Breast cancer in Men

Breast cancer is often associated with women but the fact is that even men are susceptible to it. In the United States, less than 1% of all breast cancers occur in men. In 2022, about 2170 American men are estimated to be diagnosed with breast cancer and about 530 are expected to die from it. An average man’s risk of getting breast cancer is about 1 in 1000 as against women which is one in eight.¹

Men are often diagnosed with breast cancer at an advanced stage reducing their chances of recovery. One of the reasons being lack of awareness of the possibility of developing breast cancer for men and hence they do not look out for symptoms that may indicate a breast cancer.

Signs and Symptoms

Common signs & symptoms are:

• A painless lump or thickening in the breast tissue
• Changes to the skin covering the breast such as dimpling, puckering, redness or scaling
• Changes to the nipple, such as redness or scaling, a nipple that begins to turn inward
• Discharge from the nipple²

Causes

The causes of male breast cancer are not very clear. It usually happens when breast cells divide more quickly than other healthy cells. The accumulating cells form a tumour that may spread (metastasize) to nearby tissue, to the lymph nodes or to other parts of the body. However, one of the causes could be inherited abnormal (mutated) genes that increase the risk of cancer. Mutations in one of several genes such as BRCA2 puts you at a greater risk for developing breast and prostrate cancer.

Risk factors

Factors which increase the risk are:

Older age – The older the age the higher the risk of cancer. Male breast cancer is often diagnosed in men in their 60s.

Exposure to oestrogen³ – Oestrogen-related drugs, for example, hormone therapy for prostrate cancer increases the risk of getting cancer.

Family history – Having a close family member with breast cancer, increases the risk of getting it manifold.

Obesity – Obesity increases the risk because it is associated with higher levels of estrogen in the body.

Testicle disease or surgery – Inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can increase the risk of male breast cancer.

Liver disease – Conditions such as cirrhosis of liver can reduce male hormones and increase female hormones, increasing the risk of breast cancer.

Klinefelter’s syndrome – This is a genetic syndrome and occurs when boys are born with more than one copy of the X chromosome. Klinefelter’s syndrome causes abnormal development of the testicles as a result of which lower levels of certain male hormones (androgens) and higher levels of female hormones (estrogens) are produced.⁴

Diagnosis

The diagnostic tests and procedures for male breast cancer are:

Clinical breasts exam – Here breasts and surrounding areas are examined for lumps or other changes.

Imaging tests – They create a picture of the breast tissue that allow doctors to identify abnormal areas. Breast X-rays (mammogram) or ultrasound are used for these images.

Biopsy – A sample of breast cells is removed through a specialised needle device guided by X-ray or another imaging test to extract a core of the suspicious area.

Types of male breast cancer

There are around four types of male breast cancer.

Ductal carcinoma – This cancer begins in the milk ducts. And nearly all male breast cancers are ductal carcinoma.

Lobular carcinoma – This cancer begins in the milk-producing glands. This is a rare type of cancer for men and is caused by few lobules in the breast tissue.

Paget’s disease – This is another rare type of cancer found in men.

Nipple and inflammatory breast cancer⁵ – This again is a rare type of male breast cancer.

Treatment options

The cancer stage, overall health and preferences is considered while deciding treatment options. The usual mode of treatment is surgery but it may also involve other options.

Removing all of the breast tissue (mastectomy) – The entire breast tissue including the nipple and aerola is removed surgically.

Radiation therapy – High energy beams such as X-rays and protons kill cancer cells. This usually happens after surgery to remove any remaining cancer cells in the breast, chest muscles or the armpit.

Hormone therapy – Hormone therapy is recommended if the cancer is hormone sensitive.

Chemotherapy – Chemotherapy uses medications to kill any cancer cells that may have spread outside the breast.⁶
Men are often embarrassed of their breast cancer as they feel it is a women’s disease and at times feel isolated because of their condition. At such times they can turn to support groups such as Male Breast Cancer Coalition.

References:

• Male Breast Cancer
• Signs and Symptoms of Breast Cancer in Men
• Men Get It Too! Male Breast Cancer Awareness – Your Valley Cancer Specialists (arizonaccc.com)
• Male breast cancer – Symptoms and causes – Mayo Clinic
• What Is Breast Cancer in Men? | Male Breast Cancer
• Male breast cancer – Diagnosis and treatment – Mayo Clinic