Breast cancer is generally thought of as a disease that only affects women, but it’s not. Men can get breast cancer too. In the United States, roughly 1 percent of all breast cancer cases occur in men. While the chances of being diagnosed with breast cancer as a male are rare, it does unfortunately happen.
In fact, around 2,600 new cases of invasive breast cancer will involve men each year. While these cases may be small in comparison to women who are diagnosed with breast cancer, they are numerous enough for men to take note and to be aware of the warning signs, as well as how to check and diagnose this cancer.
What are the Symptoms?
Male breast cancer is most common in older men, but it can also affect men at any age. Here are some symptoms of male breast cancer:
A lump or thickening in the breast tissue, which is generally painless, but may be tender.
Any changes to the skin covering the breast area, such as dimpling, puckering, redness or scaling
Any changes to the nipple, such as redness or scaling, or a nipple that begins to turn inward
Discharge from the nipple
Itching or rash development on the nipple
Changes in the size or shape of the breast
Pain in the nipple
An enlargement of both breasts, sometimes on one side, may also be due to gynecomastia, which is a common non-cancerous breast disorder that increases the size of the male breast tissue, which may be related to an imbalance of the hormones estrogen and testosterone, or other health issues. In most cases, gynecomastia is not a serious problem, but it may cause some physical and mental discomfort.
Types of Male Breast Cancer
Just as for women, there are several types of male breast cancer, some are not so common.
Invasive Ductal Carcinoma-The majority of male breast cancers are considered ductal carcinoma, where the cancer originates in the milk ducts and then spreads into other parts of the breast tissue.
Invasive Lobular Carcinoma – This type of cancer originates in the milk producing glands, referred to as the lobules and then spreads into the fatty tissue of the breast. It is considered very rare in men, about 2% of all male breast cancers, as men do not usually have much lobular tissue.
Paget Disease of the Nipple – This form of breast cancer forms in the milk ducts and then spreads to the nipple, creating a crusty or scaly skin around the nipple. Paget’s disease is also fairly rare amongst male breast cancer cases.
Ductal Carcinoma in Situ (DCIS) – This is considered to be the earliest type of breast cancer, where the cancer cells are in the ducts of the breast but have not spread into the surrounding breast tissue. DCIS occurs in about 5% of all cases of male breast cancer.
While researchers do not completely understand the causes of breast cancer in men, there are several factors which can increase the risk of getting it.
Inherited Genes– Inheriting a mutation in a gene, like the BRCA2 , can increase the risk of male breast cancer. These genes generally create proteins to prevent cells from growing abnormally, which helps prevent cancer. When these genes become mutated, they are no longer as effective at protecting against cancer. Patients who are worried that they may pass such a gene along to their children, either male or female, may consider genetic testing, which can help determine whether or not they are a carry a mutation.
Age – As men increase in age, their risk of breast cancer goes up. On average, men with male breast cancer are about 68 years old when they are diagnosed.
Exposure to Estrogen = There may be an increased risk for patients who have used estrogen related drugs, such as for hormonal therapy for men with prostate cancer.
Family History of Breast Cancer – Breast cancer risk increases if there are other blood relatives have had breast cancer. Overall, about 20% of men diagnosed with breast cancer have a close female or male relative with the disease.
Klinefelter’s Syndrome – This is a genetic syndrome that occurs when a boy is born with more than one copy of the X chromosome, which produces lower levels of certain male hormones and more female hormones.
Liver Disease– Some conditions like cirrhosis of the liver may reduce male hormones and increase female hormones.
Obesity – Being extremely overweight may create a risk factor for men, as fat cells in the body convert male hormones (androgens) info female hormones (estrogen). Higher amounts of fat cells in the body may produce more estrogen which could lead to a higher risk of developing breast cancer.
Radiation Exposure – Men who have been treated with radiation for cancer in the chest, such as lymphoma, may have an increased risk of developing breast cancer later in life.
Diagnosing Male Breast Cancer
A physician will want to do a thorough clinical breast examination, locating any lumps or suspicious areas, and also get a better understanding of the patient’s family medical history. Should the patient have a family history with breast cancer and also provide symptoms that suggest this disease is present, there are several tests that may be used.
Imaging Tests – Either a mammogram, an MRI or an ultrasound test will be used to detect whether there are any suspicious masses in the patient’s breast tissue.
Biopsy – This test involves inserting a fine needle into the breast to remove tissue to analyze under a microscope. A biopsy is the only way to tell if an abnormality in the breast is cancerous and there are different types of biopsy options that work better for particular cases.
Breast Cancer Treatments
Treatments for male breast cancer are similar to treatments for women with breast cancer. Determining a treatment will involve considering several factors, such as the patient’s age, the stage of their cancer, their overall health and what preferences the patient may prefer. Treatments for men generally include surgery and may involve other treatments.
Surgery – The purpose of this treatment is to remove a cancerous tumor and any surrounding breast tissue. Surgery procedures may include the following.A mastectomy is a surgery to remove all of the breast tissue and sometimes may include the removal of nearby tissues, such as the underarm lymph nodes.Lymph Node surgery involves removing one or more lymph nodes to determine if the breast cancer has spread to the underarm area. This is an important component of determining the stage of the cancer as well as the treatment. If the lymph nodes are affected, there is an increased chance that the cancer has spread to other parts of the body. If no cancer cells are detected, there is a good chance that the patient’s cancer has not spread beyond the breast tissue.
Radiation – Following surgery, radiation therapy may be used to eliminate any remaining cancer cells within the breast, as well as chest muscles or the arm pit. This type of treatment involves using high-energy beams to kill cancer cells.
Chemotherapy – This treatment uses various types of cancer fighting drugs to kill cancer cells that may have spread to areas outside of the breast area, such as with metastatic or advanced breast cancer. Depending upon the type of chemotherapy, treatments may be administered intravenously through a port or taken orally by pill.
Hormone Therapy – Men with breast cancer generally have tumors that rely on hormones to grow. This is referred to as hormone sensitive. In these cases, hormone therapy may be recommended to help reduce or block the hormones, like anti-estrogen treatments such as Tamoxifen.
As with any type of cancer treatment, certain side effects may be involved. Your cancer care team will provide you with information about possible side effects for each type of treatment. It is important to let your team know about any side effects you may experience, such as those from chemotherapy, as there are ways to help ease the patient’s symptoms.
As is the case for women who are diagnosed with breast cancer, the successful treatment for this disease in men improves with early detection. Breast cancer in men is often diagnosed at a later stage. Perhaps it’s because some men may be embarrassed about a change in their breast or chest area and put off seeing a health provider.
Because the prognosis improves the sooner it can be diagnosed, it’s important for men to be aware of breast cancer for themselves and to know what symptoms to look for. If there are symptoms or changes in the breast, don’t delay in having your physician check it out. Survival is highest when breast cancer is found early.