男性乳腺癌的临床研究进展

男性乳腺癌发病罕见,过去25年问发病率呈上升趋势.目前对男性乳腺癌生物学、自然病程以及治疗策略的研究大部分是基于对女性乳腺癌的研究成果.男性乳腺癌的发病风险因素包括BRCA2基因突变和职业因素,而职业因素又包括高温工作环境、燃料和尾气;此外,性激素失衡,如生殖腺功能失调、肥胖、辐射等均可增加患病风险.临床病情进展可缓慢或快速转移.病理类型绝大多数为导管癌,10%为导管原位癌.常采取的手术是乳房切除术和腋窝淋巴结清扫或前哨淋巴结活检术.放疗步骤和方法同女性乳腺癌.由于90%的男性乳腺癌患者雌激素受体阳性,因此他莫昔芬是标准的辅助内分泌治疗药物,个别病例也可从化疗中获益.本文对近年有关男性乳腺癌的流行病学、生物学和治疗方面的相关内容进行总结.

Clinical research advancement on male breast cancer

Male breast cancer is a rare disease and the incidence has increased over the past 25 years. Current knowledge regarding its biology, natural history, and treatment strategies is mainly based on the research findings on female breast cancer. Genetic risk factors include BRCA2 mutations. Occupational risk factors include high temperature environments and exhaust fumes. Hormonal imbalances, such as gonadal dysfunction, obesity, and radiation exposure also contribute to the occurrence of male breast cancer. It may be indolent or progress slowly, or invade rapidly. Most cases are ductal tumors and 10% of the cases are ductal carcinoma in situ. The surgical operation is usually mastectomy with axillary clearance or sentinel node biopsy. Indications for radiotherapy, as well as the steps and methods, are similar to that for female breast cancer. Because 90% of the patients are estrogen receptor-positive, tamoxifen is a standard adjuvant therapy, but some individuals could also benefit from chemotherapy. In this article, the latest information on the epidemiology, biology, and treatment of male breast cancer is reviewed.