PDF(Pubmed)
Abstract：
BACKGROUND: Male breast cancer constitutes a minority of breast cancer diagnoses, yet its incidence has been on the rise in recent decades. However, elderly male breast cancer patients have been inadequately represented in clinical trials, posing challenges in treatment decisions. This study seeks to clarify the efficacy of chemotherapy in this demographic and identify the population most likely to benefit from such intervention.
METHODS: We conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database, encompassing a total of 1900 male breast cancer patients aged 70 years or older. Among them, 1652 were categorized in the no-chemotherapy group, while 248 were in the chemotherapy group. A multifactorial logistic regression model was employed to investigate the determinants influencing the administration of chemotherapy in elderly male breast cancer patients. Additionally, the multivariate Cox proportional hazards regression model was applied to identify factors associated with outcomes, with overall survival (OS) as the primary endpoint.
RESULTS: Multivariate logistic regression analysis revealed that grade, tumor size, and nodal status were robust predictors for elderly male breast cancer patients receiving chemotherapy. Furthermore, the multivariate analysis demonstrated that chemotherapy conferred benefits compared to the no-chemotherapy group (HR = 0.822, 95% CI: 0.682-0.991, p = 0.040). Stratified analyses indicated that individuals with N+, poorly/undifferentiated grade, and stage II/III disease could derive benefits from chemotherapy. Upon further investigation of progesterone receptor (PR) positive patients, it was found that only stage III patients experienced significant benefits from chemotherapy (HR = 0.571, 95% CI: 0.372-0.875, p = 0.010). Conversely, in PR negative patients, both stage II (HR = 0.201, 95% CI: 0.051-0.792, p = 0.022) and stage III patients (HR = 0.242, 95% CI: 0.060-0.972, p = 0.046) derived benefits from chemotherapy.
CONCLUSIONS: Adjuvant chemotherapy may benefit certain elderly male breast cancer patients, specifically those with positive lymph node status, poorly/undifferentiated grade, and PR-positive in stage III, as well as PR-negative expression in stage II/III. Given favorable physical tolerance, it is advisable not to hastily dismiss chemotherapy for these elderly male breast cancer patients.
METHODS: We conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database, encompassing a total of 1900 male breast cancer patients aged 70 years or older. Among them, 1652 were categorized in the no-chemotherapy group, while 248 were in the chemotherapy group. A multifactorial logistic regression model was employed to investigate the determinants influencing the administration of chemotherapy in elderly male breast cancer patients. Additionally, the multivariate Cox proportional hazards regression model was applied to identify factors associated with outcomes, with overall survival (OS) as the primary endpoint.
RESULTS: Multivariate logistic regression analysis revealed that grade, tumor size, and nodal status were robust predictors for elderly male breast cancer patients receiving chemotherapy. Furthermore, the multivariate analysis demonstrated that chemotherapy conferred benefits compared to the no-chemotherapy group (HR = 0.822, 95% CI: 0.682-0.991, p = 0.040). Stratified analyses indicated that individuals with N+, poorly/undifferentiated grade, and stage II/III disease could derive benefits from chemotherapy. Upon further investigation of progesterone receptor (PR) positive patients, it was found that only stage III patients experienced significant benefits from chemotherapy (HR = 0.571, 95% CI: 0.372-0.875, p = 0.010). Conversely, in PR negative patients, both stage II (HR = 0.201, 95% CI: 0.051-0.792, p = 0.022) and stage III patients (HR = 0.242, 95% CI: 0.060-0.972, p = 0.046) derived benefits from chemotherapy.
CONCLUSIONS: Adjuvant chemotherapy may benefit certain elderly male breast cancer patients, specifically those with positive lymph node status, poorly/undifferentiated grade, and PR-positive in stage III, as well as PR-negative expression in stage II/III. Given favorable physical tolerance, it is advisable not to hastily dismiss chemotherapy for these elderly male breast cancer patients.
摘要：
背景：男性乳腺癌占乳腺癌诊断的少数，然而，近几十年来，它的发病率一直在上升。然而,老年男性乳腺癌患者在临床试验中的代表性不足，在治疗决策中提出挑战。这项研究旨在阐明这种人口统计学中化疗的疗效，并确定最有可能从这种干预中受益的人群。
方法：我们使用监测进行了回顾性分析，流行病学,和最终结果(SEER)数据库，包括1900名70岁或以上的男性乳腺癌患者。其中,1652被归类为无化疗组，化疗组248人。采用多因素逻辑回归模型来研究影响老年男性乳腺癌患者化疗的决定因素。此外,多变量Cox比例风险回归模型用于识别与结局相关的因素，以总生存期（OS）为主要终点。
结果：多因素logistic回归分析显示，肿瘤大小,淋巴结状态是接受化疗的老年男性乳腺癌患者的有力预测因子。此外，多变量分析表明,与未化疗组相比,化疗组获益(HR=0.822,95%CI:0.682~0.991,p=0.040).分层分析表明，具有N+的个体，不良/未分化等级，和II/III期疾病可以从化疗中获益。在进一步调查孕激素受体（PR）阳性患者后，研究发现,只有III期患者从化疗中获益(HR=0.571,95%CI:0.372-0.875,p=0.010).相反，在PR阴性患者中，II期(HR=0.201,95%CI:0.051-0.792,p=0.022)和III期(HR=0.242,95%CI:0.060-0.972,p=0.046)患者均可从化疗获益.
结论：辅助化疗可能使某些老年男性乳腺癌患者受益，特别是那些淋巴结状态阳性的人，不良/未分化等级，在III期PR呈阳性，以及II/III期PR阴性表达。给定良好的物理耐受性，建议不要仓促放弃对这些老年男性乳腺癌患者的化疗。
方法：我们使用监测进行了回顾性分析，流行病学,和最终结果(SEER)数据库，包括1900名70岁或以上的男性乳腺癌患者。其中,1652被归类为无化疗组，化疗组248人。采用多因素逻辑回归模型来研究影响老年男性乳腺癌患者化疗的决定因素。此外,多变量Cox比例风险回归模型用于识别与结局相关的因素，以总生存期（OS）为主要终点。
结果：多因素logistic回归分析显示，肿瘤大小,淋巴结状态是接受化疗的老年男性乳腺癌患者的有力预测因子。此外，多变量分析表明,与未化疗组相比,化疗组获益(HR=0.822,95%CI:0.682~0.991,p=0.040).分层分析表明，具有N+的个体，不良/未分化等级，和II/III期疾病可以从化疗中获益。在进一步调查孕激素受体（PR）阳性患者后，研究发现,只有III期患者从化疗中获益(HR=0.571,95%CI:0.372-0.875,p=0.010).相反，在PR阴性患者中，II期(HR=0.201,95%CI:0.051-0.792,p=0.022)和III期(HR=0.242,95%CI:0.060-0.972,p=0.046)患者均可从化疗获益.
结论：辅助化疗可能使某些老年男性乳腺癌患者受益，特别是那些淋巴结状态阳性的人，不良/未分化等级，在III期PR呈阳性，以及II/III期PR阴性表达。给定良好的物理耐受性，建议不要仓促放弃对这些老年男性乳腺癌患者的化疗。
