Male Breast Cancer in the Age of Genetic Testing: An Opportunity for Early Detection, Tailored Therapy, and Surveillance.
Male Breast Cancer in the Age of Genetic Testing: An Opportunity for Early Detection, Tailored Therapy, and Surveillance.
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DOI：
10.1148/rg.2018180013
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Moy L
中科院分区：
文献类型：
--
作者：
Gao Y;Heller SL;Moy L
在检测、治疗和随访方面，男性乳腺癌历来落后于女性乳腺癌。总的来说，乳腺癌在男性中比在女性中更少见，这限制了筛查的效用，但男性乳腺癌的发病率正在上升，而且男性患乳腺癌的风险很高。虽然乳腺癌高危妇女有很好的特征，在筛查、补充筛查、风险预防、咨询和宣传方面有明确的指导方针，但对乳腺癌高危男子的识别却很差，是公共卫生领域的一个盲点。今天，更标准化的遗传咨询和更广泛的基因检测使得识别乳腺癌女性的高危男性亲属，以及易患乳腺癌的基因突变男性成为可能。这可能为我们更新男性乳腺癌的治疗方法提供一个新的机会。本文综述了男性乳腺癌的人口统计学、危险因素、肿瘤生物学和肿瘤遗传学；认识到男性乳腺癌与女性乳腺癌的不同；强调其诊断挑战；讨论了扩大多基因面板检测临床应用的意义；概述了目前针对高危男性的国家综合癌症网络指南（2018年第1版）；并探讨了有针对性的筛查和监测的可能效用。了解男性乳腺癌管理的现状及其挑战对于塑造未来的护理考虑是重要的。将男性乳腺癌的检测模式转向有针对性的精准医学，可能是改善这种罕见疾病临床结果的答案。
In detection, treatment, and follow-up, male breast cancer has historically lagged behind female breast cancer. On the whole, breast cancer is less common among men than among women, limiting utility of screening, yet the incidence of male breast cancer is rising, and there are men at high risk for breast cancer. While women at high risk for breast cancer are well characterized, with clearly established guidelines for screening, supplemental screening, risk prevention, counseling, and advocacy, men at high risk for breast cancer are poorly identified and represent a blind spot in public health. Today, more standardized genetic counseling and wider availability of genetic testing are allowing identification of high-risk male relatives of women with breast cancer, as well as men with genetic mutations predisposing to breast cancer. This could provide a new opportunity to update our approach to male breast cancer. This article reviews male breast cancer demographics, risk factors, tumor biology, and oncogenetics; recognizes how male breast cancer differs from its female counterpart; highlights its diagnostic challenges; discusses the implications of the widening clinical use of multigene panel testing; outlines current National Comprehensive Cancer Network guidelines (version 1, 2018) for high-risk men; and explores the possible utility of targeted screening and surveillance. Understanding the current state of male breast cancer management and its challenges is important to shape future considerations for care. Shifting the paradigm of male breast cancer detection toward targeted precision medicine may be the answer to improving clinical outcomes of this uncommon disease.
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影响因子：
6.4
作者：
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