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How Rare Is Breast Cancer In Males

Enlarged Axillary Lymph Nodes

Breast cancer in men: Rare, but possible

Lymph nodes produce lymph, a fluid composed of white blood cells, for the purpose of fighting infections detected in the body. Axillary lymph nodes are located within the armpit and can become swollen or enlarged when a threat to the body has been detected. Enlarged axillary lymph nodes can indicate breast cancer, although they may also be the result of another condition, such as a cold or injury.More information about enlarged axillary lymph nodes, a rare breast cancer type, can be found by visiting our axillary lymph nodes page here.

Cancer Symptoms In Men

Men are notorious for ignoring health problems. In some cases, if the underlying cause of a problem is cancer, ignoring symptoms could put men at risk. Some cancer symptoms in men are specific only to men , and others symptoms such as pain or fatigue are general and could have many causes.

Breast cancer in men is not common, but is it possible. Any mass in the breast area, or breast changes such as:

  • dimpling or puckering of the skin,
  • nipple retraction,

Men possess a small amount of nonfunctioning breast tissue that is concentrated in the area directly behind the nipple on the chest wall. Like breast cancer in women, cancer of the male breast is the uncontrolled growth of some of the cells of this breast tissue that have the potential to spread elsewhere in the body. These cells become so abnormal in appearance and behavior that they are then called cancer cells.

Breast tissue in healthy young boys and girls consists of tubular structures known as ducts. At puberty, a girl’s ovaries produce female hormones that cause the ducts to grow and milk-producing glands to develop at the ends of the ducts. The amount of fat and connective tissue in the breast also increases as girls go through puberty. On the other hand, male hormones secreted by the testes suppress the growth of breast tissue and the development of lobules. The male breast, therefore, is made up of predominantly small, undeveloped ducts and a small amount of fat and connective tissue.

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 .

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Male Breast Cancer: A Rare Increasing Trend

The color pink isnt exclusive to women, and neither is the disease that it often represents: breast cancer. While breast cancer is more than 100 times more common in women than men, men are much less likely to detect breast cancer early on, notes;David Euhus, M.D., director of breast surgery at the Johns Hopkins Breast Center.

When addressed with standard treatment, breast cancer survival rates are the same in men and women. But Euhus notes that key differences occur in diagnosis and screening and the results are less than favorable for men. Men are more likely to ignore a lump in their breast and tend to present at higher stages than women, Euhus says.

This trend is believed to be the primary factor contributing to the 25 percent higher mortality rate for male breast cancer compared to female breast cancer.Once the disease has spread to the lymph nodes, which is more common among men, it requires more aggressive treatment and can increase the likelihood of developing a second cancer. Men who have had breast cancer have a higher risk for developing cancer in the opposite breast, melanoma and prostate cancer.

Euhus adds that historically, the issue has been compacted because men werent being offered the traditional breast cancer regimen provided to women. Standard treatment for;male breast cancer;includes a combination of chemotherapy, hormone therapy and;mastectomy.

Brca2 Inherited Gene Mutations And Cancer Risk

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Men who have a BRCA2 inherited gene mutation, and to a lesser degree men who have a BRCA1 inherited gene mutation, have an increased risk of breast cancer .

For example, the lifetime risk of breast cancer is :

  • About 50-80 in 1,000 men with a BRCA2 inherited gene mutation
  • About 12 in 1,000 men with a BRCA1 inherited gene mutation
  • About 1 in 769 men in the general population

Men who have a BRCA1/2 gene mutation also have an increased risk for prostate cancer, pancreatic cancer and melanoma .

Other inherited gene mutations are under study for a possible link to breast cancer in men .

Learn more about BRCA2 inherited gene mutations and cancer risk in men.

For a summary of research studies on BRCA1/2 inherited gene mutations and cancer, visit the Breast Cancer Research Studies section.

BRCA2 inherited gene mutations and genetic testing

While 5-10 percent of breast cancers in women are thought to be due to inherited gene mutations, up to 40 percent of breast cancers in men may be related to BRCA2 inherited gene mutations alone . This means men who get breast cancer are more likely to have an inherited gene mutation than women who get breast cancer.

The National Comprehensive Cancer Network recommends all men diagnosed with breast cancer have genetic testing for BRCA1/2 mutations .

Your health care provider can recommend a genetic counselor so you can learn more about genetic testing.

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How Is Male Breast Cancer Treated

Treatment for men with breast cancer is the same as that for women. The treatment offered to you will depend on different factors such as the type of tumour, the stage of the disease and your general health.

The main treatments used are surgery, chemotherapy, radiotherapy, hormone therapy and targeted therapies. Read more about treating breast cancer.

Symptoms Clinical Signs And Manifestations

The most common presentations are painless palpable mass, skin ulceration, and nipple retraction or discharge in approximately 75% of the cases, similar to women . Since the breast tissue in men is undersized, the nipple is mostly involved at early stages. The incidence of retraction is 9%, discharge 6% and ulceration is 6% . The mass is frequently localized to the subareolar region. It is seen less frequently in the upper outer quadrant . The left breast is involved more frequently than the right; 1% of the cases are bilateral.

Male patients are frequently at a higher age than female breast cancer at diagnosis and at a higher stage .

The staging of the disease during presentation is as follows on the basis of the Tumor-Node-Metastasis system presented by the largest case series in the literature: Stage 1: 37%, stage II: 21%, stage III: 33%, stage IV: 9% . While the period between disease onset and diagnosis was 29 months in the past , this period has been reduced to 6 months in the newer series . It is evident that the disease is diagnosed at more advanced stages in men as compared to women. In fact, more than 40% of the patients are already at stage 3 or 4 when they present to the clinic. The lesser amount of breast tissue in men also results in the involvement of chest wall at an early stage. For that reason, it has also been stated that the TNM may not be appropriate for men .

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What Are The Stages Of Male Breast Cancer

After diagnosing breast cancer, providers classify the disease using a process called staging. Providers measure the tumor and look at its location. They determine whether the tumor has spread to lymph nodes, surrounding breast tissue or other parts of your body. Lymph nodes are small organs that move fluid through the body and help protect you from illness.

To gather this information, your provider may order tests such as a sentinel node biopsy, PET scan or CT scan. These tests allow your cancer care team to determine the disease stage.

The stages of male breast cancer are:

Stage 0: Cancer cells are only in the ducts. Cancer has not spread to other breast tissue.

Stage I: The tumor is small and hasnt spread to the lymph nodes.

Stage II: One of these is true:

  • The tumor is smaller than 20 millimeters and has spread to a few axillary lymph nodes. Axillary nodes are lymph nodes in the armpit.
  • The tumor is 20 mm to 50 mm across and has not spread to the axillary lymph nodes . Or the tumor is 20 mm to 50 mm and has spread to the axillary lymph nodes .
  • The tumor is larger than 50 mm and has not spread to a few axillary lymph nodes.

Stage III: Cancer has spread typically to several lymph nodes. Cancer cells may also be in the chest wall or skin. It has not spread to other areas of the body away from the breast.

Stage IV: Cancer cells have spread to other parts of the body away from the breast. Cancer can spread to all areas of the body, including the lungs, bones, liver or brain.

Sharing Your Diagnosis With Others

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You might find it difficult to tell others about your diagnosis. If so, it can be helpful to start by telling your family and close friends first. This will help you become familiar with peoples responses and reactions. As breast cancer in men is rare, you may find that people want to ask you questions. You may like to have a few answers prepared.

Many people who are diagnosed with cancer find that it affects their friendships. Sadly, this usually happens when friends and family dont know how to cope with the news. Sometimes, a person you thought would be there for you will respond by stepping back. At other times, the opposite happens, and people who you do not have regular contact with you may respond by making contact and offering help. Ultimately, there is no right or wrong way to respond to breast cancer. Just find what works for you, your family and your friends.

Seek out support that is available to you like family, friends, doctors and nurses. Ask lots of questions and get as much information as you can to understand the disease. I found reading online forums, books and pamphlets helpful. Matthew

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Male Breast Cancer Treatment

Treatments for breast cancer in men are the same as for women and include:

  • Chemotherapy: Drugs to destroy cancer cells or slow their growth
  • Radiation therapy: High-energy X-rays to kill cancer cells and spare surrounding cells
  • Hormone therapy: Drugs to destroy cancer cells by eliminating the hormones that fuel them
  • Targeted therapy: Medications that interfere with molecules involved in cancer cell growth
  • Surgery: Removing cancer cells and surrounding cancer-free tissue to prevent regrowth
  • Clinical trials: Approved research studies that investigate new treatments and their effectiveness

Learn more about breast cancer in men. If you are concerned about your risk for male breast cancer or have symptoms, reach out to your primary care provider.

When To Seek Care

Having one or more symptoms does not mean you have breast cancer. Symptoms of breast cancer can be similar to those of other conditions.

Male breast cancer is rare, making up only about 1 percent of all cases. That said, its easier to treat breast cancer before it spreads, so see your doctor if you have:

  • a lump or hard mass on your chest or underarm
  • nipple inversion or discharge
  • dimpling or puckering of the skin

A large retrospective study published in 2019 concluded there is a potential benefit to screening men at high risk of developing breast cancer. If you think you may be at high risk of breast cancer, it might be worth discussing with your doctor or a genetic specialist.

Most breast lumps are caused by something other than cancer but may still require treatment.

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Male Breast Cancer And Gynecomastia

Male breast cancer is much less common than breast cancer in females. The literature suggests that for every male who are diagnosed with breast cancer, there will be approximately 100 females diagnosed with breast cancer.

Because of the rarity of male breast cancer, routine screening mammograms are not recommended for males at any age. Diagnosis of breast cancer in males is almost exclusively centered on the evaluation of lumps in the breast. Since there are multiple causes of male breast lumps , it is important that both physicians and patients have a clear understanding of the significance of lumps or new symptoms, such as nipple discharge or pain in the male breast.

Rare Types Of Breast Cancer That May Be Unfamiliar

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By Elizabeth Morey

Those who have never had cancer or watched a loved one battle cancer often think theres just one type of breast cancer. But the reality is that there are several types, some more common than others. And all these different types present themselves in different ways, spread at different rates, and respond differently to treatment.

Even if you do have some experience with cancer, you may be unfamiliar with some of the more rare kinds of it. Many of the breast cancers in this list are special types, meaning their cells have particular characteristics not found in most breast cancers.

Check out the list below for a better understanding of 10 rare types of breast cancer.

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Lymphoma Of The Breast

Lymphoma of the breast is an uncommon cancer mostly observed in older women. It occurs when lymphocytes, a type of white blood cell in the lymphatic system, begin dividing uncontrollably. Several different types of treatment are used for this type of cancer, and the prognosis depends on various criteria.

Rare Forms Of Invasive Ductal Carcinoma

While invasive ductal carcinoma;is generally common, below are four types of invasive ductal carcinoma that are less common:

Medullary ductal carcinoma:;This type of cancer is rare and accounts for 3 percent to 5 percent of breast cancers. It is called medullary because, under a microscope, it resembles part of the brain called the medulla. Medullary carcinoma may occur at any age, but it typically affects women in their late 40s and early 50s. Medullary carcinoma is more common in women who have a BRCA1 gene mutation. Medullary tumors are often triple-negative, which means they test negative for estrogen and progesterone receptors and for the HER2 protein. Medullary tumors are less likely to involve the lymph nodes, are more responsive to treatment, and may have a better prognosis than more common types of invasive ductal cancer.

Surgery is typically the first-line treatment for medullary ductal carcinoma. A lumpectomy;or mastectomy may be performed, depending on the location of the tumor.;Chemotherapy;and radiation therapy may also be used.

Surgery is typically recommended to treat mucinous ductal carcinoma. A lumpectomy or mastectomy may be performed, depending on the size and location of the tumor. Adjuvant therapy, such as radiation therapy,;hormonal therapy;and chemotherapy, may also be required. Because most mucinous carcinomas test negative for receptors for the protein HER2, they arent typically treated with trastuzumab .

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What Are The Symptoms

The most common symptoms of breast cancer in men are

  • A lump or swelling in the breast.
  • Redness or flaky skin in the breast.
  • Irritation or dimpling of breast skin.
  • Nipple discharge.
  • Pulling in of the nipple or pain in the nipple area.

These symptoms can happen with other conditions that are not cancer. If you have any symptoms that worry you, see your doctor right away.

When To See Your Gp

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See your GP if you have:

  • a lump in your breast
  • any other worrying symptoms, such as nipple discharge
  • a history of breast cancer in members of your family and you’re worried about your chances of getting it

It’s very unlikely you have cancer, but it’s best to get your symptoms checked. Your GP will examine your breast and can refer you for;tests and scans for breast cancer if needed.

If you do not have symptoms but have a clear family history of breast cancer, your GP may refer you to a genetic specialist to discuss your risk of getting it.

There are some inherited genes that increase your risk of cancer and a blood test can be done to check for these.;Read about;testing for cancer risk genes.

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