What Is Breast Cancer In Men
Breast cancer occurs mainly in women, but men can get it, too. Many people do not realize that men have breast tissue and that they can develop breast cancer. Cells in nearly any part of the body can become cancer and can spread to other areas.
Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant if the cells can grow into surrounding tissues or spread to distant areas of the body.
To learn more about how cancers start and spread, see Cancer Basics.
Risk Factors For Breast Cancer In Men
A risk factor is anything that affects your chance of getting a disease, such as breast cancer.
But having a risk factor, or even many, does not mean that you are sure to get the disease. Some men with one or more breast cancer risk factors never develop the disease, while most men with breast cancer have no apparent risk factors.
We don’t yet completely understand the causes of breast cancer in men, but researchers have found several factors that may increase the risk of getting it. As with female breast cancer, many of these factors are related to your body’s sex hormone levels.
Lobular Carcinoma In Situ
Lobular carcinoma in situ may also be called lobular neoplasia. In LCIS, cells that look like cancer cells are growing in the lobules of the milk-producing glands of the breast, but they havent grown through the wall of the lobules. LCIS is not a true pre-invasive cancer because it does not turn into an invasive cancer if left untreated, but it is linked to an increased risk of invasive cancer in both breasts. LCIS is rarely, if ever seen in men.
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Treatments For Breast Cancer In Men
The treatment for breast cancer in men depends on how far the cancer has spread.
Possible treatments include:
- surgery to remove the affected breast tissue and nipple and some of the glands in your armpit
- radiotherapy where radiation is used to kill cancer cells
- chemotherapy where cancer medicine is used to kill cancer cells
- other medicines that help stop breast cancer growing including tamoxifen and trastuzumab
Many men have surgery followed by 1 or more of the other treatments. This can help stop the cancer coming back in the future.
Read more about treatments for breast cancer in men.
Family Members With Breast Cancer Or A Breast Cancer Gene
Men who have female relatives with breast cancer have an increased risk of breast cancer, especially if the women are close relatives . The risk also increases if the women were diagnosed at a young age . Men, as well as women, can inherit faulty genes that increase the risk of breast cancer.
Around 2 in 100 breast cancers diagnosed in women are thought to be due directly to an inherited faulty gene . In men, this might be more common. Doctors think that around 5 to 10 out of 100 breast cancers diagnosed in men are due to inherited faulty genes . In men with breast cancer, changes in the BRCA2 faulty gene are more common than BRCA1.
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Treatment Options For Male Breast Cancer By Stage
Breast cancer in men is treated the same as breast cancer in women.
Therapy given after an operation when cancer cells can no longer be seen is called adjuvant therapy. Even if the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given radiation therapy, chemotherapy, hormone therapy, and/or targeted therapy after surgery, to try to kill any cancer cells that may be left.
Node-negative: For men whose cancer is node-negative , adjuvant therapy should be considered on the same basis as for a woman with breast cancer because there is no evidence that response to therapy is different for men and women.
Node-positive: For men whose cancer is node-positive , adjuvant therapy may include the following:
- Targeted therapy with a monoclonal antibody .
- Tamoxifen .
- Other hormone therapy.
These treatments appear to increase survival in men as they do in women. The patients response to hormone therapy depends on whether there are hormone receptors in the tumor. Most breast cancers in men have these receptors. Hormone therapy is usually recommended for male breast cancer patients, but it can have many side effects, including hot flashes and impotence .
Treatment options for metastatic breast cancer may include the following:
Ductal Carcinoma In Situ
Ductal carcinoma in situ is considered non-invasive or pre-invasive breast cancer. In DCIS , cells that lined the ducts have changed to look like cancer cells. The difference between DCIS and invasive cancer is that the cells have not spread through the walls of the ducts into the surrounding tissue of the breast . DCIS is considered a pre-cancer because some cases can go on to become invasive cancers. Right now, though, there is no good way to know for certain which cases will go on to become invasive cancers and which ones wont. DCIS accounts for about 1 in 10 cases of breast cancer in men. It is almost always curable with surgery.
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Paget Disease Of The Nipple
This type of breast cancer starts in the breast ducts and spreads to the nipple. It may also spread to the areola . The skin of the nipple usually appears crusted, scaly, and red, with areas of itching, oozing, burning, or bleeding. There may also be an underlying lump in the breast.
Paget disease may be associated with DCIS or with infiltrating ductal carcinoma. It is rare and accounts for about 1-3% of female breast cancers and a higher percentage of male breast cancers.
Risk Factors And Signs
Chirrey agreed its important for men to share these stories honestly, and with so much focus on prevention and treatment for women breast cancer makes up 25.5 per cent of all cancers in women men also have to know the signs.
While the Canadian Cancer Society doesnt recommend taking self-breast exams anymore , it is still important to be breast aware.
Know the signs: check for discharge or bleeding nipples, crusting of the nipple, inverse nipples, swelling or pain of the nipples, lumps in the armpit or open sores that dont heal.
But before this, know your risk factors.
If you have a family history of breast cancer, thats something men should be aware of even before they start seeing symptoms, he saidl
Chirrey noted that besides a family history of the disease, other known risk factors include BRCA gene mutations, which are changes to the breast cancer genes. Men who carry these gene mutations may pass them on to their children. Children of men with breast cancer have a higher risk of developing breast cancer.the Canadian Cancer Society noted.
Klinefelter syndrome is a rare genetic disorder in which men have lower than normal levels of androgens and higher levels of estrogen. This can also lead to a higher risk of breast cancer in men.
And when it comes to radiation, exposure in the chest area also increases the risk of breast cancer.
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Differences Between Male And Female Breast Cancer
While many are unaware, both men and women have breast tissue. Until puberty, both male and female breast tissue is very similar. During puberty, the ovaries produce female hormones that allow the breast to develop and differentiate, forming ductal systems, milk-producing lobules and increased fatty or stromal tissue. In contrast, during puberty in males, the testicles produce hormones that prevent the growth and differentiation of the breast tissue.
Since men have less breast tissue compared to women, it is much easier to identify breast tumors or abnormalities in men. However, since breast cancer is much more common in women, many men consider breast cancer to be only a female cancer and rarely see physicians for breast abnormalities. Many men ignore the initial signs of breast cancer and tend to attribute them to infection or other causes.
The most common breast abnormality in men is non-cancerous and is a condition called gynecomastia, an increasein the amount of breast tissue. It is most commonly found in adolescent boys and is related to changes in the hormone balance during puberty. However, older men with hormonal imbalances can develop this condition. Gynecomastia is characterized by a button-like or disc-like growth under the nipple and areola. While the cause of gynecomastia is not fully understood, certain factors have been linked to its development such as liver disease, Klinefelterâs syndrome and certain medications .
Can Breast Cancer Return After A Double Mastectomy
During the course of breast cancer treatment, a woman may decide, after discussion with her doctors, to have both of her breasts removed.
She might choose to have a double mastectomy in the hope that it will reduce the risk of breast cancer recurring in the remaining tissue or a new cancer developing in the opposite, unaffected breast.
A woman who has had breast cancer does not inherently or automatically face an increased risk of being diagnosed with another type of cancer, says Ellis Levine, MD, Chief of Breast Medicine at Roswell Park Comprehensive Cancer Center.
Unless they have an underlying hereditary genetic mutation, I do not consider them at exquisite risk to develop another type of cancer, he says. The cancer that is most often genetically linked to breast cancer is ovarian, due to mutations in the BRCA 1 or BRCA 2 genes.
When mastectomies are performed, surgeons will remove as much of the cancerous tissue as possible. If a woman, in consultation with her doctors, decides to have a skin-sparing or nipple-sparing mastectomy, a small amount of healthy breast tissue may be left behind on the skin to allow for reconstruction of her breasts.
Even if the full breast is removed, surgeons will not have removed 100% of the breast cells, explains Jessica Young, MD, a breast surgeon at Roswell Park. The risk of cancer recurring is lower if the whole breast is removed, but it is not zero percent.
Breast Cancer Treatment
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How Is Breast Cancer Treated
As in women, treatment for breast cancer in men depends on how big the tumor is and how far it has spread. Treatment may include surgery, chemotherapy, radiation therapy, hormone therapy, and targeted therapy. For more information, see the National Cancer Institutes Male Breast Cancer Treatment.external icon
Genetics And Family History
A genetic mutation is a permanent alteration in the DNA sequence that makes up a gene. The result is that one or more of the body’s processes may not work in the way they should.
There are a number of genetic mutations known to increase your risk of developing breast cancer. The most significant mutation identified is known as the BRCA2 mutation. Faulty genes are believed to be the cause of male breast cancer in around 1 or 2 in every 10 cases.
There’s also evidence that breast cancer can run in families, especially in men who have a first-degree relative who has developed breast cancer, such as a mother or sister.
Routine testing for the faulty genes that cause breast cancer in men isn’t usually carried out on the NHS, unless specifically requested by a specialist. However, some private clinics may offer gene testing. Tests can be expensive, with prices ranging from around £2,000 to £3,000.
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How Is Male Breast Cancer Diagnosed
Your healthcare provider will ask about your symptoms and examine your breast tissue, paying close attention to any lumps or abnormalities. Your provider may take a sample of your blood and send it to a lab.
To look for cancer cells in breast tissue, your provider may do a biopsy. Using a thin needle, your provider removes a sample of the breast tissue and sends it to a lab. The lab tests the tissue for cancer cells.
To see pictures of your breast tissue, your provider may order imaging studies. These include:
- Mammogram: A mammogram is an X-ray of breast tissue.
- Ultrasound: An ultrasound uses sound waves to see images of soft tissues.
- MRI: An MRI produces images of breast tissue using a high-powered magnet and radio waves.
Outlook For Breast Cancer In Men
The outlook for breast cancer in men varies depending on how far it has spread by the time it’s diagnosed.
It may be possible to cure breast cancer if it’s found early.
A cure is much less likely if the cancer is found after it has spread beyond the breast. In these cases, treatment can relieve your symptoms and help you live longer.
Speak to your breast care nurse if you’d like to know more about the outlook for your cancer.
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Your Body After Surgery
After surgery, there’ll be a straight scar across your chest where your nipple used to be and possibly a dent where the breast tissue was removed.
The scar will be raised and red at first, but it should flatten and fade with time. The area will also be bruised and swollen for a few weeks.
It may be possible to have further surgery at some point to improve the appearance of your breast and create a replacement nipple. Other options include tattooing a new nipple on to your chest.
Talk to your care team about how your chest will look after surgery and what options you have for improving its appearance if necessary.
If Cancer Is Found Tests Are Done To Study The Cancer Cells
- How quickly the cancer may grow.
- How likely it is that the cancer will spread through the body.
- How well certain treatments might work.
- How likely the cancer is to recur .
Tests include the following:
- Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
- HER2 test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer is called HER2/neu positive. This type of breast cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and pertuzumab.
What Is The Most Common Type Of Breast Cancer In Men
The most common type of breast cancer in men is infiltrating ductal cancer. This is cancer that starts in milk duct and spreads to nearby tissues.
Other less-common types of breast cancer in men include inflammatory carcinoma and Paget disease of the nipple. A type of breast cancer called lobular carcinoma in situ is very rare in men. This is because men don’t have much lobular tissue. Lobular tissue is where breast milk is made.
Why Is It Important To Get Tested
When a man is diagnosed with breast cancer, Smania said, doctors usually do genetic testing as well to determine if he carries BRCA1 or BRCA2 mutations, also known by the National Breast Cancer Foundation as the “Breast Cancer Gene.”
These mutations are genetic and can be passed down to children, which would significantly increase the chances of a daughter having breast cancer, Smania said.
The National Breast Cancer Foundation said 55%-65% of women with the BRCA1 mutation and about 45% with the BRCA2 mutation will develop breast cancer by the age of 70.
“Education in this matter is critical,” Rhodes said. “Men are statistically less likely to have a primary care physician, go to yearly exams or conduct self breast exams.”
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In New Zealand Around 25 Men Are Diagnosed With Breast Cancer Each Year
Breast cancer in men is the same disease as affects women. Although most of the available information is directed at women it is generally relevant for men too, as the diagnosis, treatment and survival rates for both sexes is very similar.
All men need to know what signs of breast cancer to look for, and to report any breast changes to their GP. For most men, breast cancer doesn’t come to mind when they notice a change in their breasts, which can delay diagnosis. Learn the signs of male breast cancer, so you can detect it early.
What Are The Treatments For Male Breast Cancer
Male breast cancer treatment depends on the type and stage of the disease. Your team of providers will discuss your options with you. Your medical history will help guide what treatment is best for you. Treatments include:
- Surgery: During breast cancer surgery, your provider removes as much of the tumor as possible. You may need a lumpectomy or a mastectomy . Because men have limited breast tissue, mastectomy is more commonly done. You may also need surgery to remove lymph nodes.
- Radiation: Your provider uses targeted radiation therapy to kill cancer cells. Radiation for breast cancer usually follows surgery .
- Chemotherapy : Your provider delivers chemotherapy drugs into a vein, usually through an infusion. You might also take oral chemotherapy pills . These medications kill cancer cells and stop them from multiplying. You may receive chemo treatments over several weeks or months.
- Hormone therapy : Your provider prescribes medications that affect your hormones. These drugs may lower levels of estrogen or block the effects of estrogen. Providers usually use hormone therapy to treat women with breast cancer, but it can be an effective treatment for men, too. These medications treat breast cancers that use hormones to grow. Hormone therapy can be given in the form of pills and/or injections.
- Medications: Several medications kill cancer cells or stop them from growing. Your provider will discuss these medications with you. These may include medications called targeted therapy.
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