When we hear about breast cancer, we immediately associate it with women. The majority of people diagnosed with breast cancer are female. Many of the known treatments for breast cancer have women as its target demographic. However, what many people may not know is that men may also be diagnosed with breast cancer as well. Both men and women have breast tissue; for women, their breast tissue develop during puberty, while breast tissue in men do not develop at all. For this reason, women are more susceptible to breast cancer, however, there are several factors that lead to the development of breast cancer in men.
Men developing breast cancer is considered incredibly rare, accounting for less than 1% of all breast cancer diagnosis. Due to its rarity, medical research about the condition is not as vast compared to breast cancer in women. Although it is rare, it is still important to note that men developing breast cancer, is a reality.A lot of the findings show that breast cancer in men is as severe as those in women. Most of the symptoms and treatments for both are also similar.
Risk factors for breast cancer in men
There are quite a few risk factors that increase a man’s chances of developing breast cancer. However, it is important to note that having several of these risk factors does not mean that a person would get breast cancer, but may be seen as a precautionary guide to be more vigilant. While it is still unclear what causes breast cancer in men, research enumerates factors that may increase the risk of having breast cancer. Just like in women, many of these factors involve sex hormone levels. Here are some of the risk factors for men:
Just like in women, the possibility of having breast cancer increases as a person grows older. However, men are usually diagnosed later, commonly around 60-70 years old.
1 out of 5 men that have breast cancer has a male or female in the family that has been previously diagnosed as well.
Men with a mutation defect in the BRCA 2 gene are in the possible risk of cancer. BRCA 2 is a tumor suppressor gene; it usually helps cells to repair DNA problems. A change in the BRCA 2 gene could increase the risk of developing breast cancer in men. Commonly, men with a history of breast cancer in the family face this problem. Though, there are cases of men having such mutation defect even without a history of cancer running in the family.
Klinefelter syndrome is a congenital condition, where a man has two or more X chromosomes instead of one. Men with this condition are 20-60 times more at risk of developing breast cancer than men without it.
A man who has had radiation treatment, or radiation exposure, particularly in the chest area might be at a higher risk of developing breast cancer.
Alcohol and Liver Disease
Excessive drinking could increase the risk of breast cancer and could also lead to liver diseases. Infection of the liver could lead to an imbalance in hormone levels, which could eventually lead to breast cancer.
Estrogen-related drugs, a standard treatment for prostate cancer, could slightly increase the risk of developing breast cancer. People who are undergoing sex reassignment could also be at risk.
Obesity could also increase the risk of developing breast cancer in both women and men. For men, fat cells convert androgens into estrogen, which could lead to cancer.
Infections and operations in regards to the testicles could increase the possibility of breast cancer. Testicular conditions affect the Estrogen levels in men, which increases the risk of breast cancer.
Signs and symptoms of breast cancer in men
Most symptoms of breast cancer in men are similar to that in women. However, because the condition is very rare amongst men, men tend to delay consulting doctors even after noticing one symptom that suggests a development of breast cancer. It is not until they experience another one of the symptoms that they start to seek a doctor’s help. At this point, cancer may have already spread. So, it is still essential to take note of these following symptoms:
- A lump or swelling, which is often painless
- Skin dimpling or puckering
- Nipple retraction
- Redness or scale-like nipples or breast skin
- Discharge from the nipple
Once you notice any change in the breast area, like a lump, consult a medical professional as soon as possible.
Types of breast cancer in men
Breast cancer is classified into types, based on the type of cell it starts to form, and grades, depending on how the cells look and the pace of growth. A series of lab tests are done after a biopsy or surgery to distinguish cancer’s type and grade.
Breast cancer could either be carcinoma or sarcoma. Most breast cancers are carcinoma, specifically a type called adenocarcinoma. This type of cancer starts in cells in glandular tissues like ducts (the milk ducts) or lobules (milk-producing glands). On the other hand, sarcoma is a less common type of cancer than carcinoma. This type of breast cancer starts in the cells of the muscle, fat, or connective tissue.
After finding out the type of cancer, the doctor will then classify cancer depending on the extent to which the cancer cells have spread. If the cancer cells remain in the duct or lobule and have not yet spread to the surrounding tissues, it is classified as in situ; if the cancer cells have spread to the surrounding tissues or other parts of the body, it is classified as invasive or infiltrating.
Here are the general types of breast cancer in men:
Ductal carcinoma in situ (DCIS)
Also known as intraductal carcinoma, in DCIS, cells that line the ducts have turned into cancer cells, but have not spread to the surrounding tissue. It is considered as pre-cancer as DCIS can become invasive later on. 1 in 10 cases of breast cancer in men is DCIS, and can be addressed through surgery.
Lobular carcinoma in situ (LCIS)
LCIS is also called lobular neoplasia. Here, cancer cells grow within the lobules but have not spread to the surrounding tissue. It is not considered pre-cancer as it does not develop into invasive cancer if left untreated. However, it could cause a higher risk of developing invasive breast cancer. LCIS is a rare type of breast cancer in men.
Infiltrating (or invasive) ductal carcinoma (IDC)
IDC is considered as the most common type of breast cancer. Here, cancer cells start to form in the ducts and spread into the fatty tissues of the breast. Once cancer breaks through the wall of the duct, it can spread to different parts of the body. 8 out of 10 cases of breast cancer in men is found to be IDC.
Infiltrating (or invasive) lobular carcinoma (ILC)
ILC starts in the lobules and spread to the surrounding breast tissue. It can also spread to different parts of the body, just like IDC. ILC is rare because men don’t have much lobular breast tissue; only 2% of breast cancer in men are found to be ILC.
Paget disease of the nipple
Here, cancer starts in the ducts and spreads to the nipple(s), or until the areola. The skin of the nipple will be crusted, scaly, and red, with areas that are itching, burning, or bleeding. It can be associated with DCIS or IDC. It is rare, accounting to 5% of breast cancer cases in men.
Inflammatory breast cancer
It is an aggressive but rare type of breast cancer, especially for men. Rather than forming a lump, it makes the breasts look swollen, red, warm, and tender. It could be mistaken for an infection of the breast.
After identifying the type, the cancer is then diagnosed depending on the grade, or how the cancer cells look and react. For invasive cancer types, one that has spread to the surrounding breast tissue, it is graded on a scale of 1-3:
Grade 1 or well-differentiated
Cancer cells are slow-growing and look like normal breast tissues.
Grade 2 or moderately differentiated
Cancer cells are growing at speed and look less like normal breast tissues.
Grade 3 or poorly differentiated
Cancer cells are growing at a fast pace and look very different from normal breast tissue.
The grade helps in determining the best treatment or course of action for the patient.
Treatment & prevention for breast cancer in men
There is no clear answer to whether or not a person could prevent breast cancer. Breast cancer in men is rare, so there are not many findings yet on what specifically causes the disease. However, one could reduce some of the risks mentioned earlier by maintaining the ideal body weight and decreasing the consumption of alcohol.
Men diagnosed with breast cancer usually undergo therapy to cure the condition. Different types of surgeries are done for various reasons, depending on the situation. It could be done for the following reasons:
- Remove as much cancer possible
- Detecting if the cancer has spread to the surrounding areas
- Preventing advanced symptoms of cancer
If a person decides to undergo surgery to remove cancer, there are two common ways of doing so: Mastectomy and Breast Conservation Surgery.
It removes the entire breast, all breast tissue, and, sometimes, surrounding tissue. It is a typical operation for men with breast cancer because men have less breast tissue.
Breast Conservation Surgery (BCS)
It only removes the area affected by the cancer cells.
In some cases, men with breast cancer undergo radiation therapy, in addition to other treatments. Here, cancer cells are destroyed through high-energy rays. The patient can have one type of radiation therapy or a combination of different types. The need for such treatment depends on the surgery the patient already had or if the cancer has spread to other parts of the body. The most common type of radiation therapy for men with breast cancer is called external beam radiation, where a medical machine focuses the radiation on the area affected by cancer.
Other treatments include using medical drugs that are given by mouth or directly through the bloodstream. It is called Systemic treatments because they can reach the cancer cells from any part of the body. Here are some of the types of systemic treatments:
With chemotherapy, cancer-killing drugs are taken by mouth or injected into the veins. The drug then travels through the bloodstream to different parts of the body that is affected by cancer.
This type of therapy uses hormones, drugs, or treatments that affect other hormones. It is usually done after surgery (to help lower the risk of cancer coming back) or before the surgery. It could also be done to cases where the cancer has spread or come back. Hormone therapy is a more likely treatment for men with breast cancer.
There are changes in cancer cells that make them spread. Targeted drugs are used to stop specific cancer cell changes from happening and spreading. Some targeted drugs aid in having other types of treatment to work better.
After treatment for breast cancer in men
When a person decides to undergo treatment or surgery to address breast cancer, it is essential to have follow-up check-ups with the doctor. The visits may include some more lab tests, but it is crucial to monitor the patient’s health.
There is a possibility of cancer coming back. So, aside from visiting the doctor, it is essential to maintain a healthy lifestyle. A person could prevent cancer from progressing or coming back by:
- Maintaining an ideal weight
- Being physically active
- Having a stable and healthy diet
- Drinking recommended supplements
- Avoiding alcohol and cigarettes
It may be uncommon, but it is still important to know about breast cancer in men. Remember that by maintaining a healthy lifestyle, developing this rare condition could be prevented.