Understanding Male Breast Cancer
Many people do not realize that male breast cancer is possible, and although numbers are small, it is important that people know what the symptoms are so that they can get checked if they suspect something is wrong.
How Do Men Get Breast Cancer?
Everyone is born with breast tissue that contains lobules that produce milk, and there are ducts which carry the milk to the nipple. Women’s breasts develop during puberty and produce more tissue, whereas men’s breasts do not grow any further. However, the small amount of breast tissue they have means that abnormal cells can grow there, like they can in any other part of the body, forming a cancer tumor.
The American Cancer Society estimates that in the U.S., 2,620 new cases of invasive male breast cancer will be diagnosed in 2020 and around 520 men will die of breast cancer. Statistics show that black men will have a worse prognosis than white men and the overall risk of a man getting breast cancer is 1 in 833. This compares to 1 in 8 women, demonstrating that men are around 100 times less likely to get breast cancer compared to women.
Signs and Symptoms of Male Breast Cancer
The signs of male breast cancer are very similar to those for women. For example, the most common sign is a lump which is usually painless, but not always.
Other symptoms may be:
- Inverted nipples
- Swollen chest area
- Enlarged lymph nodes in the armpit
- Tender nipples
- Ulcers on the chest or nipple
- Discharge from the nipple
- Rash around nipple
In summary, any changes to the breast, chest or armpit area should be reported to your doctor. Although, most will not be diagnosed as breast cancer, so it is vital that it is caught early to give a person the best chance of recovery.
Risk Factors for Male Breast Cancer
The biggest risk factor for male breast cancer is age and most men who are diagnosed are over 60 years old.
Estrogen and Breast Cancer
Estrogen is a hormone that is linked to both male and female breast cancer. All men produce low levels of estrogen but certain health conditions can lead to elevated levels. This can then be linked to breast cancer. If a man is treated for prostate cancer, then they may receive drugs that contain estrogen. Obese men often have higher levels of estrogen, as well as men who have a chronic liver disease, such as cirrhosis.
Some genetic conditions are linked with an increased risk of male breast cancer, such as Klinefelter’s syndrome, where men are born with an extra female chromosome. Also, if you have a family history of breast cancer, then you are more likely to get it, even as a man. The risk is higher if it was a mother or sister, and particularly if they were diagnosed at a younger age, below 40. If a man has had testicular surgery or an inflamed testicle, then there is an increased risk, as well as if the chest area has been exposed to radiation.
If your doctor thinks you have breast cancer, then they will refer you to a clinic for tests. These usually comprise a range of tests including a mammogram, an x-ray of the breast or an ultrasound. During the ultrasound they may use a thin needle to remove some tissue to be tested for the presence of cancer cells. Biopsies can also be collected from the lymph nodes in the armpit. If it is suspected that the cancer has spread beyond the breast, then extra scans will be organized, such as an MRI, a CT and bone scans.
Treatment Options for Male Breast Cancer
The treatment plan for male breast cancer is similar to treatments for women. There are usually a range of treatments and your doctor will decide which is best for you. This includes surgery, to remove the tumor, chemotherapy, radiotherapy, hormone therapy, such as tamoxifen, and targeted therapy, such as Herceptin.
For men, the most common surgery for breast cancer is a mastectomy, to remove the entire breast. This is because men do not have much breast tissue, so it is not usually practical to leave some behind. Depending whether there are cancer cells in the lymph nodes, some of these may be removed too. Any lymph nodes and breast tissues that are removed are sent to the laboratory for testing to find out the type of cancer and how aggressive it is. It is possible to have a nipple reconstruction but that is usually done after the wound has fully healed. Skin can be taken from another part of the body to form a nipple and another option is to have a nipple tattooed on the breast.
Chemotherapy affects the whole body and is recommended to kill any remaining cancer cells and reduce the risk of it returning.
Radiotherapy is when high doses of intense energy are used to shrink or eradicate the cancer cells, and it is focused on the breast area, where the cancer is located.
If a man has hormone receptor positive breast cancer, then a therapy such as Tamoxifen may be prescribed. This treatment blocks hormone receptors, making it less likely that the cancer will return. The treatment usually lasts for five years and can cause side effects such as hot flashes, low libido, nausea and weight gain.
Targeted Drug Treatment
If the breast cancer contains HER2 receptors then a targeted drug treatment such as Herceptin (trastuzumab) is given every few weeks, usually by injection. It is much rarer for these receptors to be found in men, but it is still possible.
Early Diagnosis Is Best
Since male breast cancer is so rare, the symptoms may sometimes go unnoticed. It’s vital that any changes to the breast or armpit area are reported to a doctor, so that if cancer is diagnosed it can be treated early and produce the best outcome.