Signs and Symptoms of male breast cancer

Breast cancer is not a disease that exclusively affects women; men can develop breast cancer as well.  Although men have less breast tissue than women, they also have breast tissue that can undergo cancerous changes. Statistically, women are 100 times more likely to develop breast cancer than men. Male breast cancer is most common in men ages 60-70. Although male breast cancer and breast cancer in women are similar, there are some distinct differences between the two. Such as breast size, and awareness affect early diagnosis, and survival chances for men with breast cancer.

Signs and Symptoms

As with female breast cancer, it is important that male breast cancer is detected at an early stage, which can help save lives. The earlier the disease is discovered, the higher the survival chance. Most breast lumps are not cancerous, but a lump is often the most common indicator for breast cancer in men. The lump is more than often painless. Other signs of breast cancer in men are:

  • Skin dimpling or puckering
  • Development of a new retraction or indentation of the nipple
  • Redness of scaling of the nipple or breast skin
  • Nipple discharge of clear or bloody fluid

There is no certain way of saying why one man develops breast cancer, while another doesn’t. Doctors do say that between 5 and 10% of breast cancer in men is inherited.

There are certain risk factors that increase the chance of developing breast cancer:

  • Age – average diagnosis age is 67
  • Family History – if a close relative, such as a mother or sister, with breast cancer, the risk increases
  • Radiation exposure
  • Klinefelter syndrome
  • Exposure to estrogen
  • Liver disease
  • Excess weight
  • Excess use of alcohol

Screening and staging

Screening The majority of lumps are a result of gynecomastia, which are harmless. But it is always important to have lumps checked out by your doctor, because if there is a problem it has to be dealt with in a timely fashion. Male cancer is rare, and therefore routine screening is not recommended for most men. It is however recommended if there is a strong family history of the disease, so if multiple members of the direct family have, or have had, breast cancer. When a doctor suspects breast cancer in a man, he or she conducts a series of tests in order to diagnose the patient. These tests include:

  • Clinical Breast exams – The doctor will exam the patient’s breast for lumps and changes; he/she will also examine the rest of the patients body for signs that the cancer has spread, such as enlarged liver or lymph nodes.
  • Mammogram – Mammograms for men are administered the same way as with women, the test results are actually more accurate than with women, because a man’s breast is less dense. The mammogram is administered by compressing the breasts between two plastic plates while x-rays are taken.
  • Ultrasound – Male ultrasounds are the same as the ones performed on women. Ultrasound is an imaging technique used to visualise structures within the body.
  • Nipple Discharge Examination – If the patient has nipple discharge, the doctor may examine it for cancerous cells.
  • Biopsy – Biopsy is the only way for a doctor to know whether a lump is actually cancerous, they can provide information about the lump, but also help determine the required treatment (if needed). There are three types of Biopsy:
    • Fine-needle aspiration – The doctor uses a thin, hollow needle to withdraw cells from the lump. These cells are then analysed by a lab.
    • Core needle – The doctor again uses a hollow needle, but instead of withdrawing just cells, he/she withdraws tissue. This tissue is then also analysed by a lab for cancer.
    • Surgical – Surgical is the complete or partial removal of the lump.
  • Oestrogen and progesterone receptor tests – If the initial biopsy points towards cancer, doctors will recommend a few additional tests. The estrogen and progesterone receptor test determines whether the cancer cells are affected by female hormones. Based on the results doctors can recommend the appropriate treatment method.
  • HER2 – If a biopsy is undergone, and malignant cells are found, doctors may test the tissue samples for the presence of human epidermal growth factor 2 (HER2), which is a protein. Approximately 30% of male breast cancer cases have too much of this protein, these types of cancer are usually more aggressive, and can grow/spread quicker than most other breast cancers.

Staging

Like women, male breast cancer is staged from Stage 0 through Stage IV.

Stage 0 refers to noninvasive cancer (in situ), these types of cancer don’t have the ability to spread to other parts of the body, or invade the surrounding tissue. Nonetheless, these tumors are removed, avoiding the risk of the tumor becoming invasive. Treatment at this stage offers the best chance of recovery.

Stages I through IV are invasive cancer that have the ability to spread to other parts of the body. The different stages are used to categorise the size, and to which extent the cancer has spread. Doctors can determine at which stage the patient is at through a number of tests as X-ray, CAT scan, MRI scan or PET scan.


Treatment

Male breast cancer is treated in the same fashion as breast cancer in women. It is important to learn as much as possible about the treatment methods before deciding how you want to be treated. Your doctor, and health care team will be able to assist you in your decision, but it is always smart to consider a second opinion. We also recommend that you don’t only limit your sources to the internet, try to find good books, or publications from cancer organisations like the American Cancer Society or the Susan G. Komen Breast Cancer Foundation.

Each breast cancer stage has its own type of treatment. In some cases men may only need surgery, but other times an additional therapy is needed, such as radiation, chemotherapy, or hormone therapy.

When women undergo breast cancer surgery, they often have the option of choosing breast-sparing, this is not the case for men. Because a man’s breast contains much less tissue than a woman’s breast, removing the cancer means removing most of the tissue. Surgery options for men are:

  • Simple mastectomy: the entire breast tissue is removed. Depending on follow-up tests, additional therapy may be required.
  • Modified radical mastectomy: this is the most common form of surgery used. This procedure involves the removal of the entire breast, and some of the underarm lymph nodes, leaving the chest muscles intact. After surgery, the lymph nodes are tested for cancer, depending on the results, additional therapy may be required.
  • Sentinel lymph node biopsy: This procedure is used to limit the number of lymph nodes removed. As you may know, breast cancer first spreads to the axillary (underarm) lymph nodes, doctors therefore will determine to which lymph nodes the tumor drains to first. The doctors then follow the trail of the drainage, until they find a healthy lymph node. After surgery is completed, additional therapy is needed in order to ensure that all cancer cells have been successfully removed.
  • Chemotherapy: Chemotherapy is a drug based therapy used to destroy remaining cancer cells. Doctors recommend chemotherapy to kill any remaining cancer cells that could have spread outside the breast area. The treatment often involves two or more drugs, which are can be administered through an IV, pill form, or both. The treatment period is usually every 2-3 weeks for a period of 3-6 months.
  • Hormone therapy: Certain cancers are estrogen receptor positive, which encourages aggressive growth throughout the body. Approximately 75% of all diagnosed breast cancer in men is HER2 positive. This form of treatment uses hormonal medication that binds itself to sites of the body, preventing estrogen from reaching them. This may help eliminate cancer cells that have already spread, or reduce the chance recurrence (cancer returning).
  • Biological Therapy: This treatment form is meant to stimulate the patient’s body to fight the cancer. It tries to enhance the body’s natural immune system, which triggers the body’s defense system against specific diseases. The majority of Biological Therapies are still in the experimental stage, making them only available through clinical trials.

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