Overview
Male breast cancer is a form of cancer occurring in the breast tissue of men. It is a common notion that breast cancer is a disease which affects women only, but it can also affect men.
Male breast cancer can occur at any age but it is more common in the older age group. If male patients are diagnosed at an early stage with male breast cancer, they have a better prognosis.
Treatment modalities can be chemotherapy, radiation therapy or surgery to remove the invading or the whole breast tissue as per the condition of the patient.
Benign Breast Conditions of The Male Breast Tissue (not cancerous in nature) :
1. Gynecomastia
It is an increase in the amount of breast tissue in men. Gynecomastia appears like a button or disk-shaped growth under the nipple and/or areola which can be seen and/or felt. Gynecomastia is common during the teenage period due to hormonal changes in the adolescence growth phase. Similar hormonal changes can be seen during the old age period and hence seen in older men too. Gynecomastia can occur due to tumours or diseases of endocrine glands causing the man's body to produce more oestrogen which is a feminising hormone which is generally present in low levels. Liver diseases and obesity can also give a rise to this condition. Few medicines can also cause gynecomastia e.g. drugs used to treat heartburn and ulcers, heart failure, high blood pressure and psychiatric conditions.
Klinefelter syndrome is a genetic condition that can also lead to gynecomastia along with a higher risk for the development of male breast cancer.
2. Benign breast Tumors
Types of benign breast tumours are papillomas and fibroadenomas. Benign tumours are not fatal.
Male Breast Cancer Symptoms
Signs and symptoms of male breast cancer include as follows :
- A painless lump in the breast
- Abnormal thickening in the breast tissue
- Skin changes over the breast, like redness, scaling dimpling or puckering,
- Changes in the nipple, such as eczema, scaling or redness
- Inward turned nipple
- Nipple discharge
Male Breast Cancer Types
The most common types of male breast cancer are the same kinds which are found in women—
-
Invasive Ductal Carcinoma :
The invasive cells begin to proliferate in the ducts and then spread outside the ducts into other parts of the breast and can even metastasize.
-
Invasive Lobular Carcinoma :
Cancer cells proliferate in the lobules and then spread from the lobules to the breast and nearby. They possess the power to metastasize.
-
Ductal Carcinoma in Situ (DCIS):
It is a breast disease which leads to invasive breast cancer. The cancer cells are present only in the ductal walls.
-
Paget Disease of The Nipple
It starts in the breast ducts and goes to the nipple and/or areola. The skin of the nipple becomes crusted, red and scaly with eczema, burning, oozing or bleeding. An underlying breast lump might also be present. Paget disease can lead to infiltrating ductal carcinoma or DCIS.
Male Breast Cancer Causes
- Genetic: Some men inherit mutated genes (e.g. Mutated BRCA1, BRCA2 gene) which increases the risk of breast cancer and even prostate cancer.
- Positive family history of cancer can also be a possible cause.
Male Breast Cancer Treatment
To determine breast cancer treatment options, the doctor has to consider the cancer's stage, overall health condition and patient’s preferences.
Male breast cancer treatment might involve surgery or a combination of treatment modalities.
Surgery:
The goal of surgery is to remove the tumour and surrounding breast tissue if invaded. The procedures include:
- Mastectomy or removing all of the breast tissue.
- Removal of a few lymph nodes for sentinel lymph node biopsy. If cancer is detected in those, additional lymph nodes need to be removed.
Radiation Therapy:
It involves the use of high-energy beams like X-rays and protons to destroy cancer cells. In a male breast cancer patient, radiation therapy can be used after surgery to eliminate any remnant of the cancer cells in the breast, armpit or chest muscles.
Hormone Therapy:
Hormone therapy for male breast cancer often uses a medicine named Tamoxifen.
Chemotherapy:
Chemotherapy uses medications to destroy cancer cells. These medications can be administered intravenously or orally or by both methods as and when required.
Mental Support:
A patient receiving a cancer diagnosis needs to be handled with care. A few points can be kept in mind to help in coping with the situation.
- Talking to someone
- Meditation and prayer
- Creative activities and engagements
- Gentle relaxation exercises.
Male Breast Cancer Risk Factors
- Older age (>60s)
- Exposure to oestrogen.
- Genetic mutations (like BRAC1, BRAC2 genes)
- Family history of breast cancer.
- Klinefelter's syndrome. (XXY trisomy of 21st chromosome). Klinefelter's syndrome causes abnormal growth of the testicles. As a result, lower levels of androgens and higher levels of estrogens are produced.
- Liver disease.
- Obesity.
- Testicle disease (orchitis) or surgery (orchidectomy)
Diagnosis and Tests For Male Breast Cancer
- Clinical breast examination. The doctor uses their hand to examine the breasts and surrounding areas for lumps or any other changes.
- Imaging tests. Tests like breast X-ray (mammogram) or an ultrasound.
- Biopsy. A biopsy is one of the most definitive methods to make the diagnosis of breast cancer. During the biopsy procedure, the doctor uses a specialised needle which is a device guided by X-ray or USG or another imaging test to extract a sample of tissue from the area under suspicion.
- Biopsy samples are sent to a laboratory for analysis.
Determination of The Extent of The Cancer
Tests used to detect the stage of the breast cancer:
- Computerised tomography (CT) scan
- Positron emission tomography (PET) scan
- Bone scan (if bone metastasis is present)
How to Prepare for an Appointment:
One can start by seeing the family doctor if any unusual signs or symptoms are noticed. If the doctor suspects breast cancer, one might be referred to an oncologist. A few points below can be said/asked by the patient :
- Symptoms faced by the patient
- Past history or other underlying conditions
- Personal information, if necessary
- Drug History: list all your medications, vitamins and supplements.
- Treatment options
- Potential side effects of each option
- Best treatment option
- How long will the cancer treatment last?
- How will cancer treatment affect the daily routine?
- Other health conditions and how to manage them together
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