发病率与死亡率

据估计,2013年美国乳腺癌(仅男性乳腺癌)新发病例数与死亡病例数分别为:[1]

新发病例:2,240例。

死亡病例:410例。

男性乳腺癌十分罕见[2]。男性乳腺癌占所有乳腺癌的比例不足1%[3][4]。尽管各年龄男性都有可能患此病,但男性乳腺癌患者诊断时的年龄在60-70岁之间。

易感因素[5]可能包括射线暴露、雌激素药物或与引起雌激素增多的疾病例如肝硬化或Klinefelter综合征[6]。在具有较多女性乳腺癌患者亲属的男性中,男性乳腺癌有明显的家族聚集性。染色体13q上BRCA2基因突变家系中男性乳腺癌风险增高[7][8]

男性乳腺癌的病理与女性乳腺癌相似,最常见的病理类型为浸润性导管癌[9]。导管内癌也较为常见。男性乳腺癌的病理类型也包括炎性乳腺癌与乳头Paget's病,但不包括小叶原位癌[9]。淋巴结受累与血源性转移情况也与女性乳腺癌相似。男性乳腺癌的TNM分期系统与女性乳腺癌相同。(更多信息请参考PDQ总结 乳腺癌的治疗。)

已经过评估的预后因素包括病变大小和是否存在淋巴结受累,这两项因素均与预后有明确相关性[5][10]。基因扩增倍数与DNA合成S期跟生存率之间的相关性仍不确定[11]。雌激素受体、孕激素受体与HER2/neu基因扩增倍数与预后的关系也该进行报道[12]

男性乳腺癌总生存率与女性乳腺癌相似。男性乳腺癌通常预后较差,可能与诊断时分期已经处于较晚期相关[2][5][13]

参考文献

1. American Cancer Society.: Cancer Facts and Figures 2013. Atlanta, Ga: American Cancer Society, 2013. Available online. Last accessed January 10, 2014.

2. Giordano SH, Cohen DS, Buzdar AU, et al.: Breast carcinoma in men: a population-based study. Cancer 101 (1): 51-7, 2004.[PUBMED Abstract]

3. Borgen PI, Wong GY, Vlamis V, et al.: Current management of male breast cancer. A review of 104 cases. Ann Surg 215 (5): 451-7; discussion 457-9, 1992.[PUBMED Abstract]

4. Fentiman IS, Fourquet A, Hortobagyi GN: Male breast cancer. Lancet 367 (9510): 595-604, 2006.[PUBMED Abstract]

5. Giordano SH, Buzdar AU, Hortobagyi GN: Breast cancer in men. Ann Intern Med 137 (8): 678-87, 2002.[PUBMED Abstract]

6. Hultborn R, Hanson C, Köpf I, et al.: Prevalence of Klinefelter's syndrome in male breast cancer patients. Anticancer Res 17 (6D): 4293-7, 1997 Nov-Dec.[PUBMED Abstract]

7. Wooster R, Bignell G, Lancaster J, et al.: Identification of the breast cancer susceptibility gene BRCA2. Nature 378 (6559): 789-92, 1995 Dec 21-28.[PUBMED Abstract]

8. Thorlacius S, Tryggvadottir L, Olafsdottir GH, et al.: Linkage to BRCA2 region in hereditary male breast cancer. Lancet 346 (8974): 544-5, 1995.[PUBMED Abstract]

9. Burstein HJ, Harris JR, Morrow M: Malignant tumors of the breast. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1401-46.

10. Cutuli B, Lacroze M, Dilhuydy JM, et al.: Male breast cancer: results of the treatments and prognostic factors in 397 cases. Eur J Cancer 31A (12): 1960-4, 1995.[PUBMED Abstract]

11. Gattuso P, Reddy VB, Green L, et al.: Prognostic significance of DNA ploidy in male breast carcinoma. A retrospective analysis of 32 cases. Cancer 70 (4): 777-80, 1992.[PUBMED Abstract]

12. Giordano SH: A review of the diagnosis and management of male breast cancer. Oncologist 10 (7): 471-9, 2005.[PUBMED Abstract]

13. Ravandi-Kashani F, Hayes TG: Male breast cancer: a review of the literature. Eur J Cancer 34 (9): 1341-7, 1998.[PUBMED Abstract]

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