Abstract：
BACKGROUND: Although male breast cancer (MBC) is a rare disease, accounting for <1% of all breast cancers, it has significant oncological, survival and psychosocial implications for patients. The aim of this study is to assess the latest literature in the diagnosis, management, oncological outcomes, and psychosocial impact of MBC.
METHODS: A systematic literature review was conducted using the PRISMA guidelines (Moher et al., 2009) [1] to explore the management of MBC, with particular focus on investigative imaging, surgical management, oncological outcomes, survival, genetic screening and psychosocial effects. Electronic databases were searched for randomised control trials, cohort studies and case series involving more than 10 patients. Imaging and surgical techniques, local and distant disease recurrence, survival, genetic screening and psychosocial implications in the setting of MBC were assessed.
RESULTS: The search criteria identified 199 articles, of which 59 met the inclusion criteria. This included 39,529 patients, with a mean age of 64.5 years (55-71), and a mean follow-up of 66.3 months (26.2-115). Mastectomy remains the most frequently used surgical technique, with an average of 89.6%. Loco-regional and distant recurrence rate was 10.1% and 21.4% respectively. Disease-free survival (DFS) at 5 and 10 years was 66.8% and 54.5% respectively. Disease-specific survival (DSS) at 5 and 10 years was 87.1% and 67.1% respectively. Overall survival (OS) at 5 and 10 years was 72.7% and 50.7% respectively. Genetic screening was conducted in 38.6% of patients of which 4.8% and 15.8% were found to be BRCA1 and BRCA2 carriers respectively. Psychosocial studies were conducted mainly using questionnaire and interview-based methodology focusing primarily on awareness of breast cancer in men, support available and impact on gender identity.
CONCLUSIONS: This review demonstrates that men present with later stage disease with subsequent impact on survival outcomes. There remains a paucity of high-level evidence and prospective studies are required. There is a need for increasing awareness amongst the public and health care professionals in order to improve outcomes and reduce stigma associated with MBC.
METHODS: A systematic literature review was conducted using the PRISMA guidelines (Moher et al., 2009) [1] to explore the management of MBC, with particular focus on investigative imaging, surgical management, oncological outcomes, survival, genetic screening and psychosocial effects. Electronic databases were searched for randomised control trials, cohort studies and case series involving more than 10 patients. Imaging and surgical techniques, local and distant disease recurrence, survival, genetic screening and psychosocial implications in the setting of MBC were assessed.
RESULTS: The search criteria identified 199 articles, of which 59 met the inclusion criteria. This included 39,529 patients, with a mean age of 64.5 years (55-71), and a mean follow-up of 66.3 months (26.2-115). Mastectomy remains the most frequently used surgical technique, with an average of 89.6%. Loco-regional and distant recurrence rate was 10.1% and 21.4% respectively. Disease-free survival (DFS) at 5 and 10 years was 66.8% and 54.5% respectively. Disease-specific survival (DSS) at 5 and 10 years was 87.1% and 67.1% respectively. Overall survival (OS) at 5 and 10 years was 72.7% and 50.7% respectively. Genetic screening was conducted in 38.6% of patients of which 4.8% and 15.8% were found to be BRCA1 and BRCA2 carriers respectively. Psychosocial studies were conducted mainly using questionnaire and interview-based methodology focusing primarily on awareness of breast cancer in men, support available and impact on gender identity.
CONCLUSIONS: This review demonstrates that men present with later stage disease with subsequent impact on survival outcomes. There remains a paucity of high-level evidence and prospective studies are required. There is a need for increasing awareness amongst the public and health care professionals in order to improve outcomes and reduce stigma associated with MBC.
摘要：
背景：尽管男性乳腺癌（MBC）是一种罕见的疾病，占所有乳腺癌的1%，它有重要的肿瘤学，对患者的生存和心理社会影响。这项研究的目的是评估诊断的最新文献，管理,肿瘤学结果，以及MBC的社会心理影响。
方法：使用PRISMA指南进行了系统的文献综述（Moher等人。,2009)[1]探索MBC的管理，特别关注调查成像，手术管理,肿瘤学结果，生存,遗传筛查和社会心理影响。在电子数据库中搜索随机对照试验，队列研究和涉及10多名患者的病例系列。影像和外科技术，局部和远处的疾病复发，生存,我们评估了MBC背景下的遗传筛查和心理社会影响.
结果：搜索标准确定了199篇文章，其中59人符合纳入标准。其中包括39,529名患者，平均年龄为64.5岁（55-71岁），平均随访66.3个月（26.2-115）。乳房切除术仍然是最常用的手术技术，平均为89.6%。局部和远处复发率分别为10.1％和21.4％。5年和10年的无病生存率（DFS）分别为66.8％和54.5％。5年和10年的疾病特异性生存率（DSS）分别为87.1％和67.1％。5年和10年总生存率分别为72.7%和50.7%。在38.6％的患者中进行了基因筛查，其中发现BRCA1和BRCA2携带者分别为4.8％和15.8％。社会心理研究主要使用问卷调查和基于访谈的方法进行，主要关注男性对乳腺癌的认识，可用的支持和对性别认同的影响。
结论：本综述表明男性出现晚期疾病，随后对生存结果有影响。仍然缺乏高水平的证据，需要进行前瞻性研究。需要提高公众和卫生保健专业人员的认识，以改善结果并减少与MBC相关的污名。
方法：使用PRISMA指南进行了系统的文献综述（Moher等人。,2009)[1]探索MBC的管理，特别关注调查成像，手术管理,肿瘤学结果，生存,遗传筛查和社会心理影响。在电子数据库中搜索随机对照试验，队列研究和涉及10多名患者的病例系列。影像和外科技术，局部和远处的疾病复发，生存,我们评估了MBC背景下的遗传筛查和心理社会影响.
结果：搜索标准确定了199篇文章，其中59人符合纳入标准。其中包括39,529名患者，平均年龄为64.5岁（55-71岁），平均随访66.3个月（26.2-115）。乳房切除术仍然是最常用的手术技术，平均为89.6%。局部和远处复发率分别为10.1％和21.4％。5年和10年的无病生存率（DFS）分别为66.8％和54.5％。5年和10年的疾病特异性生存率（DSS）分别为87.1％和67.1％。5年和10年总生存率分别为72.7%和50.7%。在38.6％的患者中进行了基因筛查，其中发现BRCA1和BRCA2携带者分别为4.8％和15.8％。社会心理研究主要使用问卷调查和基于访谈的方法进行，主要关注男性对乳腺癌的认识，可用的支持和对性别认同的影响。
结论：本综述表明男性出现晚期疾病，随后对生存结果有影响。仍然缺乏高水平的证据，需要进行前瞻性研究。需要提高公众和卫生保健专业人员的认识，以改善结果并减少与MBC相关的污名。
