When we think of breast cancer we always typically think of women, but it is true that approximately 2,000 men per year are diagnosed with this disease in the United States alone. Yes, breast cancer may develop in men at any age but it has typically been seen in men between 60 and 70 years of age. While male breast cancer is still a rare type of cancer as it makes up less than 1% of all cases of breast cancer worldwide, it is worthwhile to understand what it is all about.
· Infiltrating ductal carcinoma: Cancer that has spread beyond the cells lining ducts in the breast. Most men with breast cancer have this type of cancer.
· Inflammatory breast cancer: A type of cancer in which the breast looks red and swollen and feels warm.
· Ductal carcinoma in situ: Abnormal cells that are found in the lining of a duct; also called intraductal carcinoma.
· Paget disease of the nipple: A tumor that has grown from ducts beneath the nipple onto the surface of the nipple.
One of the common types of breast cancer found in women is Lobular carcinoma in situ (abnormal cells found in one of the lobes or sections of the breast); this has not been seen in men.
Difference between Male and Female breast cancers
Male breast cancer seems to behave similarly to female breast cancer, and the disease in men is treated more or less similar to female disease. One difference between the two is in the timing of when men present with the disease, as versus when women seek care for the issue. Women typically undergo mammographic screening, bringing tumors that are not palpable to the attention of a doctor. Men do not undergo such screening because they usually have far less breast tissue and most tumors in the breast can be felt. Unfortunately however, while women are well aware that a breast lump is a concerning sign that should be brought to the attention of a doctor, many men still feel either embarrassed about seeking care for a breast lump, or are incredulous at the idea that they could have breast cancer or a serious illness that has become symptomatic. The consequence is that men tend to present to their doctors at a later stage, initially ignoring the finding more frequently than women do. When you compare the genders however, men do as well as women, stage for stage.
Risk factor for male breast cancer:
· Being exposed to radiation.
· Having a disease related to high levels of estrogen in the body, such as cirrhosis (liver disease) or Klinefelter syndrome (a genetic disorder.)
· Having several female relatives who have had breast cancer, especially relatives who have an alteration of the BRCA2 gene.
· Male breast cancer may sometimes be caused by inherited gene mutations (changes).
The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some altered genes related to breast cancer are more common in certain ethnic groups. Men who have an altered gene related to breast cancer have an increased risk of developing this disease.
Men with breast cancer usually have lumps that can be felt.
Lumps and other symptoms may be caused by male breast cancer. Other conditions may cause the same symptoms. Check with your doctor if you notice a change in your breasts.
The typical treatment for men having breast cancer is a mastectomy, because there is little breast tissue to save, and resecting the tumor completely with “negative margins” (a margin of normal tissue surrounding the tumor, showing that it has been completely removed) may be more difficult.
In women, the cosmetic and sexuality issues surrounding the breast prompted investigation of lumpectomy with radiation as an alternative to mastectomy, and has been found to be equally safe. In men this has not been investigated sufficiently in trials to date to conclude this is safe. Men therefore have mastectomies as standard surgical treatment, along with assessment of lymph nodes.
When a man develops a breast lump, it is consequently important that he seek evaluation by a physician. While most lumps tend to be benign, a breast surgeon is best qualified to determine if this is something that may be normal or should be further assessed to rule out breast cancer.
Never ignore such a finding, and certainly don’t be embarrassed to seek advice from your doctor. Better to “overreact” and get attention of your doctor for something that’s benign, than ignore the problem and find out too late that it could have more easily been addressed earlier.