Biostatistics Branch (BB), DHHS/NIH/NCI/Division of Cancer Epidemiology and Genetics (DCEG), EPS, Room 8036, 6120 Executive Blvd, Bethesda, MD 20892-7244, USA.
J Clin Oncol. 2010 Jan 10;28(2):232-9. doi: 10.1200/JCO.2009.23.8162. Epub 2009 Dec 7.
Because of its rarity, male breast cancer is often compared with female breast cancer.
To compare and contrast male and female breast cancers, we obtained case and population data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program for breast cancers diagnosed from 1973 through 2005. Standard descriptive epidemiology was supplemented with age-period-cohort models and breast cancer survival analyses.
Of all breast cancers, men with breast cancer make up less than 1%. Male compared with female breast cancers occurred later in life with higher stage, lower grade, and more estrogen receptor-positive tumors. Recent breast cancer incidence and mortality rates declined over time for men and women, but these trends were greater for women than for men. Comparing patients diagnosed from 1996 through 2005 versus 1976 through 1985, and adjusting for age, stage, and grade, cause-specific hazard rates for breast cancer death declined by 28% among men (P = .03) and by 42% among women (P approximately 0).
There were three intriguing results. Age-specific incidence patterns showed that the biology of male breast cancer resembled that of late-onset female breast cancer. Similar breast cancer incidence trends among men and women suggested that there are common breast cancer risk factors that affect both sexes, especially estrogen receptor-positive breast cancer. Finally, breast cancer mortality and survival rates have improved significantly over time for both male and female breast cancer, but progress for men has lagged behind that for women.
由于其罕见性,男性乳腺癌常与女性乳腺癌进行比较。
为了比较和对比男性和女性乳腺癌,我们从美国国家癌症研究所的监测、流行病学和最终结果计划中获得了 1973 年至 2005 年间诊断出的乳腺癌的病例和人群数据。标准描述性流行病学方法补充了年龄-时期-队列模型和乳腺癌生存分析。
在所有乳腺癌中,男性乳腺癌不到 1%。男性乳腺癌的发病年龄比女性晚,且分期更高、分级更低、雌激素受体阳性肿瘤更多。男性和女性的乳腺癌发病率和死亡率近年来呈下降趋势,但女性的趋势大于男性。与 1976 年至 1985 年相比,1996 年至 2005 年诊断出的患者,调整年龄、分期和分级后,男性乳腺癌死亡的特异性危险比下降了 28%(P =.03),女性下降了 42%(P 约等于 0)。
有三个有趣的结果。年龄特异性发病模式表明,男性乳腺癌的生物学特征类似于迟发性女性乳腺癌。男性和女性乳腺癌的相似发病趋势表明,存在影响两性的共同乳腺癌危险因素,尤其是雌激素受体阳性乳腺癌。最后,男性和女性乳腺癌的死亡率和生存率都随着时间的推移显著提高,但男性的进展落后于女性。