Breast Cancer In Men: How Does It Happen
Both men and women are born with breast tissue. However, during puberty, women develop more breast tissue, while men dont. But because men have this breast tissue, they can develop breast cancer.
The main concern is that breast cancer in men is often diagnosed later than in women, because men tend to be less suspicious about a change or lump in their chest, Dr. Cottrell says. Thats why its important to know your risk factors and the warning signs.
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Statistics And Survival Rates
The prognosis for breast cancer in men is similar to that in women.
According to the American Cancer Society, the chances of surviving 5 years or more after diagnosis are, on average:
- 96% when cancer affects only the breast tissue at diagnosis
- 83% when it affects nearby areas as well as the breast
- 23% when it has spread to other parts of the body
For this reason, it is essential to seek help as soon as a person notices changes. Early stage breast cancer responds well to treatment.
Diagnostic methods and treatments have improved in the last few years, and so the chances of living for at least 5 years after diagnosis are probably higher than the above figures for people currently receiving a diagnosis.
If a person notices changes in their breast, they should see a doctor.
The doctor will symptoms and the individuals personal and family medical history, including any history of estrogen use or radiation treatment.
They will also carry out a physical examination.
They may suggest the following tests:
- a mammogram
- a nipple discharge test
- a biopsy
Sometimes, a doctor will recommend removing a lump and carrying out a biopsy at the same time. They may only remove a part of the area that appears to be affected and carry out a test, or they may remove the whole area, including some of the normal breast tissue surrounding it.
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Sharing Your Diagnosis With Others
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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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.
What Are The Hormone Sources In Men
Testicular Leydig cells produce 95% of testosterone. The adrenal cortex produces the rest. About 50% of circulating testosterone is bound to sex hormone binding globulin. Much of the remainder is weakly bound to albumin. Only the free hormone is active. Oestrogen is less bound to sex hormone binding globulin than testosterone, so increases in sex hormone binding globulin reduce the ratio of active testosterone to oestrogen.
Testosterone can be converted to another potent androgen, dihydrotestosterone, by the enzyme 5 reductase in peripheral tissues. Testosterone also can be converted to oestradiol by the enzyme aromatase, found especially in adipose tissue. The weak adrenal androgen androstenedione can be converted by aromatase to oestrone, a weak oestrogen. Oestradiol and oestrone can be interconverted in peripheral tissues .
Fig 1Sources of hormones affecting breast tissue
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Common Types Of Breast Cancer In Men
The most common types of breast cancer are:
- invasive ductal carcinoma, which begins in the ducts that would carry milk to the nipple
- invasive lobular carcinoma, which begins in the lobules that would produce milk
- ductal carcinoma in situ, which is considered a pre-cancerous condition because cancer cells have not spread outside the duct
Breast cancer in males is a lot like breast cancer in females. However, research suggests some differences, including:
- Males tend to develop breast cancer at an older age, typically between 60 and 70.
- Males are more likely to have estrogen receptor-positive tumors.
- Male breast cancer is more likely to be associated with a BRCA2 gene mutation.
What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back.
At first, your visits may be every 3 to 6 months. Then, the longer youre cancer-free, the less often the visits are needed. After 5 years, they may be done once a year.
If you still have a breast , youll need to get a mammogram every year.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as well as you can.
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Symptoms Of Breast Cancer In Men
The most common symptom for men with breast cancer include:
- lump in the breast that is nearly always painless
- oozing from the nipple that may be blood stained
- a nipple that is pulled into the breast
- swelling of the breast
- a sore in the skin of the breast
- lump or swelling under the arm
- a rash on or around the nipple
If you have any of these symptoms it is important to go to your GP straight away. Finding a cancer early gives the best chance of successful treatment.
What Are Risk Factors For Breast Cancer In Men
A risk factor is anything that may increase your chance of having a disease. Risk factors for a certain type of cancer might include smoking, diet, family history, or many other things. The exact cause of someones cancer may not be known. But risk factors can make it more likely for a person to have cancer.
Things you should know about risk factors for cancer:
Risk factors can increase a person’s risk, but they do not necessarily cause the disease.
Some people with 1 or more risk factors never develop cancer. Other people can develop cancer and have no risk factors.
Some risk factors are very well known. But there is ongoing research about risk factors for many types of cancer.
Some risk factors, such as family history, may not be in your control. But others may be things you can change. Knowing the risk factors can help you make choices that might lower your risk. For example, if an unhealthy diet is a risk factor, you may choose to eat healthy foods. If excess weight is a risk factor, your healthcare provider may check your weight or help you lose weight.
Risk factors for breast cancer in men include:
Female relatives with breast cancer
A breast cancer 2 gene mutation in the family
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How Is Breast Cancer In Men Treated
The main treatment for male breast cancer is surgery. The most common surgery is a mastectomy. This means removing the breast tissue and the nipple. Sometimes lymph nodes under the arm, the lining over the chest muscles, and even part of the chest wall muscles under the breast are also removed.
Other treatments that may be used after surgery include:
What Kind Of Treatment Will I Need
There are many ways to treat breast cancer, but the main types of treatment are local or systemic.
Surgery and radiation are used to treat only the cancer. They do not affect the rest of the body. This is called local treatment.
Chemo and hormone treatment drugs go through the whole body. They can reach cancer cells anywhere in the body. They are called systemictreatment.
Doctors often use both local and systemic treatments to treat breast cancer. The treatment plan thats best for you will depend on:
- The stage and grade of the cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Your age
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
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Signs And Symptoms Of Male Breast Cancer
Many men dont think about the health of their breasts, but there are several signs and symptoms of male breast cancer to watch for. The symptoms in men are similar to those in women. Most men are diagnosed with breast cancer after discovering a lump in their chest.
There are other symptoms too. You might notice these during routine activities such as showering or changing your clothes.
Signs and symptoms of male breast cancer can be:
- a painless lump in your chest, usually near or under the nipple, is the most common sign of male breast cancer
- changes to the nipple, including discharge, crusting, or a nipple that suddenly points inward
- pain or swelling of the breast
- a lump in the armpit
- an open sore, or ulcer, on the skin of the breast that doesnt heal
It is important for you to know what is normal for your breasts and to report any changes to your doctor. These changes aren’t always caused by cancer, but if you notice any breast changes, you should see your doctor as soon as possible. Early detection of breast cancer increases treatment options and often reduces the risk of dying from breast cancer.
If you want to learn more about early detection and how to do a self-exam for male breast cancer, watch this video from the Male Breast Cancer Coalition:
More severe symptoms include:
- cough or shortness of breath
- yellowing of the skin and eyes
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.
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How Breast Cancer Develops In Men
Researchers are still working to fully understand breast cancer in men, but they believe the bodys sex hormone levels may play a role, as they do in female breast cancer.
Moreover, additional research is needed to determine the differences between male and female breast cancers. Though they are often treated the same, research is putting a spotlight on differences, including the genetic variations that affect men. This may suggest differences in the biology of breast cancer for men when compared to women.
Like womens breast tissue, mens breast tissue has ducts, but has few or no lobules.
Most breast cancer starts in the milk ducts or in the glands, and men have these, even though theyre typically not functional. Other types of breast cancers that start in other breast cells are less common.
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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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.
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.
Do Underwire Bras Cause Breast Cancer
Underwire bras do not increase your risk of breast cancer.
There have been some concerns that the wires in the cup of underwire bras may restrict the flow of lymph fluid in the breast causing toxins to build up in the area. However, theres no reliable evidence to support this.
If your bra is too tight or too small, the wires can dig into your breasts and cause discomfort, pain or swelling. Find out more about wearing a well-fitting bra.
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What Else Could It Be
Several health issues can bring on symptoms that look like signs of breast cancer in men. Some of them are:
Gynecomastia. This is when your breast tissue gets larger or swells. It’s usually due to a hormonal issue. It can also cause a lump to grow under your nipple.
Lipoma. This is an oval-shaped lump thatâs made of fat. It rarely brings on other symptoms.
Pseudoangiomatous stromal hyperplasia . This noncancerous breast lesion can feel like a small lump. In some cases, it makes breasts larger.
Granular cell tumor. Itâs usually benign, and it often shows up as a single, painless lump.
Joggerâs nipple. If you do a lot of exercise that makes your shirt rub against your chest, it can irritate your nipples and cause pain, redness, or bleeding. Itâs more common when the weatherâs hot and humid.
Skin rash. These can show up anywhere on your body, including your chest. The affected skin can become tender, red, scaly, or itchy. Just a few of the things that can cause a rash are eczema, yeast infections, and hives.
American Cancer Society: âBreast Cancer Signs and Symptoms,â âCan Breast Cancer in Men Be Found Early?â âSigns and Symptoms of Breast Cancer in Men.â
UpToDate: âBreast Cancer in Men.â