What Can I Do To Reduce My Risk
If several members of your family have had breast or ovarian cancer, or one of your family members has a known BRCA1 or BRCA2 mutation, share this information with your doctor. Your doctor may refer you for genetic counseling. In men, mutations in the BRCA1 and BRCA2 genes can increase the risk of breast cancer, high-grade prostate cancer, and pancreatic cancer.
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.
What Are The Types Of Male Breast Cancer
Breast cancer in men usually begins in the breast ducts. Ducts are tubes that carry milk to the nipple. Although men have milk ducts and glands that create milk, they dont work like the ducts and milk-producing glands in women.
The types of male breast cancer include:
- Invasive ductal carcinoma: Cancer begins in the breast ducts and spreads to other parts of the breast. Cancer cells may also spread to other areas of the body. Invasive ductal carcinoma is the most common type of breast cancer in people regardless of gender.
- Invasive lobular carcinoma: Cancer begins in the lobules . Lobular breast cancer can also spread to other parts of the body.
- Ductal carcinoma in situ : Cancer cells grow in the lining of the breast ducts. They have not spread to other parts of the breast or the rest of the body. Ductal carcinoma in situ is uncommon in men.
- Inflammatory breast cancer: Usually a type of invasive ductal carcinoma, inflammatory breast cancer is very rare in men. The breast tissue is swollen and red. It feels warm to the touch, and the skin may be dimpled, but there is no lump.
- Pagets disease of the nipple: Cancer cells grow in the ducts and spread to the nipple and the area around the nipple. Pagets disease of the nipple is also called Pagets disease of the breast or mammary Paget disease.
Also Check: Nipple Piercing And Breast Cancer
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.
What Is Male Breast Cancer
Male breast cancer is a type of cancer that grows in a mans breast tissue. Although male breasts cant produce milk, they do have fatty tissue, ducts and breast cells. Breast tissue in men is similar to young girls breast tissue before they start puberty. Cancer develops when cells in these tissues grow uncontrollably, forming a tumor.
Treatment for male breast cancer includes chemotherapy, radiation, surgery, hormone therapy and targeted therapy. The outlook depends on the tumors size and whether it has spread to other parts of the body.
Recommended Reading: Invasive Breast Cancer Definition
Causes Of Breast Cancer In Men
Some factors that can increase the risk of breast cancer in men include:
family history of breast cancer in first-degree relatives who have had BRCA2 breast cancer or several relatives who have had colon, prostate or ovarian cancer
high levels of oestrogen
some testicular disorders
Klinefelter’s syndrome – a rare condition where men have two X chromosomes and one Y chromosome .
Lifestyle factors that slightly increase the risk of breast cancer in men and women include:
- drinking alcohol
- lack of physical activity.
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.
Read Also: What Stage 3 Cancer Means
Types Of Breast Cancer In Men
The most common types of breast cancer are ductal carcinoma in situ, invasive ductal carcinoma, and invasive lobular carcinoma.
Most breast cancers are carcinomas. In fact, breast cancers are often a type of carcinoma called adenocarcinoma, which starts in cells that make glands . Breast adenocarcinomas start in the ducts or the lobules .
There are other, less common, types of breast cancers, too, such as sarcomas, phyllodes, Pagets disease and angiosarcomas which start in the cells of the muscle, fat, or connective tissue.
Sometimes a single breast tumor can be a combination of different types. And in some very rare types of breast cancer, the cancer cells may not form a lump or tumor at all.
When a biopsy is done to find out the specific type of breast cancer, the pathologist also will say if the cancer has spread in to the surrounding tissues. The name of the breast cancer type will change depending on the extent of the cancer.
- In situ breast cancers have not spread.
- Invasive or infiltrating cancers have spread into the surrounding breast tissue.
These general kinds of breast cancer can be further described with the terms outlined above.
Procedures For Data Collection
Clinical files of patients, admission files and operating reports were the sources of the data. For each patient, we collected data that enabled defining the stages of the cancer, such as the tumor size, the presence of satellite lymph nodes , and metastasis. The fixed or non-fixed aspect of the tumor and/or satellite lymph nodes was assessed.
The therapeutic modalities were noted. We also had interest in the duration of the follow-up, survival without recurrence, and the overall survival of the patients.
Also Check: Stage-three Cancer
Prognosis Survival And Prognostic Factors
Despite the decrease in mortality rate in female breast cancers, the mortality rate in MBC remained unchanged since 1975 . The most important prognostic indicator is the stage at diagnosis and lymph node involvement . The overall 5-year survival rate is around 4065% . However, when evaluated according to stage at diagnosis the 5-year survival rate is 75100% for stage 1, 5080% for stage 2, and is decreased to 3060% for stage 3 . Although several studies have stated that the prognosis was worse in MBC than in females, it was determined that there were no differences in the prognosis of the two genders when paired according to age and stage . A large study with more than 335 male patients found that if nodal status is used to compare MBC and FBC, then the prognosis was similar . The less favorable results in male patients are due to the more advanced stage at presentation as well as a higher mean age at presentation leading to more co-morbidity . While estrogen-receptor positive tumors have a better prognosis, no such association has been shown for progesterone . HER2 positivity is a poor prognostic characteristic . It is reported that survival is shorter and prognosis is poor in basal-like and HER2+/ER subtypes in comparison to other groups . A secondary cancer may develop in 912% of MBC cases during follow-up . The incidence rate of bilateral breast cancer in men is low . In the presence of metastatic disease , the median survival is reported as 26.5 months .
Diagnostic Imaging Methods And Differential Diagnosis
The majority of lesions in the male breast are benign and gynecomasty constitutes most of these lesions. Within these, less than 1% is primary breast cancer. Even though male breast is relatively small, mammography is technically feasible and adds useful information to clinical examination . In the presence of a clinically suspicious lesion, MG should be preferred over ultrasonography . Sensitivity and specificity of mammography are reported as 92% and 90%, respectively . A normal male breast is essentially composed of fat tissue and contains only a few secretory canals. It does not have Cooper ligaments, and has none or very little ductal and interlobular connective tissue. For that reason, it has a radiolucent appearance on mammography . The tumor is visualized on MG as a hyperdense, well defined, lobulated mass with spiculated margins or as a structural distortion. Microcalcification is observed less as compared to FBC its tendency of clustering is low, and generally appears as wide, round and dispersed calcifications.
Doyle et al. emphasized the radiologic and pathologic differences between male and female breast cancer in their review:
The incidence of invasive lobular cancer and in-situ disease are lower in men as compared to women.
Male breast cancer more frequently manifests itself as a locally advanced disease .
MBCs are more often localized in the subareolar area, whereas FBCs are localized in the upper outer quadrant.
Read Also: Symptoms Of Stage 3 Breast Cancer
Diagnosis Of Breast Cancer In Men
Your doctor will investigate any new or unusual breast changes using a variety of diagnostic tests. These tests are the same as the ones used to study breast changes in women. They may include:
- Clinical breast examination, and taking a complete personal medical history.
- Mammogram a low level x-ray of the breast. Though mammograms are not recommended for male breast cancer screening in Australia, they can be used to help diagnose breast cancer in men.
- Ultrasound an imaging technique that uses sound waves to look at breast changes. It may help to determine whether a lump found in the breast is a fluid-filled cyst or solid .
- Biopsy your doctor may recommend a biopsy if an abnormality is found during clinical examination and/or imaging tests. A biopsy involves removing a small sample of tissue and a specialist examining the sample under microscope.
If you are diagnosed with breast cancer, your doctor may send you for further tests to help determine the extent of cancer spread in the body. Additional tests will be done to determine the molecular characteristics of the tumour, such the cancers hormone receptor status. These tests will help you and your doctors decide on the best treatment options.
Coping With A Diagnosis
Being told you have breast cancer can cause a wide range of emotions, such as shock, fear, confusion and, in some cases, embarrassment.
Feelings of isolation are also common. This may be because there’s little in the way of information and advice for men with breast cancer.
Speak to your GP or care team if you’re struggling to come to terms with your diagnosis. They can offer support and advice.
You may also find it useful to talk to other men with the condition. Cancer Research UK has Cancer Chat, an online forum for anyone affected by cancer.
Page last reviewed: 18 March 2020 Next review due: 18 March 2023
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Magnetic Resonance Imaging Of The Breast
MRI machines are quite common, but they need to be specially adapted to look at the breast. Its important that MRI scans of the breast be done on one of these specially adapted machines and that the MRI facility can also do a MRI-guided biopsy if it is needed.
MRI can be used to better examine suspicious areas found by a mammogram. MRI is also sometimes used in someone who has been diagnosed with breast cancer to better determine the actual size of the cancer and to look for any other cancers in the breast.
Treatment For Advanced Disease
Approach to metastatic breast cancer is based on the same principles in both men and women. Metastasis is identified at diagnosis in approximately 515% of MBC cases. Di Lauro et al. reported that the most frequent location for metastasis visceral in 76% , bones in 20% and soft tissue in 4% of the cases in their series of 50 male breast cancer cases. For treating metastatic diseases orchiectomy, adrenalectomy and hypophysectomy have been performed in the past. Since the response rate of the more frequent HR-positive tumors to hormone therapy is 25% to 58%, tamoxifen is currently used as first-choice therapy in such tumors. CT is recommended if the tumor is unresponsive to hormonal therapy . Progestins, androgens and luteinizing hormone-releasing hormone agonists may be used in hormone therapy, albeit at a lower rate . The value of aromatase inhibitors such as anastrozole and letrozole in metastatic breast cancers has not been fully established. Systemic CT is used in male HR-negative patients with a rapidly progressing and life-threatening visceral disease. Although it is thought that trastuzumab may be useful in HER-2/neu positive disease, the data available on this issue is insufficient.
Read Also: Hormone Therapy For Breast Cancer Stage 4
Estrogen And Progesterone Status
Estrogen and progesterone are often thought of as female hormones, but they are also present in men. These hormones can fuel the growth of male breast cancer.
In most men, breast cancer cells have receptors, or proteins, on their surface that attach to estrogen, progesterone, or both. Breast cancers that test positive for these receptors rely on these hormones to grow and are called estrogen-receptor positive or progesterone-receptor positive.
Knowing whether a cancer has estrogen, progesterone, or both receptorsa designation called hormone receptor statushelps the doctor predict whether the cancer might return after treatment. Hormone-receptor negative cancer is more likely to recur, or come back. Your doctor can tailor your treatment to lower this risk.
Hormone therapy can help prevent cancer from returning in people who have cancer that is estrogen-receptor positive, progesterone-receptor positive, or both. Older men often have hormone-receptor positive breast cancer, for reasons that are not completely understood. It may be related to the aging process.
Risk Factors For Breast Cancer In Men
While it is difficult to determine the exact causes of male breast cancer, there are some factors that are linked to an increased risk of the disease. Although these risk factors increase your risk of breast cancer, it does not mean that you will develop breast cancer. Moreover, having no known risk factors does not guarantee that you will never develop breast cancer.
Common risk factors for breast cancer in men include:
Similar to women, men are much more likely to develop breast cancer as they get older. The majority of men are diagnosed at or after age 50, although it can occur at any age.
Strong family history
A strong family history of male or female breast cancer can increase the risk of men developing breast cancer. However, most men who develop breast cancer do not have a strong family history. If you are concerned that you may have an increased risk of breast cancer due to family history, please consult your doctor.
BRCA gene mutations
Men with an inherited mutation in the BRCA2 gene, and to a lesser extent the BRCA1 gene, are at an increased risk of breast cancer. However, only a minority of breast cancers are explained by inherited mutations, and not everyone with a faulty gene will develop breast cancer. If you are concerned about your breast cancer risk due to genetic susceptibility, please speak with your doctor.
Also Check: Hormone Therapy For Metastatic Breast Cancer
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: