What is Male Breast Cancer?
All men, like women, have breast tissue and are susceptible
to develop breast cancer. Breast cancer can occur in men. Breast cancer is the
abnormal growth and uncontrolled division of cells in the breast. Cancer cells
can invade and destroy nearby healthy tissue and can spread throughout the
body, including the surrounding lymph nodes. Usually, a surgical biopsy is performed to see if the tumor has spread
elsewhere.
According to the American Cancer Society:
- Some 1,990 new cases of invasive breast cancer will be diagnosed among men in
the United States.
- The prognosis (outlook) for men with breast cancer was once thought to be
worse than that for women, but recent studies have not found this to be
true. Based on looking at each stage, the survival rates are about equal.
In other words, men and women with the same stage of breast cancer have a
similar outlook for survival.
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Risk Factors
A risk factor is anything that may increase your chance of
developing a disease. Different diseases, including cancer, have different risk
factors. Although these factors may put you at greater risk, they do not
necessarily cause the disease. Some people with one or more risk factors never
develop cancer, while others develop the disease without having any risk
factors.
Although the medical community has not determined why breast
cancer occurs, certain factors are known to increase your risk of developing
the disease. Many of these are similar to female breast cancer in that they are
often related to sex hormone levels in the body. Some of these risk factors
include:
- Aging: The average age of men diagnosed
with breast cancer is 67.
- Family history of breast cancer: 1
in 5 men diagnosed with breast cancer have a close male or female relative
with the disease.
- Inherited Gene Mutations: A
mutation (change) in the gene BRCA2, which is responsible for some breast
cancers in women, probably accounts for about 10% of breast cancers in men.
- Radiation Exposure
- Alcohol consumption
- Liver Disease
- Obesity: If you are severely
overweight, you're at increased risk
- Conditions effecting the testicles
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Common Symptoms
It is important for men to be aware that breast cancer can be found in both women and men. Men
should be aware of any unusual symptoms or changes in the breast. These symptoms may indicate that you have a
problem but do not always mean that you have cancer. You should see your doctor
as soon as possible if you experience any of these warning signs:
- A lump or swelling, which is usually (but not always) painless
- Skin dimpling or puckering
- Nipple retraction (turning inward)
- Redness or scaling of the nipple or breast skin
- Discharge from the nipple
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Screening and Diagnosis
There are currently no recommendations for breast cancer
screening in men. As with breast cancer
in women, when breast cancer is found and treated early, the chances for
survival increase significantly. You can take an active part in the early
detection of breast cancer by being aware of your family history, doing regular
self breast exams and discussing your risk with your doctor. If symptoms are found, the following tests
may be used to check for cancer:
- Medical History and Physician Exam
- Your doctor will want to take down your family medical history to assess
the likelihood of your symptoms reflecting that cancer may be
present. They will also give you a
physical examination to locate any lumps in the breast as well as examine
the rest of your body to look for evidence that the cancer may have
spread. This would include
examination of your lymph nodes to see if they are enlarged.
- Diagnostic Mammogram - A mammogram
is a procedure that uses x-rays to detect changes in breast tissues.
- Breast Ultrasound - also known as
a sonogram, uses high-frequency sound waves to
outline a part of the body. Breast
ultrasound is sometimes used to evaluate breast abnormalities that are
found during mammography or a physical exam. Ultrasound is useful for some
breast masses.
- Nipple Discharge Exam - If you
have nipple discharge, a sample of the fluid will be collected and
examined under a microscope to see if cancer cells are present. A biopsy
may still be necessary even if there are no
cancer cells found.
If a mammogram or breast exam detects a lump or abnormality,
your doctor may want to conduct a biopsy. In this procedure, doctors remove a
sample of tissue from the suspicious area and send it to a laboratory for
testing to determine the presence of cancer.
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Stages of Breast Cancer
Once a breast cancer diagnosis is made, doctors conduct
additional tests to stage the cancer, or determine if the cancer has spread and
how far. Staging helps your doctor develop an appropriate treatment plan.
Stage 0 (Tis)
Early cancer is confined to the breast (noninvasive or
in situ breast cancer), such as:
- Ductal carcinoma in situ (DCIS). Cancer cells are located
within a duct but are not found in surrounding fatty breast tissue.
- A form of DCIS that only involves the nipple (Paget's disease of the breast).
- Lobular carcinoma in situ (LCIS). Abnormal cells grow within
the lobules (milk-producing glands) but do not penetrate through the
lobule walls. Most breast specialists do not consider LCIS a true breast
cancer. LCIS is also called lobular neoplasia.
Stage I
Tumor measures 2 cm or smaller in diameter and has not spread to lymph
nodes in the armpit.
Stage II
Stage II is divided into substages known as IIA and IIB.
- Stage IIA: One of the following characteristics is true
of this stage of breast cancer:
- The tumor is smaller than 2 cm in diameter and has spread to
1 to 3 lymph nodes under the arm on the same side as the breast cancer.
Lymph nodes are not stuck to one another or to the surrounding tissues.
- The tumor is larger than 2 cm but smaller than 5 cm in diameter and has not spread
to the lymph nodes under the arm.
- Stage IIB: Either of the following characteristics is
true of this stage of breast cancer:
- The tumor is larger than 2 cm but smaller than 5 cm in diameter and has spread to
1 to 3 lymph nodes under the arm on the same side as the breast cancer.
Lymph nodes are not stuck to one another or to the surrounding tissues.
- The tumor is larger than 5 cm in diameter but has not
spread to the lymph nodes under the arm.
Stage III
Stage III is divided into substages known as IIIA, IIIB, and IIIC.
- Stage IIIA: Either the tumor or tumors measure larger
than 5 cm in diameter with any spread to lymph nodes or the lymph nodes are stuck to
one another or surrounding tissue.
- The tumor is smaller than 5 cm in diameter and has spread to
4 to 9 lymph nodes under the
arm on the same side as the breast cancer or has spread to the lymph
nodes under the breast bone (internal mammary nodes) but not under the
arm.
- The tumor is smaller than 5 cm in diameter and has spread to
4 to 9 lymph nodes under the
arm, which are matted or stuck to one another or surrounding tissue.
- The tumor is larger than 5 cm in diameter and has spread to
fewer than 10 lymph nodes under the arm or has spread to the lymph nodes
under the breast bone but not under the arm.
- The tumor is larger than 5 cm in diameter and has spread to
fewer than 10 lymph nodes under the arm, which are matted or stuck to one
another or surrounding tissue.
- Stage IIIB: Breast cancers of any size have spread to
the skin or chest wall.
- Stage IIIC: Breast cancers of any size have one of the
following characteristics.
- Breast cancer cells have spread to 10 or more lymph
nodes under the arm.
- Breast cancer cells are found in the lymph nodes under
the arm and beneath the breast bone (internal mammary nodes).
- Breast cancer cells are found in the lymph nodes above
the collarbone (supraclavicular) or below the
collarbone (infraclavicular).
Stage IV
Cancer of any size has spread (metastasized) to
distant sites, such as the bones or lungs, or to lymph nodes not near the breast.
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Common Treatment Options
Learning you have breast cancer can be devastating news, but
life-saving medical advances have armed patients with more treatment options
than ever before. Breast cancer, in particular, is very treatable, with high
survival rates.
Treatment for breast cancer is based on the type, stage, and
size of the tumor, as well as your personal preferences, general health, and
ability to tolerate certain medical procedures or medications. The goal of
treatment is to preserve healthy tissue while destroying the tumor at its point
of origin, as well as any cancer cells that have spread throughout the body.
Treatment options include:
Most patients with breast cancer undergo surgery to remove the cancerous tissue in the breast. Some axillary lymph nodes (lymph nodes in the armpit) are
removed as well to see if the breast cancer has spread. Types of surgery
include:
Wide Excision Lumpectomy - A wide
excision or lumpectomy is surgery to remove the breast tumor and a small amount
of surrounding normal tissue.
Mastectomy - A mastectomy is the
surgical removal of the entire breast. There are three different types of
mastectomies:
Simple or total mastectomy -
surgeons do not cut away any lymph nodes or muscle tissue
Modified radical mastectomy -
surgeons remove the breast and some armpit lymph nodes
Radical mastectomy - surgeons
remove the breast, axillary lymph nodes and chest
wall muscles under the breast
Even if a patient undergoes surgery
to remove the cancer, radiation therapy, chemotherapy, or hormone therapy may
be recommended to kill any cancer cells that may be left.
Radiation therapy is a non-surgical
method of treatment of cancer and other diseases using penetrating beams of high-energy
waves called x-rays or gamma rays. Radiation injures or destroys tumor cells by
damaging their genetic material, making it impossible for these cells to
continue to grow. There are two types of radiation therapy:
External beam radiation therapy -
Specialized medical equipment is used to deliver radiation to the tumor site
from outside the body.
Internal radiation therapy:
Radioactive material is placed in the body near the cancer cells (also called
implant radiation or >brachytherapy)
The way the radiation therapy is
given depends on the type and stage of the cancer being treated.
Chemotherapy is a type of treatment
that uses drugs to stop the growth of cancer cells, either by killing the cells
or by stopping the cells from dividing. Chemotherapy drugs can be taken orally
or by injection depending on the type and stage of the cancer and the type of
drug protocol your doctor has prescribed. It is important to discuss your
treatment protocol with your treatment team so you are aware of any possible
side effects.
Hormone therapy is a cancer
treatment that removes hormones or blocks their action and stops cancer cells
from growing. Hormones are substances produced by glands in the body and
circulated in the bloodstream. The presence of some hormones can cause certain
cancers to grow. If tests show that the cancer cells have places where hormones
can attach (receptors), drugs, surgery, or radiation therapy are used to reduce
the production of hormones or block them from working.
