Male Breast Cancer: What You Need to Know

Though men don’t develop breasts the way women do, men do have the same breast cells and tissue as women, which means that — though rare — it's possible for men to develop breast cancer.

Men who carry a genetic mutation associated with breast cancer, such as the BRCA1 or BRCA2 mutations, are at heightened risk for the disease, just as women who carry those genes are. Because the disease is so rare in men, men who don’t have the breast cancer (BRCA) gene or a family history are rarely screened for the disease. That's why it's important to be aware of the signs and symptoms.

Breast Cancer in Men: Statistics

Diagnoses of breast cancer in men are rare, making up less than 1 percent of all breast cancer cases. Only about 1 in 833 men will ever be diagnosed with the disease. In 2019, about 2,670 men are expected to be diagnosed.

Types of Breast Cancer That Affect Men

The overwhelming majority of men are diagnosed with infiltrating ductal carcinoma (IDC), which accounts for 70 to 80 percent of all breast cancer diagnoses. With IDC, abnormal cells develop in or around the ducts and break through the wall to invade surrounding tissue. Other, rarer types of breast cancer that can occur in men include Paget's disease of the nipple and inflammatory breast cancer. Because lobular breast cancer starts in lobules, where milk is made, this type of cancer has not been observed in men.

Risk Factors for Breast Cancer in Men

• Age While cancer can happen anytime, the risk increases with age. Men between 60 and 70 years old are most susceptible.
• High estrogen levels Heavy alcohol use and liver disease such as cirrhosis can contribute to elevated estrogen levels and reduce male hormones. Hormonal medications can also increase risk.
• Klinefelter's syndrome Men with this condition have more than one X chromosome, which results in lower levels of androgens or male hormones and a higher risk of breast cancer.
• Genetics A strong family history of breast cancer is a risk factor, particularly if male relatives have had breast cancer.
• Radiation exposure Being treated with radiation to the chest (for lymphoma, for example) increases the risk of developing breast cancer.
• Obesity Being overweight is associated with higher levels of estrogen in the body, which can increase risk.
• Testicular disease or surgery Having inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can elevate risk.

BRCA1 and BRCA2: Genetic Mutations That Can Cause Breast Cancer in Men

Genetic factors can play a significant role in breast cancer diagnoses in men. Mutations in one of several genes, particularly the BRCA1 or BRCA2 genes, increase the risk of developing both breast and prostate cancers in men.

When a male offspring of a man with breast cancer inherits the BRCA2 gene, his chance of eventually developing breast cancer is approximately 6 percent. His risk is just over 1 percent if he inherits BRCA1. Female children who inherit a BRCA1 or BRCA2 mutation are at a 40 to 80 percent risk of eventually developing breast cancer.

Symptoms of Breast Cancer in Men

The most common signs of breast cancer in men include:

• A painless lump or thickening in the breast tissue
• Changes in the skin covering the breast, such as dimpling, puckering, redness or scaling, inversion, redness, or scaling of the nipple
• Nipple discharge.

How Breast Cancer Is Diagnosed in Men

When a breast abnormality is detected, your doctor may order a mammogram, ultrasound, nipple discharge examination, or biopsy to determine if there is malignancy. An MRI may also be helpful. An MRI can serve a variety of purposes: It can show the extent of cancer in the affected breast relative to the normal tissue, determine if the cancer has spread to the other breast, and determine the extent of surgery necessary.

How Is Male Breast Cancer Treated?

Surgery

Surgery is usually the first treatment for men with breast cancer. In a simple or total mastectomy, the entire breast, including the nipple, is removed.

If the cancer is more extensive, “big” surgeries that remove lymph nodes or muscle tissue may be necessary. Breast-conserving surgery, such as lumpectomy, is not usually an option because men's breasts are so small, there is little tissue to conserve after the tumor and surrounding tissue are removed.

The possible side effects of surgery include bleeding and infection at the surgical site, hematoma (blood buildup), and seroma (clear fluid buildup) in the wound. A possible long-term effect of removing axillary lymph nodes is swelling in the arm that may result from blockage in the lymphatic system, with limited arm and shoulder movement and numbness of the skin on the upper and inner arm.

Radiation Therapy

Radiation therapy is usually administered five days a week for about five to seven weeks following surgery to reduce the risk of recurrence post mastectomy.

Hormone Therapy

About 85 percent of male breast cancer is ER-positive, meaning the cells have estrogen receptors on their surface. That statistic is roughly 10 percent higher than in women with breast cancer. Hormonal therapies such as Soltamox (tamoxifen), a category of drug known as a selective estrogen receptor modulator (SERM), have proved to be an effective therapy for ER-positive tumors in men and women. SERMs prevent estrogen from reaching the receptor on the surface of cancer cells and stimulating cancer cell proliferation.

Source: https://www.everydayhealth.com/breast-cancer/male-breast-cancer/