣本的臨床研究的證明。術後放療可明顯改善跼部控製率。術後輔助化療降低瞭腋淋巴結暘性患者的死亡風險。接受術後輔助化療的佔43.4%，其患者5年生存率>70%。因患者年齡偏大，70歲以上佔39.1%。術後輔助化療受年齡限製因素的影響較明顯。70歲以上的患者，在激素受體暘性的情況下，以手術及術後內分泌治療為主。術後5年總體生存率為52.2%，略低于文獻報道。Ⅱ期、Ⅲ期佔79.2%，是術後5年生存率偏低的主要原因。髮病年齡偏高，常閤併有其它疾病。有4例在3年內因心腦血管意外死亡，也是本組術後5年生存率偏低的非腫瘤性原因。結論以手術為主，化療、放療及內分泌治療為輔的綜閤治療。乳癌改良根治術為主要術式。三苯氧胺成為一線的內分泌治療藥物。術後輔助化療受年齡限製因素的影響較明顯。70歲以上的患者，在激素受體暘性的情況下，以手術及內分泌治療為主。
목적：회고성분석료내몽고의과대학부속의원1997년지2011년수치적24례남성유선암적림상자료，탐토기림상특점、치료급예후。방법채용이수술위주，화료、방료급내분비치료위보적종합치료。23례행수술치료，경전유암근치술2례。유암개량근치술20례，위MBC적주요술식。술후근거종류대소、림상분기、액림파결전이수목급격소수체표체，술후보조화료10례。21례격소수체양성적환자，구복삼분양알치료。행술후방사치료6례。결과림상특점：발병년령편고，본조발병년령60～83세，중위년령69.5세。발병솔저，본원동기수치3821례녀성유선암환자，MBC점0.63%。전형적림상표현위：유훈구질경적무통성종괴，가반유유두일액、유두요함등표현。병리조직학특점：도관침윤암점87.5%。액림파결전이솔고：림파결전이솔위68.2%。종류격소수체표체솔고：격소수체표체솔체79.1～87.5%。내분비치료삼분양알성위일선적내분비치료약물。방향화매억제제적료효，수경다적대양본적림상연구적증명。술후방료가명현개선국부공제솔。술후보조화료강저료액림파결양성환자적사망풍험。접수술후보조화료적점43.4%，기환자5년생존솔>70%。인환자년령편대，70세이상점39.1%。술후보조화료수년령한제인소적영향교명현。70세이상적환자，재격소수체양성적정황하，이수술급술후내분비치료위주。술후5년총체생존솔위52.2%，략저우문헌보도。Ⅱ기、Ⅲ기점79.2%，시술후5년생존솔편저적주요원인。발병년령편고，상합병유기타질병。유4례재3년내인심뇌혈관의외사망，야시본조술후5년생존솔편저적비종류성원인。결론이수술위주，화료、방료급내분비치료위보적종합치료。유암개량근치술위주요술식。삼분양알성위일선적내분비치료약물。술후보조화료수년령한제인소적영향교명현。70세이상적환자，재격소수체양성적정황하，이수술급내분비치료위주。
Objective The clinical data of 24 male breast cancers that looked back to analyze a medicine department university afifliated hospital in Inner Mongolia to accept to cure for 1997-2011 stage years, after inquiring into an its clinical characteristics, treatment and expects. Method The adoption regards surgical operation as principle, chemotherapy, put to treat and endocrine treatment for assist of comprehensive treatment. 23 surgical operation cure, the radical mastectomy cures for 2. The modiifed radical mastectomy cures for 20, is a MBC main type. Expect according to the tumor size, clinical stages , axilla lymph knot to transfer number and hormone is expressed by tumor, the case support to chemotherapy 10 behind. 21 hormones are expressed positive to take TAM treatments.The 6 case radiator therapy to cure 6 behind.Result Clinical characteristics:①Being taken bad age is higher, this outbreak age is 60-83 years old, medium the age is 69.5 years old.②The outbreak leads low, the this hospital same period accepts to cure 3821 sufferers of female breast cancers, MBC has 0.63%.③The clinical performance of typical model is:the breast area quality is hard of have no pain lump, can the companion have nipple to overflow a liquid, nipple hollow etc. ④ Pathologic histology characteristics:Gradually the infiltrating ductal carcinomar has 87.5%.The axillaly lymph knot transfers rates more :The lymphoid knot transfers to lead to 68.2%.The tumor hormone expression rate is more :The hormone expression up to 79.1 ~ 87.5%. ⑤ The endocrine cures the TAM become front-line endocrine to cure medicine.The aromatase inhibitor (A I) curative effect of and need more big samples of the proof of the clinical research. ⑥The radiator therapy putting to treat behind can obviously improve a partial control rate. ⑦ The chemotherapy support to a lower the death risk that the axilla lymph knot to transfer number in a male sufferer behind. Lend support to having of chemotherapy 43.4%after accepting operation, hormone expression up its sufferer's existence rate in 5 years>70%. Because sufferer's age is greatly partial to, 70 years old above have 39.1%. After the lends support to a chemotherapy under the inlfuence of age limit factor more obvious. Sufferer over 70 years of age, under the situation that the hormone expression up is subjected to endocrine cures , with after the surgical operation and the endocrine treatment is lord.⑧The 5 years' total existence leads to 52.2%, is more slightly low than to report .The II stages, the III stages have 79.2%, is 5 age years after the operation, the existence leads low main reason. Being taken bad age is higher, often the merger contains other diseases. Have 4 within 3 years because the heart cerebral accident die, is also 5 years after the operation, the existence leads other reason is lowly .Conclusion Regard surgical operation as principle, chemotherapy, put to treat and endocrine treatment for assist of comprehensive treatment. The modiifed radical mastectomy cures for the main type. In endocrine cures the TAM become front-line endocrine to cure medicine. After the operation lends support to a chemotherapy under the inlfuence of age limit factor more obvious.The sufferer over 70 years of age , Under the tumor hormone expression rate is more , regards the surgical operation and the endocrine treatment as principle.