Stefan Glück^1,2 MD, PhD and Christine Friedenreich³ PhD
¹Professor, Dept. Oncology, Medicine and Pharmacology & Therapeutics Faculty of Medicine, University of Calgary, Calgary, AB.
²Senior Leader, Clinical Research Program Medical Oncologist, Tom Baker Cancer Centre, Calgary, AB.
³Research Scientist, Division of Epidemiology, Prevention and Screening, Alberta Cancer Board, Calgary, AB.

Introduction
In 1996, the most recent year for which complete statistics for Canadian cancer incidence are available, a total of 118 new cases of breast cancer were diagnosed in men.¹ This incidence rate is approximately 0.7% of the 16,551 cases diagnosed in women.¹ This proportion of male to female breast cancers is typical of western populations, although exceptionally high proportions of male to female breast cancers have been found in countries such as Egypt and Zambia, with studies reporting 6% and 15%, respectively.^2,3

In many aspects, the disease has a similar clinical course in both genders. However, because male breast cancer is so rare, it has been very difficult to accumulate knowledge through research, especially through large prospective trials. Many aspects of the diagnosis and treatment of male breast cancer remain controversial and even in the future, clinical research will be difficult.

D'Arcy Little, MD, CCFP, Director of Medical Education, York Community Services, Toronto and Academic Fellow, Department of Family and Community Medicine, University of Toronto, Toronto, ON.

Introduction/Epidemiology
Osteoporosis is a common, serious disease in older adults. Until recently, osteoporosis research and treatment have focussed on postmenopausal women. Recently, however, the epidemiology of this condition in elderly men has become clearer and it is evident that osteoporosis is also prevalent in this population. In fact, men over the age of 50 years have a 19-25% lifetime risk of an osteoporotic fracture, as compared to women who have a 50% lifetime risk. In addition, it is estimated that 30% of hip fractures that occur worldwide occur in men, and lead to significant mortality and loss of independence. Indeed, post-hip fracture, men have a higher mortality rate than do women.^1,2,3,4 The role of androgens in bone physiology has suggested that testosterone may be one arm in the treatment regimen. The following article will review the place of testosterone in the management of osteoporosis in males.

Bone Physiology and Pathophysiology
Osteoporosis is a "disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture incidence."⁵ The origin of idiopathic osteoporosis lies in the aging process and normal bone physiology.