Breast cancer in men is hardly talked about because it is rare. For men, the lifetime risk of being diagnosed with breast cancer is about 1 in 1,000. Less than 1% of all breast cancers occur in men.
Men don’t have breasts, right? So how can they get breast cancer?
The truth is that boys and girls are all born with breast tissue. The difference starts when during adolescence various hormones in girls’ bodies stimulate the breast tissue to grow into full breasts. Boys’ bodies normally don’t have much breast-stimulating hormones, as a result, their breast tissue usually stays flat and small. But sometimes men can develop real breasts on both sides (called gynecomastia) because they have abnormal hormone levels, take certain medicines or heavily drink alcohol.
Men with gynecomastia stand more chances to developing breast cancer but all men can potentially develop breast cancer because everybody has breast tissue from birth.
Risks factors for male breast cancer:
- Age: This is the biggest factor. Just as is the case for women, risk increases as age increases.
- High estrogen levels: Estrogen is the “female” hormone responsible for sexual development. Although it is called “female” hormone, men also have it in smaller quantity. Abnormally high levels of estrogen in men could be inborn or caused by the following factors:
- taking certain hormonal medicines
- being overweight, which increases the production of estrogen
- consuming animals which have been fed with hormones to increase their size.
- consuming plants which contain breakdown products of certain pesticides like DDT, which can mimic the effects of estrogen in the body
- high consumption of alcohol, which can limit the liver’s ability to regulate blood estrogen levels
- having liver disease, which usually leads to lower levels of androgens (male hormones) and higher levels of estrogen (female hormones).
- Smoking marijuana
- Klinefelter syndrome: Men with Klinefelter syndrome have lower levels of androgens (male hormones) and higher levels of estrogen (female hormones). They have a higher risk of developing gynecomastia (developed breast tissue) and breast cancer. Klinefelter syndrome is a condition present at birth. Men with Klinefelter syndrome have more than one X chromosome.
- A strong family history of breast cancer or genetic alterations: Family history can increase the risk of breast cancer in men — particularly if other men in the family have had breast cancer. Men who inherit abnormal BRCA1 or BRCA2 genes (Breast Cancer 1 and 2 genes respectively) have a lifetime risk of developing breast cancer by age 70 of approximately 1% with the BRCA1 gene and 6% with the BRCA2 gene. If a first line male relative has breast cancer you might want to find out your BRCA gene status.
- Radiation exposure: Young men who are exposed to radiation therapy to the chest before the age of 30, and particularly during adolescence, may increase the risk of developing breast cancer. This has been seen in young people receiving radiation to treat Hodgkin’s disease.
- a lump felt in the breast
- nipple pain
- an inverted nipple
- nipple discharge (clear or bloody)
- sores on the nipple and areola (areola is the dark part of the breast around the nipple)
- enlarged lymph nodes or lumps under the arm
- breast looks like orange peel
Look out for signs and consult your doctor early. Most men with breast cancer are diagnosed late because most people don’t associate men to breast cancer. Earlier diagnosis could make a life-saving difference.
Tests performed to diagnose breast cancer include:
- Mammography: A mammogram is an X-ray picture of the breast done by a radiologist.
- Ultrasound: Ultrasound complements other tests. If an abnormality is seen on mammography or felt by physical examination, ultrasound is the best way to find out if the abnormality is solid (such as a benign fibroadenoma or a cancer) or fluid-filled (such as a benign cyst).
- Nipple discharge examination: If you have nipple discharge, some of the fluid may be collected and examined under a microscope to see if any cancer cells are present.
- Biopsy: A biopsy is a piece of the suspected breast tissue. It can be obtained through puncture of It is sent to pathologist who examines it and determines if it is cancer or not.
- MRI (magnetic resonance imaging): Might be complementary if cancer is confirmed.
The choice of treatment will depend on a number of factors, including the size and location of the breast tumor, the stage of the cancer, and results of other laboratory tests. Treatment options include:
- operation of the breast (surgery)
- operation of lymph nodes (surgery)
- radiation therapy (treatment with Xray techniques)
- hormonal therapy
- Targeted therapy with Herceptin or Avastin