When men get breast cancer
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When men get breast cancer
October is the month to raise recognition of breast cancer as it is designated as Breast Cancer Awareness Month. This yearly national push is meant to increase knowledge of the disease and to raise funds for research for its cause, prevention, and ultimately cure. Naturally, women are at the forefront of leading marches and giving speeches as breast cancer is predominately found 99 percent of the time in a woman. Even though it’s rare – less than 1 percent of all breast cancer - some people may not realize that men can also develop breast cancer.
Whether male or female, all people are born with some breast cells and tissue. Men do not go on to develop milk-producing breasts, but a man’s breast cells and tissue can still develop cancer.
What is breast cancer?
Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant or cancerous if the cells can grow into or invade surrounding tissue or spread (metastasize) to other areas of the body.
What is male breast tissue?
Until puberty, young boys and girls have a small amount of breast tissue consisting of a few ducts located under the nipple and areola. At puberty, a girl’s ovaries make female hormones, causing breast ducts to grow and lobules to form at the end of ducts. Even after puberty, boys and men normally have low levels of female hormones, and breast tissue doesn’t grow much. Men’s breast tissue has ducts, but only a few if any lobules.
Where does breast cancer start?
Breast cancer can develop or start in different areas of the breast. Most breast cancers begin in the ducts that carry milk to the nipple which are ductal cancers. Some start in the glands that make breast milk which are lobular cancers. Men have these ducts and glands too even though they are not normally functional. There are also types of breast cancer that start in other types of breast cells, but they are less common.
Although many types of breast cancer can cause a lump in the breast, not all of them do. Breast cancer can have other symptoms a person should be aware of and if discovered they need to see their healthcare provider.
The majority of breast lumps found are benign or noncancerous. Benign breast tumors are abnormal growths but do spread outside of the breast and are not life-threatening. However, any lump found still needs to be checked by a healthcare provider to make the final determination of whether is it malignant or benign.
How is breast cancer found in men?
Male breast cancer can exhibit the same symptoms as breast cancer in women. Breast cancer in men is usually detected as a hard lump underneath the nipple and areola. Men carry a higher mortality rate than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer. This assumption can cause a delay in seeking treatment which means then when it is discovered, it is already at an advanced stage, making the chance of survival lower.
Of the men who develop breast cancer, the cases are infiltrating ductal carcinoma (IDC) which means cells in or around the ducts begin to invade surrounding tissue. Very rarely, a man might be diagnosed with inflammatory breast cancer, or Paget disease, of the nipple.
Are there risk factors that may increase a man’s risk of developing breast cancer?
It’s important to understand the risk factors for male breast cancer. Men are not routinely screened for the disease and most men do not consider the possibility that they might get it.
There are a number of factors which can increase a man’s risk of developing breast cancer:
· Age – This tends to be the biggest risk factor for men. Just as is the case for women, risk increases as age increases. The average age of men diagnosed with breast cancer is about 68.
· High estrogen levels - Breast cell growth – both normal and abnormal – is stimulated by the presence of estrogen. Men can have high estrogen levels as a result of the following:
· Taking hormonal medications
· Being overweight, which increases the production of estrogen
· Being a heavy user of alcohol. This can limit the liver’s ability to regulate blood estrogen levels.
· Having liver disease. This usually leads to lower levels of androgens (male hormones) and higher levels of estrogen (female hormones). This can also increases the risk of developing gynecomastia (breast tissue growth that is non-cancerous) as well as breast cancer.
· Klinefelter syndrome – This is a condition present at birth that affects about 1 in 1,000 men. Normally men have a single X and a single Y chromosome. Men with Klinefelter syndrome have more than one X chromosome. Men with this condition have lower levels of androgens and higher levels of estrogen and are also at a higher risk of developing gynecomastia. Symptoms of Klinefelter syndrome include having long legs, a higher voice, and a thinner beard than average men; having smaller than normal testicles, and being infertile or unable to produce sperm.
· Strong family history of breast cancer or genetic mutations, especially related to the BRCA2 gene – Family history can increase the risk of breast cancer in men – especially if other men in the family have had breast cancer. The risk is also higher if there is a proven breast cancer gene abnormality in the family. Men who inherit the abnormal BRCA1 or BRCA2 genes have an increased risk of male breast cancer. The lifetime risk of developing breast cancer is approximately 1 percent with the BRCA1 gene mutation and 6 percent with the BRCA2 gene mutation.
A man with a family history of the inherited mutated BRCA gene, should consider genetic testing. A man should discuss this with his healthcare provider and to learn what genetic testing can and cannot tell him, carefully weighing the benefits and risks of testing before having it done. Tests results are not always clear cut and therefore it is also advised to talk with a genetic counselor or doctor with special training in genetic testing.
· Radiation exposure – If a man has been treated with radiation to the chest, such as for lymphoma, he has an increased risk of developing breast cancer.
In conclusion
Even men need to be aware of breast cancer. Any lump, mass or change in breast tissue should be brought to the attention of their healthcare provider right away to get an accurate diagnosis of what is the cause.