Breast Cancer Awareness Month: What is male breast cancer, how is it caused and can it be treated?
Breast cancer is most often found in women, but men can also get the disease. Male breast cancer is a rare cancer that forms in the breast tissue of men. Cells in nearly any part of the body can become cancer and can spread to other areas. About 1 out of every 100 breast cancers diagnosed in the US are found in a man. The American Cancer Society (ACS) estimates that about 2,620 new cases of invasive breast cancer will be diagnosed in American men in 2020 and about 520 men will die from the disease.
"Breast cancer is about 100 times less common among White men than among White women. It is about 70 times less common among Black men than Black women. As in Black women, Black men with breast cancer tend to have a worse prognosis (outlook). For men, the lifetime risk of getting breast cancer is about 1 in 833," says the ACS.
What are the symptoms?
The possible symptoms of breast cancer to watch for in men include a lump or swelling in the breast that is often painless, changes to the skin covering the breast, such as dimpling, puckering, redness or scaling, discharge from the nipple, changes to the nipple such as nipple retraction (turning inward), or redness or scaling of the nipple. Sometimes breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast is large enough to be felt.
These symptoms can, however, happen with other conditions that are not cancer. Health experts advise that anyone who notices anything unusual about their breasts, whether male or female, should contact their physician immediately.
Common types of breast cancer diagnosed in men
Invasive ductal carcinoma: When the cancer cells grow outside the ducts into other parts of the breast tissue. These cancer cells can also spread, or metastasize, to other parts of the body. This is the most common type of breast cancer: at least 8 out of 10 male breast cancers are IDCs.
Invasive lobular carcinoma: When cancer cells spread from the lobules to the breast tissues that are close by. Invasive cancer cells can also spread to other parts of the body. This is rare in men, accounting for only about 2% of male breast cancers.
Ductal carcinoma in situ (DCIS): It is a breast disease that may lead to breast cancer, and accounts for about 1 in 10 cases of breast cancer in men.
Other types of cancer. Other, rarer types of breast cancer that can occur in men include Paget's disease of the nipple and inflammatory breast cancer.
What are the risk factors?
The causes of breast cancer in men are not yet understood completely, but several factors have been identified that may increase a man’s chance of getting it. But having a risk factor, or even many does not mean that you are sure to get the disease.
Age: The risk increases with age and most male breast cancers are found after age 50. On average, men with breast cancer are about 72 years old when they are diagnosed.
Family history of breast cancer: A man's risk for the disease increases if a close family member has had breast cancer. About 1 out of 5 men with breast cancer have a close relative, male or female, with the disease.
Genetic mutations: Inherited changes (mutations) in certain genes, such as BRCA1 (about 1 in 100) and BRCA2 (lifetime risk of about 6 in 100), increase the risk.
Klinefelter syndrome: It is a rare genetic condition in which a male has an extra X chromosome. Men with this syndrome produce higher levels of estrogens and lower levels of androgens (hormones that help develop and maintain male sex characteristics). Having this condition can increase the risk anywhere between 20-60 times the risk of a man in the general population.
Radiation exposure: A man whose chest area has been treated with radiation (such as for the treatment of cancer in the chest, like lymphoma) has a higher risk of getting breast cancer.
Exposure to estrogen: If a man takes estrogen-related drugs, such as those used for hormone therapy for prostate cancer, his risk of breast cancer is elevated.
Overweight and obesity: Older men who are overweight or have obesity have a higher risk of getting breast cancer than men at a normal weight. The reason is that fat cells in the body convert androgens into estrogens, implying that obese men have higher levels of estrogens in their body.
Liver disease: Certain conditions, such as cirrhosis of the liver, can lower androgen levels and increase estrogen levels in men, increasing your risk of breast cancer.
Alcohol: Heavy drinking of alcoholic beverages increases the risk of breast cancer in men. This may be because of its effects on the liver.
Testicular conditions: Having inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can increase the risk of male breast cancer.
What can men do to lower their risk?
There is no way to completely prevent cancer. But there are things one can do that might lower the risk. Since being overweight or obese is linked with an increased risk for several cancers, the ACS recommends that men should stay at a healthy weight throughout their life and avoid excess weight gain by balancing food intake with regular exercise.
"Many studies have shown that moderate to vigorous physical activity is linked with lower breast cancer risk in women, as well as many other types of cancer. The ACS recommends that adults get at least 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity activity each week (or a combination of these), preferably spread throughout the week. Getting to or going over the upper limit of 300 minutes is ideal," explain guidelines. Health experts also recommend avoiding or limiting alcohol. According to guidelines, for men who do drink, they should have no more than two alcoholic drinks a day.
Currently, the best strategies for reducing the number of deaths caused by this disease are early detection and prompt treatment. Early detection has been a problem for men, who may not notice breast lumps or see their doctor only when the lumps have gotten large. In general, men are diagnosed with breast cancers at more advanced stages than women. If several members in the family have had breast or ovarian cancer, or a family member has a known BRCA1 or BRCA2 mutation, health experts advise sharing this information with one’s doctor. The doctor may refer the person for genetic counseling.
Diagnosis and treatments
Besides a physical exam, breast cancer can be diagnosed through multiple tests such as ultrasound, MRI scan, mammography and biopsy. Treatment can depend on how big the tumor is and how far it has spread, among other factors. After someone is diagnosed with breast cancer, doctors will try to figure out if it has spread, and if so, how far — a process known as staging. The stage of a cancer describes how much cancer is in the body and helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer’s stage when talking about survival statistics. The staging system used for breast cancer in men is the same as the one used for breast cancer in women. Treatments may include surgery, chemotherapy, radiation therapy, hormone therapy and targeted therapy. For more details, you can check here and here.