男性乳癌手術後放射線治療

POSTOPERATIVE RADIOTHERAPY OF CARCINOMA OF MALE BREAST

鍾昌宏(Chang H. Chung) ； 丁瑞山(Rudy S. Ding) ； 陳光耀(Kuang Y. Chen)

《中華放射線醫學雜誌》 2卷2期 (1977/06) Pp. 105-110

摘要

榮民總醫院癌病治療中心自1962年元月至1974年12月，共有7例乳癌發生在男性，其年齡在48至69歲之間，平均與中値年齡57歲。其中5例長在右乳頭下，2例則發生在左乳頭下。其中1例前曾患膀胱癌，1例併發男性女乳症，1例合併有梅毒性心臟病及胆囊結石，另有1例則有活動性肺結核。患者有不痛性乳房硬塊1年至6年不等。本研究中，第Ⅱ期有3例，第Ⅲ期者4例。每例均經病理學家證實爲腺癌，手術後接受放射線治療。放射線治療範圍包括患側內乳淋巴區、胸壁、腋下及鎖骨上區，其組織劑量在4,500至6,000雷得。第Ⅱ期的3例接受腫瘤切除及放射治療，有1例已生存2年4月，1例於治療後7年10月死於轉移，另1例於1年11月後死於心臟病併發充血性心衰竭。第Ⅲ期的4例中，2例接受根除性乳房切除術及放射線治療，皆在4月後死於轉移，另2例接受單純性乳房切除術或腫瘤切除加放射治療者，現已痊癒並生存了7年4月及2年10月。放射線輔助治療並未發生明顯白血球減少、臂腫、骨炎或肺纖維化等合併症。

並列摘要

Among 270 cases of carcinoma of breast treated in the Cancer Therapy Center, Veterans General Hospital, Taipei, from January 1962 through December, 1974, 7 cases developed in male patients. The mean age was 57 when the male malignant tumors were biopsied and verified pathologically. One of 7 cases had had another primary tumor previously. Five of our patients developed the cancer in the right breast. The major presenting symptom was a painless mass beneath the nipple. All patients had homolateral axillary node enlargement before surgery. Radiation was delivered to the chest wall, internal mammary chain, supraclavicular and axillary lymphatics after operation, the tissue dose being 4,500 to 6,000 rads. There were 3 cases stage II who received excisional biopsy and radiotherapy; one died of distant metastasis 7 years and 4 months after inital treatment; one died of syphilitic heart disease with aortic insufficiency without evidence of cancer, 1 year and 11 months after treatment; another one survived free from cancer 2 years and 4 months after surgery. Two stage III cases receiving radical mastectomy and radiotherapy died of wide-spread distant metastases 4 months post-combination treatment. Another 2 stage III patients survived without tumor 7 years 4 months, and 2 years 10 months respectively, after simple mastectomy or excisonal biopsy, plus radiotherapy. No major complication was encountered in our series.