What are the other Names for this Condition? (Also known as/Synonyms)

• Breast Cancer Tumor of Male Breast
• Carcinoma of Male Breast
• Male Breast Cancer

What is Breast Cancer in Men? (Definition/Background Information)

• Breast Cancer in Men is a rare form of cancer that begins in the breast tissue of men.
• The cancer occurs, when normal cells become abnormal and grows uncontrollably, forming a malignant tumor. This could potentially invade nearby tissues and spread, or metastasize to, other areas of the body.

There are various types of Male Breast Cancer:

• Ductal carcinoma: It is a type of Breast Cancer that begins in the milk ducts of the breast and is the most common type. 75% of all Breast Cancers originate in the milk ducts
• Lobular carcinoma: Breast Cancer that begins in the lobules, or milk-producing glands in the breast. About 25% of all Breast Cancers are lobular carcinomas
• Paget’s disease of the nipple: A type of Male Breast Cancer that starts in the milk ducts, but spreads to the nipple, resulting in scaly skin surrounding the nipple

Who gets Breast Cancer in Men? (Age and Sex Distribution)

The distribution of Breast Cancer in Men is as follows:

• It is most common in older men between ages 60 and 70, though men of all ages may be affected
• All racial and ethnic groups are affected

What are the Risk Factors for Breast Cancer in Men? (Predisposing Factors)

The risk factors for Breast Cancer in Men are:

• Age: Male Breast Cancer is more common in older adults in the 60-70 year age group. The risk increases as men get older
• Family history: Having a family member with Breast Cancer (either male or female), increases the risk
• Klinefelter’s syndrome: A genetic condition, when a male child is born with more than one copy of the X chromosome. Males with Klinefelter’s syndrome have smaller than usual sized testicles, which lead to lower production of male hormones (androgens) and greater production of female hormones (estrogens). It has been shown that men with this syndrome have a higher chance of developing Breast Cancer, than other men
• Liver disease: The liver is important for the metabolism of sex hormones. Having a liver disease, including cirrhosis of the liver, may decrease the male hormones, while increasing female hormones. Men with a liver disease have greater chance of developing benign male breast growth (gynecomastia) and Breast Cancer
• Estrogen treatment: Taking estrogen-related drugs, such as those used previously to treat men with prostate cancer, may slightly raise the risk for Breast Cancer. Transgender or transsexual individuals taking estrogen-related drugs as part of a sex reassignment, may also have a higher risk
• Obesity: Obesity increases the number of fat cells in the body, which convert androgens into estrogens. This increase in estrogen levels of obese men, can subsequently increase their risk
• Radiation exposure: Men who have received radiation treatment to the chest area, such as those used for treatment of a cancer in the chest, have a higher likelihood of developing Breast Cancer

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Breast Cancer in Men? (Etiology)

The cause of Breast Cancer in Men is not exactly known. There are, however, particular risk factors that may increase a man’s chance of developing Breast Cancer.

• It is known that Male Breast Cancer occurs when normal healthy cells begin transforming into abnormal cancer cells – these cancer cells grow and divide uncontrollably, resulting in the formation of a mass, or tumor. The tumors can metastasize, or spread, to other regions of the body
• Some men are at risk of developing Breast Cancer from inherited mutations in the BRCA1 or BRCA2 genes. Normally, these genes function to produce proteins that prevent cells from growing abnormally

What are the Signs and Symptoms of Breast Cancer in Men?

The signs and symptoms of Breast Cancer in Men are as follows:

• A lump or thickening of tissue in breast area
• Changes to the skin of the breast area, including dimpling, puckering, scaling, or redness
• Changes to the nipple, such as inversion, scaling, or redness
• Discharge from the nipple

How is Breast Cancer in Men Diagnosed?

Breast Cancer in Men is diagnosed as follows:

• Clinical breast exam and physical exam:  A physician will examine the breasts as well as the armpit and collarbone area to identify any lumps. The clinical exam will help determine the size and shape of any lumps, and their proximity to the skin and muscles
• Mammogram: A mammogram uses x-rays to create images of breast tissue. This procedure requires pressing the breast between two plates to make it as flat as possible. Though this compression of the breast may be uncomfortable, it lasts only a few seconds. The resulting image may indicate if a biopsy is needed to further test an abnormal area. Mammograms are generally more accurate for men than for women, as men lack dense breasts, which can affect the mammogram
• Breast ultrasound: Using high-frequency sound waves to produce images of the breast tissue, a breast ultrasound can help identify whether a breast lump is a fluid-filled cyst or a cancerous tumor
• Magnetic resonance imaging (MRI): An MRI scan involves using radio waves and magnets to provide a series of detailed images of the breast area
• Breast Biopsy: A biopsy is a procedure involving the removal of a sample of breast tissue for further examination, by microscopy. Biopsies, which are the only method to determine whether an abnormality is cancerous or not, are done by inserting a needle into a breast mass and removing cells or tissue. There are different types of biopsies:
  • Fine needle aspiration biopsy: In this method a very thin needle is used to remove a small amount of tissue
  • Core needle biopsy: A wider needle is used to withdraw a small cylinder of tissue from an abnormal area of the breast
  • Surgical biopsy: A surgical procedure used less often than needle biopsies, it is used to remove a part or all of a breast lump for analysis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Breast Cancer in Men?

The possible complications of Breast Cancer in Men are as follows:

• Various side effects from Breast Cancer treatment, such as chemotherapy, radiation therapy, hormone therapy, and targeted therapy
• Lymphedema, or swelling of the arm, can occur after any cancer treatment that removes or targets radiation to axillary lymph nodes in the underarm, as this changes the flow of lymph fluid. The resulting build-up of fluid leads to the swelling in the arm. Lymphedema can occur anywhere from months to years after surgery or radiation therapy targeting the axillary lymph nodes

How is Breast Cancer in Men Treated?

The treatments for Breast Cancer in Men are as follows:

• Surgery: Surgical procedures aim to remove the tumor along with some surrounding tissue
  • Lumpectomy: A breast-conserving surgical operation that involves removing the tumor and a small portion of the surrounding tissue
  • Modified radical mastectomy: Surgery involving removal of all breast tissue, the nipple, areola, some axillary lymph nodes in the underarm, and part of the chest wall muscles. Removing lymph nodes, however, raises the risk for lymphedema, or swelling of the arm
  • Sentinel lymph node biopsy: Surgeons remove the lymph node, which could most likely be the place, where cancer cells would have first spread. Testing of this lymph node for cancer cells can determine, whether the Breast Cancer has spread beyond the breast
• Radiation therapy: Using x-ray beams, radiation therapy kills cancer cells. Radiation therapy may be an option before surgery to shrink a tumor, or may be used afer a surgery, to remove any remaining tumor cells, or may be used in combination with chemotherapy
• Chemotherapy: Chemotherapy uses drugs to kill or stop the growth of cancer cells. It can be administered intravenously or in oral pill form. Regardless of the method of administeration, the drugs reach the cancer cells via the bloodstream. Chemotherapy may be recommended for different situations.
  • Adjuvant chemotherapy: Therapy recommended after surgery to remove any remaining cancer cells that are not visible. This helps to decrease the risk of the cancer returning
  • Neoadjuvant chemotherapy: Treatment given before surgery to help shrink tumors, allowing for easier removal during surgery
  • Chemotherapy for advanced Breast Cancer: Recommended for Breast Cancer that has spread outside the breast, at the time of diagnosis
• Hormone therapy: Hormones may stimulate the growth of some cancers. Most men with Male Breast Cancer have tumor cells that are sensitive to hormones, meaning they have hormones receptors on their surfaces. Hormonal treatment is suggested for estrogen receptor (ER)-positive or progesterone receptor (PR)-positive Breast Cancers, as it helps to prevent cancer cells from receiving the hormones needed to grow. Tamoxifen is a drug often used for hormone therapy in men. It works by preventing estrogen from binding to its receptors on cancer cells
• Targeted therapy: Newer drugs have been developed to specifically attack cancer cells, but not the other normal cells of the body. Monoclonal antibody therapy is a type of targeted therapy that uses antibodies to attach to specific substances on cancer cells or other substances that can help stimulate the growth of cancer cells. By targeting these particular substances, targeted therapy can kill cancer cells, or block them from growing or spreading

How can Breast Cancer in Men be Prevented?

Preventative measures that can be taken to prevent Breast Cancer in Men are as follows:

• Drink alcohol in moderation; limit to one or two drinks a day
• Maintain a healthy weight and exercise regularly
• Early detection and treatment can help in lowering the number of deaths, due to Male Breast Cancer

What is the Prognosis of Breast Cancer in Men? (Outcomes/Resolutions)

The prognosis of Breast Cancer in Men is dependent on the following factors:

• Stage of cancer, whether it has spread to other areas of the body
• Type of Breast Cancer
• The presence of cancer in other breast
• Estrogen-receptor and progesterone-receptor status
• Age and general health of the individual

Breast Cancer stages range from 0 to IV. 0 may indicate a small and non-invasive cancer, while IV indicates that the cancer has spread to other areas of the body. Briefly, as per National Cancer Institute (at the National Institutes of Health), Breast Cancer in Men is staged as follows:

• Stage I: The tumor is 2 centimeters in diameter or less, and has not spread outside the breast
• Stage II: The tumor may be up to 5 centimeters in diameter and may have spread to lymph nodes. Another criteria is that the tumor may be larger than 5 centimeters in diameter, but has not spread to surrounding lymph nodes
• Stage III: The tumor may be more than 5 centimeters in diameter and may have spread to several axillary lymph nodes, or to the lymph nodes near the breastbone
• Stage IV: The tumor has spread outside the breast and to other organs, such as the bones, liver, lungs, or brain, regardless of its size

With early detection and treatment, men with Breast Cancer have a good chance at recovery. Often times, men postpone seeing a doctor after discovering breast lumps. This means that many Male Breast Cancers are diagnosed at more advanced stages compared to Breast Cancers in Women.

Additional and Relevant Useful Information for Breast Cancer in Men:

More commonly known as a disease impacting women, Breast Cancer is diagnosed in over 2,100 men every year (in USA). This accounts for less than 1% of all Breast Cancer cases.