While 55,000 women in the UK are diagnosed with breast cancer every year, it is rare in men. One percent or 350 cases of breast cancer across both genders occur in males. Because it is so unusual and not commonly discussed, men are at a higher risk of mortality from breast cancer than women due to being diagnosed too late. As men are not educated on checking for the warning signs, breast cancer is usually picked up when they are older.
Types of Male Breast Cancer
A man with breast cancer may have one of four types of breast malignancy. Inflammatory breast cancer presents with a breast that is warm to the touch, swollen and inflamed, and skin may be red. Ductal carcinoma in situ involves cancerous cells in the lining of a duct. Infiltrating ductal carcinoma has moved beyond the ducts. This cancer is found most often in men. In Paget disease of the nipple, a tumour forms underneath the nipple and spreads to the surface. Only women get lobular carcinoma in situ.
While having a risk factor does not mean you will get a disease, it increases your chances. Likewise, even without risk factors, men may develop breast cancer. Screening for breast cancer in males can help to detect it earlier and result in a better prognosis so it’s important that appointments are made as soon as you can. Going private can be a good way to fast track this, with services such as Circle Health Group which has specialists who deal with male breast cancer. Circle Health Group is the UK’s largest network of private hospitals.
Risk factors for male breast cancer are radiation treatment over the chest area, being related to a woman who has had breast cancer, gene mutations, and Klinefelter syndrome. In the latter, the man has two X chromosomes and one Y chromosome. This may cause an imbalance between the amount of oestrogen and androgen hormones in the body and result in a decrease in testosterone.
Every male produces some oestrogen hormone. However, high levels can be indicated in cancer in men. The risk increases in men who are overweight, in conjunction with chronic liver conditions, and due to genetic factors.
Genetic testing is needed to identify gene mutations. The BRCA2 gene is responsible for between five and ten percent of breast cancer in both sexes. If you have a family history of breast cancer, these tests are recommended.
Age is considered the most prominent risk for male breast cancer. The majority of men are diagnosed in their 60s or 70s. This does not mean a younger man will not get breast cancer. It is best to go for screening annually as you age.
Signs and Symptoms of Male Breast Cancer
Any thickening or lump in the breast or the underarm region needs to be checked by a doctor and tested. Sometimes the breast will change shape or size and appear different from the other breast. Another sign is if the nipple becomes inverted (turns inward). Creases or dimples in the breast may be indicative of breast cancer.
The skin may develop scales, have a reddened appearance, or experience swelling. It could look like an orange peel. These changes could occur on the nipple, areola, or breast. A discharge from the nipple, which may be bloody, is also a symptom of breast cancer.
Diagnosis of Male Breast Cancer
Your medical practitioner will perform a breast examination. This will entail checking the breasts and armpits for lumps and other symptoms. Thereafter, a mammogram will be done, which is an x-ray of the area. An ultrasound scan that produces an image of body tissues may also take place to clarify findings from the physical examination and mammogram.
If cancer is suspected, a biopsy will be arranged. This is when cells are extracted from the breast and examined under a microscope. In an excisional biopsy, the whole lump is removed. An incisional biopsy takes a portion of the lump. A core biopsy recovers tissues with a wide needle, while a fine-needle aspiration biopsy generally removes fluid for testing. Blood tests may also be done.
Treatment of Male Breast Cancer
Male breast cancer is treated with surgery, radiation, chemotherapy, hormone therapy with tamoxifen, or targeted therapy. These treatments are not without side effects. During surgery, the whole breast, including the nipple and areola may be incised. Lymph nodes in the armpit will also be removed. In less severe cases where the cancer has not spread to surrounding tissue, only the lump and a small surrounding area of healthy tissue are removed, followed by radiation to destroy any remaining cancer cells.
Adjuvant therapy may be provided after surgery to prevent cancer cells from growing again. Malignant cells could already have spread elsewhere in the body even if the cancer has been caught early. Often, they move to the bones or lungs. If you had lymph glands removed during surgery, you are more likely to be given adjuvant therapy, as this is one of the key ways that cancer spreads.
Men should perform regular self-examinations of their breasts and go for screening early if they have symptoms or risk factors, as this can save lives.