Hsing A W, McLaughlin J K, Cocco P, Co Chien H T, Fraumeni J F
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
Cancer Causes Control. 1998 May;9(3):269-75. doi: 10.1023/a:1008869003012.
The etiology of male breast cancer is obscure, although an excess risk has been associated with Klinefelter syndrome, testicular disorders, benign breast disease including gynecomastia, use of exogenous estrogens, radiation, and a family history of male or female breast cancer. We conducted a case-control study to investigate risk factors further for breast cancer in men.
Based on data from the 1986 National (United States) Mortality Followback Survey (NMFS) of almost 20,000 deceased adults (age 25 years or over), we compared information obtained from next-of-kin interviews of 178 men who died of breast cancer with that of 512 male controls who died of other causes. Information was obtained on selected demographic and other factors, including diet, exercise, occupation, height and weight, and use of tobacco and alcohol.
Increased risks were found for men who were described by their next-of-kin as very overweight (odds ratio [OR] = 2.3, 95 percent confidence interval [CI] = 1.1-5.0). The risks associated with the three upper quartiles of body mass index (BMI) (wt/ht2) were 1.3, 1.6, and 2.3, respectively, with a significant dose-response relationship (P < 0.01). An excess risk was also associated with limited exercise (OR = 1.3, CI = 0.8-2.0). Consumption of red meat was associated with an increased risk, and consumption of fruits and vegetables with a decreased risk, although the trends were not significant. No association was found for tobacco or alcohol use, but an excess risk was associated with higher levels of socioeconomic status (SES) (OR = 1.8, CI = 1.1-3.0).
Our study suggests that obesity increases the risk of male breast cancer, possibly through hormonal mechanisms, while dietary factors, physical activity, and SES indicators also deserve further investigation.
男性乳腺癌的病因尚不清楚，尽管其额外风险与克兰费尔特综合征、睾丸疾病、包括男性乳房发育症在内的良性乳腺疾病、外源性雌激素的使用、辐射以及男性或女性乳腺癌家族史有关。我们进行了一项病例对照研究，以进一步调查男性乳腺癌的危险因素。
基于1986年美国全国近20000名成年死者（年龄25岁及以上）的死亡率随访调查（NMFS）数据，我们将178名死于乳腺癌的男性近亲访谈中获得的信息与512名死于其他原因的男性对照的信息进行了比较。获取了选定的人口统计学和其他因素的信息，包括饮食、运动、职业、身高和体重以及烟草和酒精的使用情况。
近亲描述为严重超重的男性风险增加（优势比[OR]=2.3，95%置信区间[CI]=1.1 - 5.0）。与体重指数（BMI）（体重/身高²）的三个上四分位数相关的风险分别为1.3、1.6和2.3，具有显著的剂量反应关系（P<0.01）。运动受限也与额外风险相关（OR = 1.3，CI = 0.8 - 2.0）。红肉消费与风险增加相关，水果和蔬菜消费与风险降低相关，尽管趋势不显著。未发现烟草或酒精使用与风险有关，但社会经济地位（SES）较高与额外风险相关（OR = 1.8，CI = 1.1 - 3.0）。
我们的研究表明，肥胖可能通过激素机制增加男性患乳腺癌的风险，而饮食因素、身体活动和SES指标也值得进一步研究。
