What's to know about male breast cancer?
A man's lifetime risk of developing breast cancer is about 1 in 833, according to the American Cancer Society (ACS).
The outlook for male breast cancer is excellent if diagnosis occurs in the early stages. However, early diagnosis is not always possible.
One factor in diagnosis delay is a lack of awareness. While many women know how to look out for changes that could indicate breast cancer, there is less awareness among men, which means they may be less likely to seek help in the early stages.
Breast cancer can also affect males differently, as they have a small amount of breast tissue in comparison with females. This can make it easier to detect small lumps, but it also means that the cancer has less room to grow within the breast. As a result, it may spread more quickly to nearby tissues.
For these and other reasons, around 40% of men with breast cancer receive a diagnosis in stage 3 or 4, when the disease has already spread to other parts of the body. As a result, overall survival rates are lower for men than for women.
Read on to find out more about how to recognize male breast cancer and what to do if changes occur.
The main symptom of male breast cancer is a lump in the breast area.
Possible symptoms of male breast cancer include:
- a lump in one breast, which is usually painless
- nipple retraction, ulceration, and discharge
- skin puckering or dimpling on the breast
- redness or scaling of the skin on the breast or nipple
If cancer spreads, additional symptoms may include:
- swelling in the lymph glands, in or near the underarm area
- breast pain
- bone pain
Statistics and survival rates
The prognosis for breast cancer in men is similar to that in women.
According to the American Cancer Society, the chances of surviving 5 years or more after diagnosis are, on average:
- 96% when cancer affects only the breast tissue at diagnosis
- 83% when it affects nearby areas as well as the breast
- 23% when it has spread to other parts of the body
For this reason, it is essential to seek help as soon as a person notices changes. Early stage breast cancer responds well to treatment.
Diagnostic methods and treatments have improved in the last few years, and so the chances of living for at least 5 years after diagnosis are probably higher than the above figures for people currently receiving a diagnosis.
Tests and diagnosis
If a person notices changes in their breast, they should see a doctor.
They will also carry out a physical examination.
They may suggest the following tests:
- a mammogram
- an ultrasound
- a nipple discharge test
- a biopsy
Sometimes, a doctor will recommend removing a lump and carrying out a biopsy at the same time. They may only remove a part of the area that appears to be affected and carry out a test, or they may remove the whole area, including some of the normal breast tissue surrounding it.
If results show that cancer is present, several treatment options are available. The choice will depend on how big the tumor is and whether cancer has spread to other areas.
Mastectomy: The surgeon removes the whole breast and some of the surrounding tissue.
Breast-conserving surgery: The surgeon removes only part of the breast.
Lymphectomy: The surgeon removes the affected lymph nodes.
A doctor will advise on the best option.
Some people may need radiation therapy after surgery to remove any remaining traces of cancer. It is also a treatment option in the later stages of the disease.
Estrogen hormone therapy
Anyone who has concerns about breast changes should see their doctor.
In some cancers, estrogen receptors are present on the walls of the cancerous cells. In these cases, estrogen helps the cells to divide and grow.
Hormone therapy can block the effects of estrogen and slow the growth of cancer.
Tamoxifen prevents estrogen from entering the cancerous cells. Another drug, toremifene (Fareston), is similar but only has approval for people with late stage breast cancer that has spread to other parts of the body.
Aromatase inhibitors block the effects of the aromatase protein. This, in turn, reduces estrogen levels in the body. These drugs have proven effective in treating breast cancer in women, and some doctors prescribe them for male breast cancer.
Fulvestrant (Faslodex) destroys estrogen receptors. Doctors may prescribe it for people with late stage breast cancer.
Depending on the type, hormone treatment can have adverse effects, such as hot flashes, sexual problems, fatigue, mood swings, a higher risk of blood clots, bone thinning, and pain in the muscles and joints.
In some cases, a doctor may recommend chemotherapy. This is treatment with a drug that kills cancer cells. A doctor often gives it as an injection, but sometimes a person can take it by mouth.
Chemotherapy can prevent cancer from returning if a person uses it after surgery, or treat the symptoms of late stage cancer that has spread to other parts of the body.
Adverse effects include:
- hair loss
- mouth sores
- nausea and vomiting
- changes in appetite
- a higher risk of infection
- easy bruising or bleeding
Most adverse effects of chemotherapy disappear after the treatment finishes.
Learn more here about chemotherapy, what it involves, and its effects.
Various genetic features and changes can affect an individual's risk of cancer. As scientists learn more about the link between different genetic mutations and cancer, they are developing drugs that can target the specific changes that result.
Targeted therapy is a relatively new type of cancer treatment that affects proteins that are involved when specific genetic changes lead to cancer. It is different from chemotherapy as it does not target the whole body.
For example, in some men with breast cancer, there is too much of a protein known as HER2 on the surface of the cancer cells. HER2-positive breast cancers tend to be more aggressive than some other types.
Some drugs, such as trastuzumab (Herceptin), appear to slow the progression of cancer by targeting HER2.
Mutations in the BRCA genes and other genes also cause protein changes, and targeted therapy may help in these cases, too.
Scientists have identified other genes that affect the course of breast cancer and continue to develop drugs that may improve the outlook for people with these specific changes.
Experts do not know exactly why cancer develops in the breast, but they have identified a number of risk factors.
A common factor appears to be a high level of the female hormone estrogen in relation to androgen. Genetic, environmental, and medical factors can all contribute to this.
Genetic mutations may increase the risk of breast cancer. Scientists have found links between breast cancer and a mutation in genes they call BRCA1 and BRCA2.
There is often a family history of breast cancer in people with these changes. Around 20% of men with breast cancer have a close family member with the condition.
As with many conditions, however, genetic features alone may not lead to cancer. Environmental factors may also need to be present.
Factors that may increase the risk of breast cancer in men include:
Age: Men who receive a diagnosis of breast cancer are over 72 years old on average.
Radiation: A man who has previously had radiation treatment to the chest area may have a higher risk.
Alcohol: There appears to be a link between high alcohol consumption and male breast cancer.
Exercise: Having a low level of physical activity may increase the risk.
Jobs: There may be a link between breast cancer and exposure to organic solvents or working with steel and rolling mills.
Other health conditions
Males with some health conditions, such as Klinefelter syndrome, appear to have a 20–60 times higher risk of breast cancer than those without the condition.
A man may have a higher risk if he has or has had:
- liver disease
- an undescended testicle
- mumps during adulthood
- gynecomasty, or excessive development of the male breasts
- thyroid conditions
These conditions and certain medical treatments — and especially those that involve estrogen — appear to increase the risk. People who undergo surgery to remove one or both testicles may also have a higher risk.
The outlook is good for people who get an early diagnosis and prompt treatment.
Early detection can help prevent the spread of cancer.
If there is a history of male breast cancer in the family, a person should regularly check for changes and see a doctor, as soon as possible, if these occur. The individual may also consider asking their doctor about genetic testing.
Leading a healthy lifestyle — for example, by exercising, maintaining a healthy weight, and limiting alcohol consumption — may help prevent male breast cancer.
If a man receives a diagnosis of breast cancer in the early stages, there is a good chance of effective treatment.
However, it can sometimes be hard to get an early diagnosis since the disease is rare and can resemble other conditions that are not cancerous. For this reason, diagnosis may come at a later stage.
Being aware of the signs and symptoms of male breast cancer increases the chances of getting early treatment.