Abstract Background Breast cancer is rare in men and managed by extrapolating from breast cancer in women. The clinicopathological features of male breast cancer, however, differ from those of female breast cancer. Because clinical trials are rare, the synthesis of real-world data is one method of integrating sufficient evidence on the optimal treatment for this patient population. Methods PubMed, Embase, and Cochrane Library databases were searched. Clinical studies were included if they evaluated the treatments of interest in male breast cancer; these evaluations included breast-conserving surgery (BCS) versus mastectomy, postmastectomy radiation therapy versus no radiation, the accuracy of sentinel lymph node biopsy (SLNB), and a comparison of various endocrine therapies. Results Forty studies were retrieved. The pooled estimate of overall survival (OS) revealed no difference between BCS and mastectomy groups. Postmastectomy radiation to the chest wall significantly increased OS relative to no postmastectomy radiation (hazard ratio (HR) 0.67, 95 per cent confidence interval 0.54 to 0.84). The pooled estimates of identification and false-negative rates of SLNB were 97.4 and 7.4 per cent respectively. Tamoxifen treatment was associated with significantly increased OS compared with no tamoxifen intake (HR 0.62, 0.41 to 0.95). Conclusion Identification and false-negative rates for SLNB were comparable to those in female breast cancer. Breast-conserving surgery can be effective and safe; postmastectomy radiation to the chest wall and 5-year tamoxifen treatment improves survival.

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男性乳腺癌的治疗：现实世界证据的荟萃分析

摘要 背景男性乳腺癌很少见，可以通过女性乳腺癌的推断来控制。然而，男性乳腺癌的临床病理特征与女性乳腺癌不同。由于临床试验很少，因此综合真实世界数据是整合足够证据来确定针对该患者群体的最佳治疗方法的一种方法。 方法检索了 PubMed、Embase 和 Cochrane 图书馆数据库。如果临床研究评估了男性乳腺癌的相关治疗方法，则纳入其中；这些评估包括保乳手术（BCS）与乳房切除术、乳房切除术后放射治疗与无放射治疗、前哨淋巴结活检（SLNB）的准确性以及各种内分泌治疗的比较。 结果检索到四十项研究。总生存期 (OS) 的汇总估计显示 BCS 组和乳房切除组之间没有差异。相对于没有乳房切除术后放疗，乳房切除术后胸壁放疗显着增加了 OS（风险比 (HR) 0.67，95% 置信区间 0.54 至 0.84）。SLNB 的识别率和假阴性率的汇总估计分别为 97.4% 和 7.4%。与不服用他莫昔芬相比，他莫昔芬治疗与 OS 显着增加相关（HR 0.62、0.41 至 0.95）。 结论SLNB 的识别率和假阴性率与女性乳腺癌相当。保乳手术既有效又安全；乳房切除术后胸壁放疗和 5 年他莫昔芬治疗可提高生存率。