Sasco A J, Lowenfels A B, Pasker-de Jong P
Unit of Analytical Epidemiology, International Agency for Research on Cancer, Lyon, France.
Int J Cancer. 1993 Feb 20;53(4):538-49. doi: 10.1002/ijc.2910530403.
Male breast cancer is a rare tumour in all parts of the world. About 1% of all breast cancers occur in men, but the male/female ratio is higher among black than among white populations. This effect can be seen in US cancer registries and even more markedly in African data. A positive correlation exists on a population scale between male breast cancer and prostate cancer. Seven case-control studies of male breast cancer are available, and a pooled analysis was conducted of the most commonly suspected risk factors. Male breast cancer appears to be associated with marital status: Mantel-Haenszel exposure odds ratio (EOR) for never married = 1.6; 95% confidence limits (CL) = 1.1, 2.3, religion (EOR for being Jewish = 2.1; 95% CL = 1.4, 3.2), previous breast pathology (EOR for positive history of benign breast disease = 2.7; 95% CL = 1.7, 4.2), gynaecomastia (EOR for positive history = 6.2, 95% CL = 3.4, 11.4), previous testicular pathology (EOR for positive history = 2.2; 95% CL = 1.5, 3.3), previous liver diseases (EOR for positive history = 1.6; 95% CL = 1.0, 2.4) and family history of breast cancer (EOR for first-degree relative with breast cancer = 2.5; 95% CL = 1.7, 3.7). No association is found with smoking history. Other potential risk factors such as reproductive history, education, occupation, anthropometric variables, association with various diseases, and specific exposures such as drug use, were not systematically evaluated in all studies and provide sometimes contradictory results, possibly due to small numbers of exposed subjects. Overall, the analytical epidemiology of male breast cancer presents similarities with the epidemiology of female breast cancer, with a potential role of factors related to hormonal status, relative hyperoestrogeny in men being potentially linked to increased risk of disease. Genetics may also play a role, with high risk linked to a familial history of breast cancer, and with a major risk in patients with Klinefelter's syndrome.
男性乳腺癌在世界各地都是一种罕见肿瘤。所有乳腺癌中约1%发生在男性中，但黑人中的男/女比例高于白人人群。在美国癌症登记处可以看到这种现象，在非洲的数据中更为明显。在人群层面上，男性乳腺癌与前列腺癌之间存在正相关。现有7项男性乳腺癌病例对照研究，并对最常见的可疑风险因素进行了汇总分析。男性乳腺癌似乎与婚姻状况有关：从未结婚者的Mantel-Haenszel暴露比值比（EOR）=1.6；95%置信区间（CL）=1.1, 2.3，宗教信仰（犹太人为2.1；95%CL=1.4, 3.2），既往乳腺病理情况（良性乳腺疾病阳性史者的EOR=2.7；95%CL=1.7, 4.2），男性乳房发育（阳性史者的EOR=6.2，95%CL=3.4, 11.4），既往睾丸病理情况（阳性史者的EOR=2.2；95%CL=1.5, 3.3），既往肝脏疾病（阳性史者的EOR=1.6；95%CL=1.0, 2.4）以及乳腺癌家族史（一级亲属患乳腺癌者的EOR=2.5；95%CL=1.7, 3.7）。未发现与吸烟史有关联。其他潜在风险因素，如生育史、教育程度、职业、人体测量变量、与各种疾病的关联以及特定暴露如药物使用等，在所有研究中未得到系统评估，且有时会得出相互矛盾的结果，这可能是由于暴露对象数量较少。总体而言，男性乳腺癌的分析流行病学与女性乳腺癌的流行病学有相似之处，激素状态相关因素可能发挥作用，男性相对雌激素过多可能与疾病风险增加有关。遗传学也可能起作用，高风险与乳腺癌家族史相关，克氏综合征患者风险更高。
