Although rare, breast cancer can affect males. Doctors use a staging system to diagnose breast cancer and decide an appropriate treatment.

This article discusses the signs, treatments, and outlook for different stages of male breast cancer.

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Stage 0 is noninvasive cancer. The cancer is only present inside the milk duct and has not spread deeper into the surrounding breast tissue. People may also have a tumor called ductal carcinoma in situ (DCIS).

Individuals may not experience any symptoms of stage 0 breast cancer. However, in some cases, people may notice a lump in the breast or discharge from the nipple.

Treatment

With stage 0 cancer, People require surgery to remove the area of cancer. Individuals may have a mastectomy, which removes the breast, or breast-conserving surgery, which avoids removing as much of the affected breast tissue as possible.

If people have breast-conserving surgery, they will have radiation therapy afterward to target the remaining breast tissue.

In some cases, DCIS may involve invasive cancer, which means the cancer has spread into other areas of the body. In these cases, individuals may require a biopsy of the underarm lymph nodes, called a sentinel lymph node biopsy.

Stage 1 means that the area of breast cancer is small and has not spread to the lymph nodes. Alternatively, it could refer to a very small spread of cancer to the sentinel lymph node.

Healthcare professionals divide stage 1 into two sections:

  • Stage 1A: This means that the tumor measures 2 centimeters (cm) or smaller, while the cancer cells have spread to the nearby tissues, but they have not reached the lymph nodes.
  • Stage 1B: This means that the cells are invading nearby tissue. There is no tumor, but there are small groups of cells that measure between 0.2 millimeters (mm) and 2 mm. It could also mean that there is a tumor in the breast that does not measure larger than 2 cm and there are small groups of cancer cells in the lymph nodes.

If people have cancer that has spread to a nearby lymph node, they may notice a swelling of the lymph nodes in the armpit.

Treatment

People will have surgery to remove the area of breast cancer, often through a mastectomy, while others may be able to have breast-conserving surgery with radiation therapy.

Individuals may need a biopsy to check for cancer in the lymph nodes. If the cancer is present in the lymph node, they may need a procedure to remove the lymph node.

Additionally, depending on the tumor size and how likely it is to spread, people may need hormone therapy, chemotherapy, or targeted therapy.

Stage 2 cancer is larger than the previous stages, and it may have spread to nearby lymph nodes.

Healthcare professionals will divide stage 2 into two sections:

  • Stage 2A: Stage 2A could mean one of the following:
    • There is no tumor in the breast, but cancer cells are present in the axillary lymph nodes under the armpit.
    • The tumor is 2–5 cm in size and has not spread to the axillary lymph nodes.
    • The tumor measures smaller than 2 cm but has not spread to the lymph nodes.
  • Stage 2B: The tumor measures 2–5 cm and has also spread to the axillary lymph nodes. It could also mean that the tumor measures larger than 5 cm but has not spread to the lymph nodes.

If cancer has spread to nearby lymph nodes, people may notice a lump or swelling under the arm or on the same side as the breast cancer.

Treatment

People may undergo drug therapy for stage 2 breast cancer, either before or after surgery, to remove the area of cancer. Doctors may use drugs before surgery to reduce the size of the tumor and minimize surgery.

Individuals may also require a procedure called axillary lymph node dissection (ALND), which removes any lymph nodes containing cancer.

For a tumor that is large or has spread, people may have radiation therapy after surgery to reduce the risk of the cancer returning.

Drug therapy depends on the type of tumor but may include chemotherapy, human epidermal growth factor receptor 2 (HER2) targeted drugs, or hormone therapy.

In stage 3 breast cancer, the tumors are larger or have spread into the surrounding skin or muscle. The cancer may have also spread to nearby lymph nodes.

Doctors will divide stage 3 into the following sections:

  • Stage 3A: Stage 3A could mean one of the following:
    • There is no tumor, but the cancer is in the axillary lymph nodes. It may have spread to the nearby lymph nodes near the breastbone.
    • The tumor measures 5 cm or smaller and has spread to the axillary lymph nodes.
    • The tumor measures larger than 5 cm and has spread to the axillary lymph nodes.
  • Stage 3B: The tumor can be any size and has spread to the breast or chest wall. The cancer may have also spread to the axillary lymph nodes.
  • Stage 3C: There may be no sign of breast cancer, and a tumor, if present, can measure any size. It may have also spread to the breast and chest wall. The cancer could have also reached the axillary lymph nodes and lymph nodes near the collarbone and breastbone.

If the cancer has spread to the lymph nodes, people may notice:

  • swelling or a lump under the armpit
  • swelling in the arm or hand
  • swelling or a lump in the breast bone or collar bone area

Treatment

People may undergo chemotherapy to target the tumor before they have surgery to remove it. If a person has a HER2-positive tumor, a doctor may recommend the drugs trastuzumab and pertuzumab before a mastectomy. Individuals may also require an ALND.

People could also have radiation therapy following surgery. If a person has a hormone receptor-positive tumor, they may need to take tamoxifen, a type of hormone therapy drug, for at least 5 years. People may also need to take trastuzumab for HER2-positive breast cancer for 1 year.

Stage 4, or metastatic, breast cancer is when the cancer has spread to other parts of the body, beyond the breast and nearby lymph nodes.

The breast cancer may have spread to the bones, liver, lungs, or any other organs and tissues. As it spreads, it may reach the brain.

According to Cancer Research UK, people with advanced breast cancer may notice the following symptoms:

  • fatigue and low energy
  • feeling under the weather or not their usual self
  • reduced appetite
  • unintentional weight loss

If cancer has spread to the bones or organs, an individual may have additional symptoms, such as:

  • aching or pain in the affected bone
  • bones fracturing more easily
  • shortness of breath
  • bleeding or bruising more easily
  • nausea
  • yellowing skin or eyes
  • persistent cough or chest pain
  • headaches

Treatment

People may have one or more of the following drug therapies for stage 4 breast cancer:

  • hormone therapy
  • chemotherapy
  • targeted therapy
  • immunotherapy

Individuals may also have radiation therapy or surgery to:

  • treat a breast tumor that causes an open wound in the breast or chest area
  • treat a small amount of metastatic cancer in the brain
  • prevent bone fractures
  • treat any pressure on the spinal cord from an area of cancer
  • treat a blood vessel blockage in the liver
  • relieve painful symptoms

People may also have chemotherapy directly into a certain area, such as into the liver or the fluid surrounding the brain.

Recurrent breast cancer is breast cancer that has returned after successful treatment. This can occur years afterward.

Recurrent breast cancer may be:

  • localized, occurring in the same place as the previous cancer, and contained to the breast or surgical scar
  • regional, where cancer occurs in nearby lymph nodes
  • distant, where cancer occurs in other areas of the body than the breast or lymph nodes

If breast cancer occurs in a different breast to where it was originally, it is a new case of breast cancer rather than a recurrence.

Symptoms may vary depending on where the cancer is present in the body, but they may be the same as those of previous stages.

Treatment

Treatment for recurrent breast cancer may depend on what therapies people have had previously. For localized cancer, a person may have further surgery and radiation therapy.

However, radiation therapy may not be suitable if someone has had it previously, as it may damage the surrounding tissue.

After any surgery or radiation therapy, people may have one or more drug therapies, including:

  • hormone therapy
  • trastuzumab
  • immunotherapy
  • Trodelvy

If cancer is in the lymph nodes, doctors will remove the lymph nodes and may apply radiation therapy and drug therapy.

For recurrent distant breast cancer, treatment is the same as stage 4 treatment, although strategies may differ depending on any previous therapies.

Outlook and survival rates may depend on the stage and location of the cancer in the body. The Surveillance, Epidemiology, and End Results database provides survival rates depending on whether the cancer is localized, regional, or distant:

  • Localized: There is no sign the cancer has spread outside the breast.
  • Regional: The cancer has spread to nearby lymph nodes and structures.
  • Distant: The cancer has spread to other parts of the body, such as the brain.

The 5-year relative survival rates for cancer location are as follows:

  • Local: 97%
  • Regional: 83%
  • Distant: 22%

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the disease.

For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without it.

However, it is important to remember that these figures are estimates. A person can consult with a healthcare professional about how their condition might affect them.

According to 2020 research, the probability of survival is lower in males compared to females. The researchers note that the overall median survival for females was 13.2 years compared to 11.4 years for males.

A study from 2016 suggests that this may be due to its rarity among males alongside a lack of awareness. As a result, diagnosis typically occurs at later stages.

Healthcare professionals use a staging system to identify breast cancer and find appropriate treatments. This method of staging can also indicate the potential outlook.

There are different types of staging systems that healthcare professionals use to stage cancer.

Learn more about the different staging systems for cancer.

It is important to remember that survival rates can vary depending on age, overall health, and specific properties in the cancer cells.

If people notice any unusual changes in the breast or underarm area, they can speak with their doctor for a checkup.