What Are Causes And Risk Factors Of Male Breast Cancer
As with cancer of the female breast, the cause of cancer of the male breast has not been fully characterized, but both environmental influences and genetic factors likely play a role in its development. The following health risk factors for the development of male breast cancer have been identified.
Exposure to ionizing radiation has been associated with an increased risk of developing male breast cancer. Men who have previously undergone radiation therapy to treat malignancies in the chest area have an increased risk for the development of breast cancer.
Klinefelters syndrome is an inherited health condition affecting about one in 1,000 men. A normal man has two sex chromosomes . He inherited the female X chromosome from his mother and the male Y chromosome from his father. Men with Klinefelters syndrome have inherited an extra female X chromosome, resulting in an abnormal sex chromosome makeup of XXY rather than the normal male XY. Affected Klinefelters patients produce high levels of estrogen and develop enlarged breasts, sparse facial and body hair, small testes, and the inability to produce sperm. Some studies have shown an increase in the risk of developing breast cancer in men with this condition. Their risk for development of breast cancer is markedly increased, up to 50 times that of normal men.
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Men And Breast Cancer: Statistics
According to the American Cancer Society:
Breast cancer in men is rare less than 1 percent of all breast cancer occurs in men.
About 2,350 new cases of invasive breast cancer were diagnosed in men in the U.S in 2015.
Breast cancer is about 100 times more common in women.
About 440 men in the U.S. died from breast cancer in 2015.
Some people use statistics to figure out their chances of getting cancer. Or they use them to try to figure out their chance of being cured. Because no two people are alike, statistics cant be used to predict what will happen to one person. These statistics describe large groups of people. They dont take into account a person’s own risk factors, such as family history, behaviors, or cancer screenings. If you have questions, talk with your healthcare provider.
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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Effects On Sexual And Psychiatric Functioning And Postfinasteride Syndrome
Q34.10 Infrequently decreased libido, erectile and ejaculatory dysfunction, decreased ejaculate volume, and testicular pain are reported in 4% to 8% of older men taking 5 mg finasteride 108,115 and in 2% to 4% of younger patients receiving 1 mg finasteride . Although these effects reportedly decrease with longer-term use and reverse upon drug discontinuation, recent reports cite persistent sexual dysfunction after treatment discontinuation.108,116,117
In a recent retrospective health records review of over 11,000 men, persistent erectile dysfunction lasting months to years occurred in approximately 1% of men aged 16 to 42 years taking finasteride 1mg, and longer-term exposure was possibly associated with greater risk.118 Chronic exposure in rats to 5-Î± reductase inhibitors has been shown to change corpus cavernosum muscle and affect erectile function.119
Postfinasteride syndrome is a recently coined term to characterize a constellation of symptoms including sexual dysfunction, gynecomastia, cognitive impairment, depression, anxiety and suicidal ideation that persist after discontinuation of 5-Î± reductase inhibitors. Controversy currently exists regarding this entity, in part that large clinical trials before Propecia release did not demonstrate significant increases in these risks.
Breast Cancer Mortality Over Time
Breast cancer mortality rates in the U.S. increased slowly from 1975 through the 1980s .
From 1989-2018 , breast cancer mortality decreased by 41 percent due to improved breast cancer treatment and early detection . Since 1989, about 403,200 breast cancer deaths in U.S. women have been avoided .
Breast cancer mortality in women decreased by about one percent per year from 2014-2018 . Different breast cancer mortality trends may have been seen in some groups of women.
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Statistics At A Glance: The Burden Of Cancer In The United States
Statistics at a Glance: The Burden of Cancer Worldwide
- Cancer is among the leading causes of death worldwide. In 2018, there were 18.1 million new cases and 9.5 million cancer-related deaths worldwide.
- Generally, cancer rates are highest in countries whose populations have the highest life expectancy, education level, and standard of living. But for some cancer types, such as cervical cancer, the reverse is true, and the incidence rate is highest in countries in which the population ranks low on these measures.
Metastatic Breast Cancer At Diagnosis
Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer.
Some people have metastatic breast cancer when they are first diagnosed. This is called de novo metastatic breast cancer. In the U.S., 9 percent of men have metastases when they are first diagnosed with breast cancer .
Learn more about metastatic breast cancer.
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Men Get Breast Cancer Too
About 480 men are expected to die from breast cancer this year.
Like women, men have susceptible breast tissue that can develop cancer. About 2,550 men will be diagnosed with invasive breast cancer and about 480 will die of it this year, according to the American Cancer Society.
Unlike women, who are advised to get regular mammograms, men usually discover they have breast cancer when they feel a lump or experience symptoms such as discharge from a nipple.
Men dont think they have breaststhey have chests, says Bret Miller, who started the Male Breast Cancer Coalition after his own diagnosis. Men need to realize they do have breast tissue and they can get breast cancer. They should do self-exams like women do.
At age 17, Miller felt a lump in his breast, but doctors told him it was probably calcium buildup. Seven years later, after he got health insurance through his job, he had a mammogram, the lump was removed and it was found to be cancerous.
Miller, now 32, is unusual: Most men with breast cancer are age 60 or older. Those with BRCA gene mutations or a family history of breast cancer are at higher risk.
Men with breast cancer often dont receive optimal treatment, according to a recent study. Fatima Cardoso, MD, and colleagues with the International Male Breast Cancer Program analyzed nearly 1,500 men diagnosed with breast cancer. They found that although half had small tumors, most underwent mastectomy rather than breast-conserving procedures, such as lumpectomy.
Should Men At Higher Risk For Breast Cancer Get Screening Mammograms
Men have less breast tissue than women and fewer than 1 percent of men develop breast cancer, so national cancer screening guidelines do not recommend regular screening mammograms for men. However, if a doctor suspects breast cancer, a diagnostic mammogram may be needed to look for malignant tumors.
However, when a man is determined to be at higher risk for breast cancer, it is recommended that he have an annual clinical breast exam to check for breast changes that could indicate breast cancer.
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How Many People Survive Breast Cancer
- Almost nine in ten of women survive breast cancer for five years or more.
- Breast cancer survival is improving and has doubled in the past 40 years in the UK due to a combination of improvements in treatment and care, earlier detection through screening and a focus on targets, including faster diagnosis.
- An estimated 600,000 people are alive in the UK after a diagnosis of breast cancer. This is predicted to rise to 1.2 million in 2030.
For many the overwhelming emotional and physical effects of the disease can be long-lasting.
Every year around 11,500women and 85 men die from breast cancer in the UK thats nearly 1,000 deaths each month, 31 each day or one every 45 minutes.
Breast cancer is the fourth most common cause of cancer death in the UK.
Breast cancer is a leading cause of death in women under 50 in the UK.
Dcis Of The Male Breast
DCIS accounts for approximately 5% of breast cancers in men.84 It usually presents clinically with symptoms of a retro-areola cystic-type mass or bloody nipple discharge. Clinical, rather than mammographic, detection possibly accounts for the different incidence of DCIS between men and women. The predominant histological subtypes of DCIS in men are papillary and cribriform. Standard treatment is total mastectomy with excision of the nippleâareola complex but wide excision and radiotherapy is being used more frequently.85 Pure DCIS in men is usually of low or intermediate grade less than 3% of cases are high grade. In a series of 114 patients, 84 with pure DCIS and 30 with DCIS and invasive cancer, there were no cases of high-grade comedo DCIS in men without an invasive tumour.86 The percentage of men with DCIS that eventually develop an invasive cancer is not known.
Sarika Jain, William J. Gradishar, in, 2018
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What This Means For You
If youre a man who has been diagnosed with breast cancer, this study may seem disheartening. But it does show that you need to be your own best advocate to make sure that you get the treatments that are best for your unique situation. Based on the study results, undertreatment is likely the reason for much of the survival rate difference between men and women diagnosed with breast cancer.
Its also very important to talk to your doctor right away about any changes in your breasts, including:
- nipple pain
- sores on the nipple and/or areola area
- enlarged lymph nodes under the arm
Because many men dont consider the possibility that they may develop breast cancer, they may wait a year or longer to talk to their doctor after noticing a breast symptom. This means the cancer is diagnosed at a later stage, which also contributes to higher mortality rates for men with breast cancer.
Future research should focus on why and how clinical characteristics, as well as biological features, may have different implications for the survival of male and female patients with breast cancer, the researchers concluded. Additional factors, particularly compliance to treatment, biological attributes, and lifestyle factors , should be assessed to help in developing treatments tailored for men, which would mitigate this sex-based disparity.
For more information, visit the Breastcancer.org pages on Male Breast Cancer.
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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Warning Signs Of Breast Cancer In Men
The most common sign of breast cancer in men is a painless lump or thickening in the breast or chest area .
However, any change in the breast or nipple can be a warning sign of breast cancer in men including :
- Lump, hard knot or thickening in the breast, chest or underarm area
- Change in the size or shape of the breast
- Dimpling, puckering or redness of the skin of the breast
- Itchy, scaly sore or rash on the nipple
- Pulling in of the nipple or other parts of the breast
- Nipple discharge
These may also be signs of a benign breast condition.
Because men tend to have much less breast tissue than women, some of these signs can be easier to notice in men than in women.
Mortality Rates And Number Of Breast Cancer Deaths
Sometimes its useful to have an estimate of the number of people expected to die from breast cancer in a year. This number helps show the burden of breast cancer in a group of people.
Numbers, however, can be hard to compare to each other. To compare mortality rate in different populations, we need to look at mortality rates rather than the number of breast cancer deaths.
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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:
How Is Breast Cancer Treated In Men
The treatment for male breast cancer is similar to how we treat women with breast cancer. A biopsy is necessary to determine what the mass is, along with particular markers that the pathologist will study under the microscope.
If the mass is diagnosed to be a breast cancer, the patient will see a breast surgeon and as a team determine which approach is most appropriate breast conserving therapy or a mastectomy.
The patient also will see an oncologist to determine if endocrine therapy or chemotherapy or radiation therapy is necessary.
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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
Klinefelters 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
Whats The Difference Male Breast Cancer And Female Breast Cancer
Despite outward appearances, breasts in men and women are built very much the same. Human breasts in both sexes have nipples, fatty tissue, breast cells and ducts. Men and women also share some of the same risk factors for breast cancer. Both genders may have inherited mutations in their BRCA1 and BRCA2 genes that may increase cancer risk. And both genders produce the hormone estrogen, which at certain levels may increase breast cancer risk. So why do so few men get breast cancer?
In general, the incidence of breast cancer in men is far less than in women because although the breast tissue in both are similar, male breast tissue is mainly fat and fibrous tissue called stroma and they have fewer ducts and lobules, says Sramila Aithal, MD, Hematologist & Medical Oncologist at our Philadelphia hospital. When womens breasts mature during puberty, they develop working lobules and milk ducts to produce and carry milk after childbirth. Most breast cancers in women develop in those ducts and lobules. Most men produce far fewer and smaller ducts and may not produce lobules. Inherited gene mutations may increase cancer risk in both sexes, but are likely to affect genders differently. While BRCA mutations significantly increase a mans risk of breast cancer, men with those mutations are at a higher risk of prostate cancer more than breast or other cancers.
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Can Men Get Breast Cancer
It may come as a surprise to learn that men can develop breast cancer. Though it is uncommon, breast cancer does occur in men. In Australia, fewer than 1% of breast cancer cases each year are in men.
Men, like women, have breast tissue. Although women have a lot more breast tissue than men and are more likely to develop breast cancer, cancer can also develop in male breast tissue.
About 164 men are diagnosed with breast cancer each year in Australia, and the majority of these men will be diagnosed after the age of 50. With an aging population, it is likely that the number of men diagnosed with breast cancer will continue to increase.