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男性乳腺癌生物学、筛查、治疗及随访:一篇综述

Male Breast Cancer Biology, Screening, Treatment, and Follow-Up: A Narrative Review.

作者信息

Akbari Morteza, Nasiri Hadi, Ziaee Mojtaba

机构信息

Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Iran J Public Health. 2024 Dec;53(12):2694-2704.

Abstract

Male breast cancer (MBC) is a rare type of cancer that affects men, accounting for only 1% of all cancers in men and all breast cancer cases worldwide. Its rarity is due to the differences in male endocrine function and the smaller amount of mammary tissue in males. Due to its infrequency, there is limited knowledge about the disease, and treatment recommendations are often based on extrapolation from clinical trial data involving female breast cancer patients. Men with MBC typically present in their 50s or older and may mistake a suspicious breast mass for a benign condition called gynecomastia. Various known risk factors contribute to breast cancer in men. Currently, there are no international randomized control trials (RCTs) specifically focused on MBC, and management guidelines are primarily derived from studies conducted among female patients. Localized and resectable cases of breast cancer typically require surgical intervention, followed by radiotherapy, chemotherapy, hormonal therapy, or potentially utilizing recent advancements in immune-oncology agents. A comprehensive approach that involves a multidisciplinary team ensures appropriate treatment and can lead to favorable outcomes. However, screening for MBC is limited due to the lack of large-scale international RCTs demonstrating its effectiveness in reducing MBC-related mortality.

摘要

男性乳腺癌(MBC)是一种罕见的癌症,仅占全球男性所有癌症及所有乳腺癌病例的1%。其罕见性归因于男性内分泌功能的差异以及男性乳腺组织较少。由于其发病率低,对该疾病的了解有限,治疗建议通常基于涉及女性乳腺癌患者的临床试验数据推断而来。患有MBC的男性通常在50多岁或更年长时发病,可能会将可疑的乳房肿块误认为是一种名为男性乳房发育症的良性病症。多种已知风险因素会导致男性患乳腺癌。目前,尚无专门针对MBC的国际随机对照试验(RCT),管理指南主要源自针对女性患者开展的研究。乳腺癌的局部可切除病例通常需要手术干预,随后进行放疗、化疗、激素治疗,或者可能采用免疫肿瘤药物的最新进展。多学科团队参与的综合治疗方法可确保进行适当治疗并带来良好预后。然而,由于缺乏大规模国际RCT证明其在降低MBC相关死亡率方面的有效性,MBC的筛查受到限制。

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本文引用的文献

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Breast Cancer Screening in Men.男性乳腺癌筛查。
J Breast Imaging. 2023 Mar 20;5(2):104-111. doi: 10.1093/jbi/wbac095.
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Molecular characteristics of Asian male BRCA-related cancers.亚洲男性BRCA相关癌症的分子特征
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Endocrinol Diabetes Nutr (Engl Ed). 2023 Jun-Jul;70(6):415-420. doi: 10.1016/j.endien.2022.02.024. Epub 2022 Dec 9.
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Cancer Risks Associated With and Pathogenic Variants.与 BRCA1/2 基因和致病变异相关的癌症风险。
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