Czene Kamila, Bergqvist Jenny, Hall Per, Bergh Jonas
Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Stockholm, Sweden.
Breast. 2007 Dec;16 Suppl 2:S147-54. doi: 10.1016/j.breast.2007.07.024.
The prevalence for breast cancer in males in Europe is estimated to be 1 or less per 100,000. Male breast cancer has a peak incidence at the age of 71 years. There are no randomized data giving information on the optimal therapy for male breast cancer patients, thereby limiting firmer conclusions. The preferred primary surgical therapy is modified radical/simple mastectomy, but breast-conserving surgery has also been used in males. Post-operative radiotherapy should be used on a more routine basis; as males have shorter breast-anatomical distances and males are diagnosed at a later stage compared with females. The so far preferred adjuvant therapy modality has been tamoxifen for patients with endocrine responsive disease. The use of aromatase inhibitors in males is more controversial, since they may not deplete the estradiol levels sufficiently. Different chemotherapy regimens have been used in the adjuvant and metastatic setting. The use of adjuvant therapy has in institutional and review comparisons been demonstrated to result in an improved outcome.
欧洲男性乳腺癌的患病率估计为每10万人中1例或更低。男性乳腺癌的发病高峰年龄为71岁。目前尚无随机数据提供有关男性乳腺癌患者最佳治疗方法的信息，因此难以得出更确凿的结论。首选的主要手术治疗方法是改良根治性/单纯乳房切除术，但保乳手术也已应用于男性患者。术后放疗应更常规地使用；因为男性的乳房解剖距离较短，而且与女性相比，男性确诊时病情较晚。迄今为止，对于内分泌反应性疾病患者，首选的辅助治疗方式一直是他莫昔芬。芳香化酶抑制剂在男性中的使用存在更多争议，因为它们可能无法充分降低雌二醇水平。在辅助治疗和转移性治疗中使用了不同的化疗方案。在机构和综述比较中，辅助治疗的使用已被证明能改善预后。
