Personal Stories From Men With Breast Cancer
While 144 men are diagnosed with breast cancer every year, it can be isolating being diagnosed with what is considered a ‘women’s cancer’. It may help to read stories from other men with breast cancer to know you are not alone. Read stories from men with breast cancer, or connect with other men in a similar situation on BCNA’s online network.
Global Breast Cancer Statistics
- Breast cancer is the most common cancer worldwide.
- In 2020, there were 2.3 million women diagnosed with breast cancer and 685,000 deaths globally with breast cancer surpassing lung cancer as the most commonly diagnosed cancer.
- As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer over the past five years.
Types Of Breast Cancer In Men
The types of breast cancer that affects men are similar to those found in women. Common types of male breast cancer include:
- Invasive ductal carcinoma this is the most common type of breast cancer found in men. It occurs when cancer cells grow outside the duct and spreads into nearby breast tissue. If untreated, the cancer cells can spread to other parts of the body.
- Invasive lobular carcinoma this type of breast cancer occurs when the cancer cells grow outside of the lobules and spreads into nearby breast tissue. It can also metastasise if not treated.
- Ductal Carcinoma In situ this breast disease occurs when cells within the duct are abnormal. The cancer cells are contained within the ducts and have not spread into nearby tissue. It can be referred to as a non-invasive breast cancer, although DCIS may lead to invasive breast cancer over time.
Men can also be diagnosed with less common forms of breast cancer, such as Pagets disease of the nipple, or inflammatory breast cancer.
Multivariate Cox Regression & Kaplan Meier Analysis
Multivariate Cox regression was performed, and the data is shown in . In addition, Kaplan Meier survival probabilities were calculated. In our study, increasing age and tumor size were among the independent factors affecting mortality. Patients who were diagnosed at an older age had reduced survival as well as those whose tumors were larger at diagnosis . These findings are similar to those of previously reported, albeit smaller studies .
Incidence Rates And The Number Of New Cases
To know whether or not breast cancer rates are changing over time, you have to compare rates, rather than the number of new cases.
For example, lets compare the number of new cases of breast cancer in U.S. in 2009 to the number of new cases in 2016. In 2009, there were an estimated 192,370 new cases of breast cancer in U.S. women . In 2016, there were an estimated 246,660 new cases .
Although more breast cancer cases occurred in 2016 than in 2009, this doesnt mean the rate of breast cancer increased over this time period.
We expect the number of cases to increase over time because the population of the U.S. increases over time . The more people there are, the more cancers there will be.
Our population is also living longer . Since age increases the risk of breast cancer, we expect to have more breast cancers over time.
To know if breast cancer rates are changing over time, we look at incidence rates, rather than the number of new cases. The incidence rate shows the number of breast cancer cases in a set population size. Its usually written as the number of cases in a population of 100,000 people.
The breast cancer incidence rate among women in 2009 was 131 and the estimated breast cancer incidence rate in 2016 was also 131 . This means there were 131 breast cancer cases per 100,000 women in the U.S. population in both time periods.
So, although the number of breast cancer cases increased over time, breast cancer rates were fairly stable.
Treatment Of Locally Advanced Disease
The treatment of male patients with T3/T4 or inflammatory breast cancer is initiated with neo-adjuvant CT and surgery is performed on those whose tumor becomes amenable to operation. Subsequently, adjuvant tamoxifen is recommended for HR positive cases. It should also be kept in mind that adjuvant hormonal therapy may be an alternative to CT in most cases .
Higher Death Rates Later
To conduct the analysis, Dr. Shu and her colleagues used information from the National Cancer Database to compare death rates for 16,025 men and 1,800,708 women who were diagnosed with breast cancer between 2004 and 2014.
The National Cancer Database, which is sponsored by the American College of Surgeons and the American Cancer Society, includes more than 70% of newly diagnosed cancer cases in the United States.
In the study, men had higher death rates than women across all stages of breast cancer, even after the researchers adjusted for differences in patients clinical characteristics, such as the type and stage of disease, treatments received, age, race/ethnicity, and access to care.
In addition, the study found that a larger percentage of men than women were diagnosed with advanced-stage disease, which the researchers said could be attributed to a lack of awareness of and screening for breast cancer in men.
A higher percentage of men than women in the study had stage IV breast cancer at diagnosis , for example.
Despite having more aggressive disease overall, male patients were more likely than women to be undertreated, the researchers found. For instance, men were less likely than women to receive radiation therapy, including those who had breast-conserving surgery.
Clinical characteristics and undertreatment explained only about two-thirds of the difference in mortality. Hopefully, future studies will be able to identify additional factors, said Dr. Shu.
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Lifetime Risk Of Breast Cancer Worldwide
Women who live in developed countries tend to have a higher lifetime risk of breast cancer than women who live in developing countries .
Although we dont know all the reasons for these differences, lifestyle and reproductive factors likely play a large role .
Low screening rates and incomplete reporting can make rates of breast cancer in developing countries look lower than they truly are and may also explain some of these differences.
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.
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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.
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.
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Uk Breast Cancer Statistics
Incidence of breast cancer in the UK
- Breast cancer is the most common cancer in the UK.
- Breast cancer represented 15% of all new cancer cases in 2017.
- There are around 55,000 new cases of breast cancer every year, thats over 150 cases every day.
- In women, there were 54,700 new cases in 2017.
- 17% of breast cancers were in women under 50, between 2015-2017.
- 24% of breast cancers occurred in women over 75 between 2015-2017.
- In men, there were 390 new cases in 2017.
- Breast cancer is now the most common cancer globally.
The growth of breast cancer over the years
Breast cancer in UK women has:
- increased by 23%between 1993 and 2017.
- increased by 5% between 2007 to 2017.
- dropped by 4% between 2014 and 2017.
Rates for men have remained stable over the past two decades.
The overall risk of getting breast cancer
- A woman born after 1960 and living in the UK has an estimated1 in 7 lifetime risk of developing breast cancer.
- A UK mans lifetime risk of developing breast cancer is around1 in 870.
Breast cancer prevention
- The proportion of breast cancer cases that can be prevented is estimated to be between 23%-37%.
- It is estimated that at least, 13,000 breast cancer cases could be prevented by making lifestyle changes.
Breast cancer mortality
Breast cancer survival
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 .
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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
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.
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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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.
Klinefelter’s 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 Klinefelter’s syndrome have inherited an extra female X chromosome, resulting in an abnormal sex chromosome makeup of XXY rather than the normal male XY. Affected Klinefelter’s 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.
Cirrhosis of the liver
How Is A Male Breast Cancer Diagnosis Made
If a doctor has reason to suspect cancer, the following tests and procedures may be used to arrive at a diagnosis:
- Clinical breast exam. Usually a first step, this is performed in the office. The doctor feels the breast and underarm area for palpable lumps and examines the skin and nipple for any breast changes.
- Imaging tests. Next, the doctor may order such tests as a mammogram with a breast ultrasound and, occasionally, a magnetic resonance imaging of the breasts. A radiologist will examine these imaging tests to look for malignant tumors.
- Breast biopsy. A breast biopsy is a procedure in which a small piece of tissue is removed and sent to a pathology lab, where it is evaluated to determine if it is malignant or benign. The four main kinds of breast biopsies are the core needle biopsy, excisional biopsy, fine need aspiration, and punch skin biopsy.
- HER2 test. This test measures the amount of the growth-factor protein known as HER2, found in the breast tissue. This information helps a medical oncologist choose the right therapy for treatment.
Hormone-sensitivity tests. If cancer is found, an estrogen and progesterone receptor test is performed to determine whether the tumor contains receptors for estrogen and progesterone. If it does, the patient can also be treated with medications that suppress estrogen and progesterone in the body, depriving cancer cells of those hormones. This is done in addition to surgical therapy.
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Diagnosing Male Breast Cancer
Diagnosis male breast cancer starts with providing a complete personal and family medical history, describing your symptoms and being examined by your doctor.
After that, you may have screening with one of a few possible technologies, including a diagnostic mammogram, a breast ultrasound, a magnetic resonance imaging scan and/or possibly a test to study your nipple discharge.
Your doctor may also test your blood chemistry to look for unusual amounts of a substance that might suggest disease.
If your diagnostic tests show you may have cancer, the next step is a biopsy. A variety of different biopsies can involve removing cells through a needle, including fine-needle aspiration or core needle biopsy, or removing the whole lump or part of the suspicious area through surgery.
If cancer is found, additional tests will help your doctor know how quickly it may grow, how likely it is to spread or recur and what treatments may be the most appropriate.
Those would include:
- An estrogen and progesterone receptor test that measure the amount of these receptors in the cancer
- A HER2 test to measure the presence and level of HER2 protein
Men tend to be diagnosed with breast cancers that are hormone receptor-positive and HER2-negative.
The spread of cancer from breast to lymph nodes and other parts of the body in men appears to be similar to what women experience.
The stage of breast cancer is determined by your care team based on:
How Is Breast Cancer Similar In Both Men And Women
Both men and women may have breast cancer cells in the lymph nodes. The patterns of the spread of cancer are similar. The staging system for male breast cancer is the same as the staging system for female breast cancer. Breast cancer in both men and women are assessed in the same way to determine the prognosis. This includes the size of the lesion and whether or not lymph nodes have cancer cells. These factors affect the choice and outcome of treatment. Overall survival rates are similar in both men and women with breast cancer. Although male breast cancer is often diagnosed at a later stage.
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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 .