男性早期乳癌：一病例報告

Early-stage Male Breast Cancer: A Case Report

男性乳癌（male breast cancer）相較於女性乳癌，發生率極低，僅佔所有乳癌的百分之一不到。大部分民眾對男性乳癌缺乏認識，甚至誤以為乳癌是女性的專利，因此針對這個疾病往往警覺性不足，甚或可能導致求診時機延誤。本文報告一位57歲中年男性，在就診前一至兩週開始出現左側乳房疼痛，且在左側乳房發現腫塊。理學檢查在左側乳暈下面的地方摸到一伴隨著壓痛感之腫塊及輕微乳頭凹陷；經安排乳房超音波（breast ultrasonography）及乳房攝影（mammography）後，發現左側乳暈下區域有一界限不清的異質性腫塊，且合併有左側乳頭凹陷及乳暈下皮膚增厚之情形。轉介外科進行切片後，病理報告顯示為侵襲性腺管癌（invasive ductal carcinoma），其後病患接受左側乳房根除術，之後進行荷爾蒙治療並持續追蹤。本篇文章針對男性早期乳癌做一簡要介紹，主要目的是想藉此病例增加基層醫師對男性乳癌的認識、提高對具有危險因子之男性罹患乳癌的警覺性，並在適當時候提供相關諮詢及建議，掌握早期診斷及適時轉介的時機，以期給予病患最適切的照護。

Compared to female breast cancer, the incidence of male breast cancer is relatively low, as these cases make up less than one percent of all cases of breast cancer. Public awareness of this disease is generally insufficient and this might lead to a delay in diagnosis. We present the case of a 57-year-old male who complained of pain in the left breast and a palpable mass which had developed over the previous two weeks. Physical examination revealed a tender mass in the left subareolar region as well as mild nipple retraction. Breast ultrasonography and mammography showed an ill-defined heterogeneous mass in the left subareolar area, accompanied by nipple retraction and thickening of the subareolar skin. The patient was then referred to the Department of General Surgery for a biopsy and the pathology report revealed invasive ductal carcinoma. The patient underwent a total left mastectomy and has continued to receive chemotherapy. The purpose of this report is to raise awareness of male breast cancer and to remind primary care physicians to be more cognizant of the associated risk factors as well as the management of the disease so that an early diagnosis can be made and a higher quality of care delivered.