Treating Breast Cancer In Men
Treatment for breast cancer in men largely depends on how far the cancer has spread.
Most hospitals use multidisciplinary teams to treat men with breast cancer. These are teams of specialists who work together to make decisions about the best way to proceed with your treatment.
Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions you’d like to ask the specialist. For example, you could ask about the advantages and disadvantages of particular treatments.
Causes Of Breast Cancer In Men
The exact cause of breast cancer in men is not known, but there are some things that increase your risk of getting it.
- genes and family history inheriting faulty versions of genes called BRCA1 or BRCA2 increases your risk of breast cancer
- conditions that can increase the level of oestrogen in the body including obesity, Klinefelter syndrome and scarring of the liver
- previous radiotherapy to the chest area
It’s not certain that you can do anything to reduce your risk, but eating a balanced diet, losing weight if you’re overweight and not drinking too much alcohol may help.
Page last reviewed: 18 March 2020 Next review due: 18 March 2023
If You Notice Any Of These Signs Or Consider Yourself High Risk Contact Your Doctor
If you notice any of these changes or are worried youre at high risk of developing breast cancer, its important not to dismiss your concerns. The first thing you should do is get in contact with your doctor.
Your doctor will be able to set up tests or a treatment plan to help you get the care you need.
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What Is The Outlook For Men With Breast Cancer
The prognosis for men who have breast cancer depends on the tumors size and if it has spread. These are reflected in the cancer stage. In general, a higher stage indicates a worse prognosis. Early diagnosis can improve the outlook significantly. But because men dont get regular breast cancer screenings like women, the first sign of cancer is usually a lump. By that time, the cancer has often spread to the lymph nodes or other areas of the body.
Healthcare providers measure cancer outlook by the five-year survival rate. Overall, the survival rate for male breast cancer is 84%. The survival rate for men with breast cancer that has not spread beyond the original tumor is 97%. For men with cancer that has spread to other parts of the body, the survival rate is about 22%.
Male Breast Cancer Diagnosis
A physician may conduct diagnostic tests and procedures to diagnosis breast cancer in men, including:
- A clinical breast exam . The breasts and surrounding areas are examined for lumps or other changes. Lump size, shape, texture, and location are assessed.
- Imaging tests. Pictures of the breast are created so the physician can identify abnormalities. Imaging tests may include a mammogram or an ultrasound.
- A biopsy. The definitive diagnostic step. During the procedure, a physician uses a tiny needle and X-ray guidance to collect tissue from a suspicious area. Collected tissue is then sent to the laboratory where it is examined for cancer.
If cancer is present, the type of cells involved, aggressiveness , and presence of hormone and other receptors that may influence treatment are determined.
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Breastcancerguidelines In Response To The Letter By Wong 1 Our Recommendations Do Not Represent A Substantial Departure From Previous Guidance 2 Independent Canadian National Guidelines Did Not Previously Recommend Routine Screening Mammograms For Average Risk Women Aged 40
- Although treatment outcomes for patients with breastcancer have improved in recent years, data have shown that 1 in 8 women is likely to develop breastcancer in their lifetime. 1 In 2021 alone, the United States recorded 281,550 new cases of invasive breastcancer, 49,290 new cases of noninvasive breastcancer, and 43,600 deaths from the disease. 2 Currently, the evolving treatment …
- Nccn guidelines 2022 pdf
- National Comprehensive Cancer Network NCCNGuidelinesBreastCancer Screening and Diagnosis Guidance PDF v.1.2019, 2/24/20. U.S. Preventive Services Task Force Siu AL, on behalf of the U.S. Preventive Services Task Force. Screening for BreastCancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med …
- 2019. 5. 1. ·Request PDF | NCCN Guidelines Updates: Breast Cancer | Advances in molecular testing have ushered in the new era of precision medicine. The 2018 publication of the TAILORx trial helped refine the …
- These NCCN Clinical Practice Guidelines for Breast Cancer include recommendations for clinical management of patients with carcinoma in situ, … phyllodes tumor Breast Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology J Natl Compr Canc Netw. 2022 Jun 20:691-722. doi: 10.6004/jnccn.2022.0030. Authors
Genetic Testing In Men With Or At Risk For Breast Cancer
Breast cancer in men is sometimes caused by inherited mutations in certain genes. You can inherit gene mutations from your mother or your father and can potentially pass them on to your sons and daughters.
The lifetime risk of developing breast cancer is approximately 1% for men who have a BRCA1 gene mutation and 7-8% for men who have a BRCA2 gene mutation, compared to a risk of 0.1% for men in the general population. Mutations in the ATM, CHEK2, PALB2, and other genes are also associated with breast cancer in men, but more research is needed to understand the specific risks from those genes.
According to guidelines from the American Society of Clinical Oncology and the National Comprehensive Cancer Network, all men who have been diagnosed with breast cancer should be offered genetic counseling and genetic testing for genetic mutations linked to a higher risk of breast cancer.
Men who havent been diagnosed with breast cancer but who have a family history of breast, ovarian, pancreatic, or prostate cancer, or who have a family member who was found to have an inherited gene mutation that increases the risk of cancer, should also consider getting genetic testing.
Here are some of the reasons its useful for you and your medical team to know if you have a gene mutation linked to a higher risk of breast cancer:
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What Are The Symptoms Of Breast Cancer In Men
Because men dont have regular mammogram scans like women, physical signs of breast cancer are often the first indication a man notices. The most common symptoms of breast cancer in men include:
- Breast lump: A thickened area, lump or mass may grow on the breast, behind the nipple or in the armpit.
- Change in appearance: The breast tissue may look larger, puckered, misshapen or sunken. There may be a dimple or several small divots or pits, like the skin of an orange.
- Pain: You may have tenderness, sensitivity or pain in the breast tissue or underarm area. Instead, you may have a painless lump in the breast or armpit.
- Problems with the nipple: Clear fluid or bloody liquid may come out of the nipple. An inverted nipple can be another sign of breast cancer.
- Skin changes: Red, flaky or scaly skin may appear anywhere on the breast or nipple area. You may see ulcers on the skin.
Symptoms Of Male Breast Cancer
The first sign of male breast cancer is usually a lump in the breast that feels like a hard knot or pebble. Since most men arent regularly checking their breasts and arent aware of the early warning signs of male breast cancer, it may take some time for them to notice a lump or other breast change and bring it to the attention of their doctor. While the majority of lumps are not breast cancer, its important to have any unusual changes to your breast, chest, or armpit checked by a doctor as soon as you can. When breast cancer is found early, its usually easier to treat successfully.
The signs and symptoms of breast cancer in men to watch out for include:
change in the size or shape of the breast
These changes can also can be signs of less serious conditions that are not cancer. Some benign breast conditions in men are:
Gynecomastia is an increase in the amount of breast tissue in males. It can involve swelling or overall enlargement of one or both breasts. Often, the first symptom is a lump of fatty tissue under the nipple that may be tender or sore.
Men can develop other types of abnormal lumps or masses of tissue in the breast that are not cancer and do not spread outside the breast. Some examples are lipomas , cysts , hematomas , and fat necrosis .
Again, be sure to see your doctor right away if you notice any abnormal change in the breast, chest, or armpit.
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A Lump Could Be A Sign Of Breast Cancer
A new mass in the chest area is a common sign of breast cancer, Ruddy said. This can feel like a small, pea-sized lump and is often the sign that leads to a cancer diagnosis in men.
Really, breast cancers arent diagnosed until theyre clinically evident, meaning until they create a mass thats actually palpable to the man or to his doctor, Ruddy said.
Male Breast Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Breast
Breast cancer may occur in men. Breast cancer may occur in men at any age, but it usually occurs in men between 60 and 70 years of age. Male breast cancer makes up less than 1% of all cases of breast cancer.
The following types of breast cancer are found in men:
- Infiltrating ductal carcinoma: Cancer that has spread beyond thecells liningducts in the breast. This is the most common type of breast cancer in men.
- Ductal carcinoma in situ: Abnormal cells that are found in the lining of a duct also called intraductal carcinoma.
- Inflammatory breast cancer: A type of cancer in which the breast looks red and swollen and feels warm.
- Paget disease of the nipple: A tumor that has grown from ducts beneath the nipple onto the surface of the nipple.
Lobular carcinoma in situ , which sometimes occurs in women, has not been seen in men.
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Male Breast Cancer Is Sometimes Caused By Inherited Gene Mutations
The genes in cells carry the hereditary information that is received from a persons parents. Hereditary breast cancer makes up about 5% to 10% of all breast cancer. Some mutated genes related to breast cancer, such as BRCA2, are more common in certain ethnic groups.Men who have a mutated gene related to breast cancer have an increased risk of this disease.
There are tests that can detect mutated genes. These genetic tests are sometimes done for members of families with a high risk of cancer. See the following PDQ summaries for more information:
Invasive Breast Cancer Symptoms
Most breast cancers start in the ducts, or the tubes that carry milk to the nipple, or in the lobules, the little clusters of sacs where breast milk is made. Invasive breast cancer refers to breast cancer that spreads from the original site to other areas of the breast, the lymph nodes or elsewhere in the body. In these cancers that form in the ducts or lobules, invasive ductal carcinoma or invasive lobular carcinoma , the cancer spreads from the ducts or lobules to other tissue. Depending on the stage, you may notice symptoms.
Invasive breast cancer symptoms may include:
- A lump or mass in the breast
- Swelling of all or part of the breast, even if no lump is felt
- Skin irritation or dimpling
- A lump or swelling in the underarm lymph nodes
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Targeted Cancer Drug Therapy
Your doctor will check your cancer cells for proteins called HER2 receptors. But these are rarely found in male breast cancer. If your cancer cells have a lot of these receptors, your doctor will prescribe a targeted drug treatment for you.
The most common targeted drug for breast cancer is trastuzumab .
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.
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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Male Breast Cancer Risk Factors
Men are encouraged to be cognizant of risk factors and control them when possible, including:
- Age. Breast cancer risk increases with age. It is most often diagnosed in men in their 60s.
- Estrogen exposure. Estrogen-related drugs that are taken for prostate cancer increase the risk of breast cancer.
- Family history. Men who have a family member, especially a close one, with breast cancer have a greater chance of developing the disease.
- History of Klinefelters syndrome. Occurs when boys are born with more than one copy of the X chromosome. Abnormal development of the testicles results, which leads to lower production of androgens and increased production of estrogens .
- History of liver disease. Liver cirrhosis and other conditions may reduce androgens and increase estrogens, which increases breast cancer risk.
- Obesity. Obese patients have higher levels of estrogen in the body.
- History of testicle disease or surgery. Testicle inflammation or removal can increase the risk of breast cancer.
What Are The Breast Cancer Symptoms In Women
For most women, the first sign or symptom of breast cancer is a lump or area of thickened tissue in their breast.
While 90 per cent of such lumps are not cancerous, it is vital to get them checked by your GP at the earliest opportunity detecting the disease early can mean treatment is more effective.
It is important to be “breast aware” – know what feels normal for you, and therefore what changes to look out for.
One in three women do not regularly check their breasts, and a fifth of these women say it is because they don’t know how to do it.
Symptoms to look out for include:
- a new lump or thickening in your breast or armpit
- a change in size, shape or feel of your breast
- skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
- fluid leaking from the nipple in a woman who isnt pregnant or breast feeding
- changes in the position of the nipple
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Breast Lumps Aren’t Always Cancer But They Should Still Be Checked Out
While male breast cancer often results in a lump you can feel, not all breast lumps are cancerous.
“Gynecomastia, which is a benign increase in the amount of breast tissue, is more common than male breast cancer and can also feel and appear like a small growth,” says Dr. Darcourt. “Additionally, papillomas and fibroadenomas are abnormal but benign masses that can occur in breast tissue, although they’re fairly rare in men.”
But while feeling a breast lump isn’t necessarily cause for immediate panic, it shouldn’t be brushed off.
“Not every breast lump is cancerous, but that’s certainly not a reason to delay mentioning it to your doctor,” says Dr. Darcourt. “The overall risk may be low, but remember, the earlier breast cancer is detected and treated, the better.”
Breast Cancer Is More Common In Black Men And In Older Men
There are certain risk factors you should keep in mind when monitoring yourself for breast cancer.
According to Abuhadra, Black men are more likely to develop breast cancer than other groups. A 2019 study in the journal JNCI Cancer Spectrum found that breast cancer was 52% higher in Black men than in white men.
Its also more likely for breast cancer to appear in older men, Abuhadra said. The risk of male breast cancer increases in their 50s, 60s and 70s. In women, breast cancer peaks in their 50s.
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Risk Factors For Male Breast Cancer
Several factors are known to increase the risk that a man will develop breast cancer. But its important to know that many men who develop breast cancer do not have any of these risk factors.
Factors that can increase a mans breast cancer risk include:
The risk of male breast cancer increases as you age. The average age of men diagnosed with breast cancer in the United States is about 67. But breast cancer can occur in young men, too.
A mans risk for breast cancer is higher if any of his close relatives have had breast cancer, and especially if any male relatives have had the disease.
Men who inherit certain genetic mutations from their mothers or fathers have a higher risk of developing breast cancer. A man who inherits a BRCA1 mutation has about a 1% risk of developing breast cancer in his lifetime, compared to a risk of 0.1% for the average man. A man who inherits a BRCA2 mutation has a 7% to 8% risk.
Mutations in the ATM, CHEK2, PALB2, and other genes are also linked to breast cancer in men, but more research is needed to understand those risks.
You may think of testosterone as a male hormone and estrogen as a female hormone. The truth is, both men and women have different levels of testosterone and estrogen in their bodies. Men have less estrogen than women, but all men have some estrogen in their bodies.
Higher levels of estrogen can increase the risk of male breast cancer. Men can have high estrogen levels as a result of: