由於一般男性對乳癌警覺性不夠, 就醫時大都是中晚期, 這名病患到院檢查時癌細胞已轉移到淋巴腺, 經手術切除後, 目前還在進行化療,
中山醫學大學附設醫院外科主治醫師姚忠瑾今天表示, 雖然機率不高, 但男性也有可能得乳癌, 臨床上, 大部分看到的男性乳房腫塊都是良性, 根據國外的統計,
男性乳癌的發生率約萬分之一, 約占所有乳癌的百分之一、所有男性癌症的百分之零點二, 相對的, 女性乳癌則占了所有女性癌症的百分之二十六。
都不會很在意, 有時甚至會認為和勤練體能, 導致胸大肌發達有關, 一直到腫塊愈長愈大才來求診, 像這名男病患在就診前半年就發現乳房有硬塊,
姚忠瑾說, 根據二００四年的研究顯示, 男性乳癌的發生率比二十五年前增加了百分之二十五, 女性乳癌則比同時期增加百分之五十二, 研究也發現,
男性乳癌的病患第一次來求診時比女性乳癌病患要來的晚期, 可能是因為男性不被認為會罹患乳癌, 同時也不女性較常進行自我檢查及篩檢。
姚忠瑾強調, 男性乳癌和女性乳癌治療方法和預後差不多, 愈早發現治療的效果愈好, 治療的原則以手術切除為主, 包括整個乳房及腋下淋巴腺廓清,
姚忠瑾提醒, 男性乳癌的症狀與女性乳癌差不多, 都會在乳房先出現硬塊, 接著皮膚凹陷、出現分泌物, 由於男性乳暈較小、乳房組織較少,
因此, 癌細胞較容易轉移到其他部位, 他建議, 超過五十歲以上的男性, 如有單側乳房腫塊最好找一般外科專科醫師求診,
Detailed Guide: Male Breast Cancer
What Is Breast Cancer in Men?
Breast cancer is a malignant tumor that has developed from cells of the
breast. The disease occurs primarily in women but occasionally occurs in
Many people do not realize that men have breast tissue and that they can
develop breast cancer. Until puberty, young boys and girls have a small
amount of breast tissue consisting of a few ducts (tubular passages) located
under the nipple and areola (area around the nipple). At puberty, a girl's
ovaries produce female hormones, causing breast ducts to grow, lobules (milk
glands) to form at the ends of ducts, and the amount of stroma (fatty and
connective tissue surrounding ducts and lobules) to increase. On the other
hand, male hormones produced by the testicles prevent further growth of
breast tissue. Men's breast tissue contains ducts, but only a few if any
Like all cells of the body, a man's breast duct cells can undergo cancerous
changes. Because women have many more breast cells than men do and perhaps
because their breast cells are constantly exposed to the growth-promoting
effects of female hormones, breast cancer is much more common in women.
Many types of breast disorders can affect both men and women. Most breast
disorders are benign (not cancerous). Benign breast tumors do not spread
outside of the breast and are not life threatening. Other tumors are
malignant (cancerous) and may become life threatening. Benign tumors, such
as papillomas and fibroadenomas, are common in women but are extremely rare
Lymphatic vessels are important structures in the breast. They are like
veins, except that they carry lymph instead of blood. Lymph is a clear fluid
that contains tissue fluid and waste products and immune system cells (cells
that are important in fighting infections). Lymph nodes are small
bean-shaped collections of immune system cells that are found along
lymphatic vessels. Cancer cells can enter lymphatic vessels and spread to
Most lymphatic vessels in the breast connect to lymph nodes under the arm (axillary
lymph nodes). Some lymphatic vessels connect to lymph nodes inside the chest
(internal mammary nodes) and either above or below the collarbone (supra- or
When breast cancer cells reach the axillary (underarm) lymph nodes, they may
continue to grow, often causing the lymph nodes in that area to swell. If
breast cancer cells have spread to the underarm lymph nodes, they are more
likely to have spread to other organs of the body as well. This is why it is
important to find out if breast cancer has spread to your axillary lymph
nodes when you are choosing a treatment.
Benign Breast Conditions
Gynecomastia is the most common male breast disorder. It is not a tumor but
rather an increase in the amount of a man's breast tissue. Usually, men have
too little breast tissue to be felt or noticed. A man with gynecomastia has
a button-like or disk-like growth under his nipple and areola, which can be
felt and sometimes seen. Gynecomastia, common among teenage boys, is due to
changes in hormone balance during adolescence. The same condition is also
common in older men and is also due to changes in their hormone balance.
Rarely, gynecomastia occurs because tumors or diseases of certain endocrine
(hormone-producing) glands cause a man's body to produce more estrogen (the
main female hormone). Although men's glands normally produce some estrogen,
it is not enough to cause breast growth. Diseases of the liver, which is an
important organ in male and female hormone metabolism, can change a man's
hormone balance and lead to gynecomastia. Obesity may be another cause of
elevated estrogens in men.
Many commonly prescribed medicines can sometimes cause gynecomastia, too.
These include some drugs used to treat ulcers and heartburn, high blood
pressure, and heart failure. Men with gynecomastia should ask their doctors
about whether any medicines they are taking might be causing this condition.
Klinefelter syndrome, a rare genetic condition, can lead to gynecomastia and
increase a man's risk of developing breast cancer. This condition is
discussed further in the section on risk factors for male breast cancer.
Types of Breast Cancer
Adenocarcinoma: Nearly all breast cancers start in the ducts or lobules of
the breast. Because this is glandular tissue, they are called
adenocarcinomas, a term applied to cancers of glandular tissue anywhere in
the body. The 2 main types of breast adenocarcinomas are ductal carcinomas
and lobular carcinomas.
Ductal carcinoma in situ (DCIS): DCIS is an uncommon type of breast
adenocarcinoma in men (about 10%). Cancer cells fill the ducts but do not
invade through the walls of the ducts into the fatty tissue of the breast or
spread outside the breast. It is almost always curable.
In situ is the term used for the early stage of cancer, when it is confined
to the immediate area where it began. Specifically in breast cancer, in situ
means that the cancer remains confined to ducts (ductal carcinoma in situ)
or lobules (lobular carcinoma in situ). It has not invaded surrounding fatty
tissues in the breast nor spread to other organs in the body.
Infiltrating (or invasive) ductal carcinoma (IDC): Starting in a duct of the
breast, this type of adenocarcinoma breaks through the wall of the duct and
invades the fatty tissue of the breast. At this point, it can metastasize
(or spread) to other parts of the body. IDC (alone or mixed with other types
of invasive or in situ breast cancer) accounts for 80% to 90% of male breast
Other Breast Cancers
Lobular breast cancers in men are very rare, accounting for only 2% of
adenocarcinomas. This is because men do not usually have lobular tissue, the
Paget disease of the nipple: This type of breast cancer starts in the breast
ducts and spreads to the skin of the nipple. It may also spread to the
areola (the dark circle around the nipple). The skin of the nipple usually
appears crusted, scaly, and red, with areas of itching, oozing, burning, or
bleeding. Using the fingertips, a lump may be detected within the breast. If
no lump can be felt, the prognosis (outlook for survival) is generally good.
Paget disease may be associated with in situ carcinoma or with infiltrating
breast carcinoma. It accounts for about 1% of female breast cancers and a
higher percentage of male breast cancers. Because the male breast is much
smaller than the female breast, all male breast cancers start relatively
close to the nipple, so spread to the nipple is more likely.