Ian S. Fentiman

Ecancermedicalscience is the peer-reviewed open access cancer journal founded by the European Institute of Oncology in Milan. We consider articles on all aspects of research relating to cancer, including molecular biology, genetics, pathophysiology, epide

Aromatase inhibitors bind reversibly or irreversibly to the aromatase enzyme in peripheral fat and also in the breast, leading to undetectable plasma levels of oestrogens in postmenopausal women. These agents have been shown to be more effective than tamoxifen in first‐line treatment of oestrogen receptor‐positive advanced and metastatic breast cancer. Additionally, they have been demonstrated to be superior as both adjuvant and neoadjuvant treatment. It is likely that they will also be useful for breast cancer prevention but the cost/benefit ratio has yet to be determined.

Breast cancer usually develops after a series of epithelial changes in the terminal ductolobular unit. There are multiple benign causes of breast lumps, the majority of which are not associated with an increased risk of breast cancer. Histological changes of pre‐malignancy such as atypical hyperplasia and in situ carcinoma can be identified, and these are indications for either close surveillance or further surgery. At the time of diagnosis, breast cancers can be staged both clinically and pathologically, and this facilitates international comparisons of results of treatment.

The most important epidemiological, aetiological, diagnostic and therapeutic problems related to male breast cancer are reviewed. Early diagnosis is important in order to achieve optimal results, which can be similar to those following the treatment of female breast cancer.

One hundred and fifty-five patients with carcinoma of the breast treated by mastectomy were randomised to receive no additional treatment or to receive adjuvant testosterone. After a minimum follow up of 15 years there is no difference in either relapse free survival or overall survival between the treated and control groups. Stratification by pathological nodal status showed no benefit either for those with negative or positive axillary lymph node involvement.