Breast cancer is most commonly thought of as a disease that affects women, however, men are born with a small amount of breast tissue and therefore can also develop breast cancer. Male breast cancer is rare, as only 1% of men in the United States are diagnosed with the disease. The most common sign of breast cancer is a painless lump or thickening of the breast or chest area. Other warning signs and symptoms include:
- Dimpling, puckering, scaling, or redness of the skin of the breast
- Hard knot, lump, or thickening in the breast, chest, or underarm area (may be tender)
- Inversion of the nipple or pulling of other parts of the breast
- Itchy, scaly sore or rash on the nipple
- Discharge from the nipple
A breast lump found in men may be a symptom of gynecomastia, a benign and common breast condition in men. It is not caused by a tumor, but instead is an increase in the amount of a man’s breast tissue. It is often common among teenage boys and older men, due to changes in hormone balance. Gynecomastia can manifest as a button-like or disk-like growth under the nipple. As breast cancer and gynecomastia can both be felt as a growth, it is important to have a doctor examine any lumps.
The most common form of breast cancer in men is Infiltrating Ductal Carcinoma (IDC), which involves the cells in or around the ducts invading surrounding tissue. Treatment for male and female cancer patients is similar. Male breast cancer, like female breast cancer, can be classified by cancer cell receptors: HER2, estrogen, and progesterone. About 90% of male breast cancers are hormone-receptor positive, while another 9% are hormone-receptor positive and HER2-positive. These receptors are targeted with cancer drugs to slow or stop the disease’s growth. The standard care for men is to undergo a mastectomy surgery, rather than a lumpectomy. Hormone therapy is commonly part of the treatment regime and chemotherapy may be recommended if the surrounding lymph nodes test positive for cancer or if the tumor exhibits high-risk features. Radiation treatment is also commonly recommended if the lymph nodes are positive.
Men with breast cancer have a higher mortality rate than women. This higher rate of mortality is primarily due to the fact that men are often diagnosed at an older age and more advanced stage of breast cancer than women, as they are less likely to assume a lump to be breast cancer. Studies show that patients of the same age and stage have similar survival rates.
Men who inherit the BRCA1 or BRCA2 gene are at higher risk of developing breast and prostate cancers. Approximately 8-15% of male breast cancer patients have a BRCA mutation, compared to 5-10% in female populations. BRCA2 mutations are particularly linked to breast cancer, and men carrying this mutation have a near 10% lifetime risk of developing the disease. The risk of breast cancer is doubled for men who have a parent, sibling, or child with the disease. If you have a strong family history of cancer, consult your doctor, who may recommend genetic counseling. Other risk factors include:
- The risk of breast cancer increases as you age. Male breast cancer is most frequently diagnosed in men in their 60s.
- Exposure to estrogen. Taking estrogen-related drugs, such as those used for hormone therapy for prostate cancer, increase your risk of breast cancer.
- Klinefelter’s syndrome. This genetic syndrome occurs when boys are born with more than one copy of the X chromosome. Klinefelter’s syndrome causes abnormal development of the testicles, which causes lower levels of certain male hormones (androgens) and higher levels of female hormones (estrogens).
- Liver disease. Certain conditions, including cirrhosis of the liver, can reduce male hormones and increase female hormones.
- Enlarged breasts caused by a hormone imbalance or certain medications increases risk.
- Obesity is associated with higher levels of estrogen in the body.
- Testicle disease or surgery. Having inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can increase your risk of male breast cancer.
- African-American men have a higher risk of male breast cancer than non-Hispanic white men.
- Heavy alcohol use. High levels of alcohol intake can limit the liver’s ability to regulate blood-estrogen levels.
- Radiation exposure. Receiving radiation treatment in the chest area, such as for lymphoma, increases the risk for developing breast cancer.
If you exhibit any of the mentioned symptoms or have a strong family history of breast cancer, be sure to contact your doctor about your concerns. If you are diagnosed with male breast cancer and feel isolated, reach out to other breast cancer survivors. Male breast cancer may be rare, but it is important to raise awareness as early diagnosis and treatment are key to beating this disease.
Resources
“Male Breast Cancer.” Mayo Clinic. Mayo Foundation for Medical Education and Research, February 28, 2020. https://www.mayoclinic.org/diseases-conditions/male-breast-cancer/symptoms-causes/syc-20374740.
“Male Breast Cancer.” National Breast Cancer Foundation. Accessed June 10, 2020. https://www.nationalbreastcancer.org/male-breast-cancer.
Richardson, Lucy, and MD Anderson Cancer Center. “Male Breast Cancer: What Men Should Know.” MD Anderson Cancer Center. MD Anderson Cancer Center, January 10, 2013. https://www.mdanderson.org/publications/cancerwise/male-breast-cancer-what-men-should-know.h00-158826489.html.
“Male Breast Cancer.” MD Anderson Cancer Center. Accessed June 10, 2020. https://www.mdanderson.org/cancer-types/breast-cancer/male-breast-cancer.html.
Brown, Ken. Male Breast Cancer Treatment and Prognosis: Johns Hopkins Breast Center, October 27, 2017. https://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/breast_cancer_in_men.html.
“What Is Breast Cancer in Men?: Male Breast Cancer.” American Cancer Society, April 27, 2018. https://www.cancer.org/cancer/breast-cancer-in-men/about/what-is-breast-cancer-in-men.html.
“The Risk Factors for Male Breast Cancer.” Breastcancer.org, September 29, 2016. https://www.breastcancer.org/symptoms/types/male_bc/risk.
“Warning Signs of Male Breast Cancer.” Susan G. Komen®. Accessed June 10, 2020. https://ww5.komen.org/Blog/Warning-Signs-of-Male-Breast-Cancer/.