An Overview of Male Breast Cancer

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While it is rare, men can develop breast cancer. In the United States, approximately 2,600 men develop breast cancer each year, and it is estimated that one out of every 833 men is expected to have the disease throughout their lifetimes. (For comparison, about one in eight women develop breast cancer.)

Invasive ductal carcinoma (IDC) is the most common male breast cancer. IDC originates in the duct and breaks into, or invades, the surrounding fatty tissue.

Early detection is the key to a better outcome. Generally speaking, men are far less likely than women to think about the possibility of developing breast cancer, so the diagnosis usually comes as a surprise.

There is a range of outcomes depending on the stage (how far it has spread), grade (aggressiveness of the tumor), tumor type (which area of breast tissue it originated from), and a man's overall health.

male v. female breast composition
Verywell / Jessica Olah

Symptoms

Breast cancer typically does not cause signs or symptoms until it reaches a relatively advanced stage. In men, pain or discomfort or changes in the appearance of the breast and surrounding areas may be the first indication of breast cancer.

Signs and symptoms of breast cancer in men include:

  • Pain, tenderness, or discomfort of the breast or nipple
  • A lump in the breast; benign lumps are not uncommon in women, but are rare in men
  • A lump or tenderness of the lymph nodes (underneath the armpit)
  • Dimpling, scaling, or thickening of the skin of the breast
  • A wound, sore, or ulcer of the nipple or skin of the breast
  • Nipple discharge, discoloration, or change in appearance

Because breast cancer might not be on your mind, you might think that you pulled a muscle or had a small injury. It is important not to ignore these problems.

Keep in mind that even if breast cancer is not the cause of your symptoms, whatever is causing your them may worsen without treatment.

Causes

There are a few conditions that are associated with breast cancer in men, but males can develop the disease even without having any predisposing factors. The condition increases with advancing age, and the most common age of breast cancer diagnosis in men is around 68.

Known risk factors for male breast cancer include:

  • Family history
  • Genetics
  • Klinefelter's Syndrome
  • History of cancer treatment
  • Hormone imbalance
  • Smoking
  • Heavy alcohol use
  • Obesity

If you're at high risk, you should get regular breast exams and screening when you go to the doctor, and you need to learn how to do your own monthly self-exams.

Family History and Genetics

Men who have close family members (male or female) with breast cancer are at increased risk of developing the condition. Inheriting the breast cancer variants of the BRCA1 or BRCA2 gene increases the chances of a man developing breast cancer.

Variants in the CHEK2, PTEN, and PALB2 genes may also be associated with male breast cancer.

Klinefelter's Syndrome

Klinefelter syndrome is a rare genetic problem that is associated with a 50-fold increase in male breast cancer. This syndrome occurs when a man is born with an extra X chromosome, resulting in 47 chromosomes instead of 46. It is often represented as 47 (XXY).

Because they have a Y chromosome (which women do not have), children with this syndrome develop male characteristics and male genitals. But the extra X chromosome associated with Klinefelter syndrome often causes affected men to have smaller testicles, enlarged breasts, and possibly impaired fertility.

History of Cancer Treatment

Radiation therapy and chemotherapy are associated with an increased risk of cancer. Radiation and chemotherapeutic medications are used to destroy cancer cells, but they can also cause alterations in normal cells, increasing the risk of disease and cancer.

While uncommon, there is a slight increase in secondary cancer among survivors who were treated for cancer.

Radiation therapy to the chest, such as in treatment for lymphoma, for example, is more likely to be associated with breast cancer than radiation to other areas of the body, such as the brain or abdomen.

Cancer treatment that alters hormone levels, such as estrogen therapy for prostate cancer and orchiectomy for testicular cancer, are also associated with an increased risk of breast cancer in men.

Hormone Imbalance

Hormone imbalance, whether caused by disease or medication use can increase the risk of breast cancer in men. Often, hormonal therapy is necessary for the treatment of illness or to improve a person's quality of life.

Keep in mind that transgender women who use estrogen therapy have an increased risk of breast cancer compared to men, and that risk is estimated to be about the same as those assigned female at birth. If you are a transgender woman, be sure to discuss screening mammograms with your doctor.

Lifestyle Risk Factors

Smoking is one of the leading causes of breast cancer among women and men. Heavy alcohol use also is associated with breast cancer, possibly, in part, because alcohol can increase estrogen levels.

Obesity is another risk factor as well, as it alters hormone levels in the body, increasing the production of hormones that promote breast cancer initiation and growth.

Breast Size and Your Risk

Gynecomastia, the enlargement of male breasts, is a common condition that affects approximately 25% of adolescent boys. Medications, obesity, and liver disease can cause gynecomastia in adult men. Gynecomastia is not thought to increase a man's risk of breast cancer, but you should discuss it with your doctor, as there may be a medical cause behind it.

Diagnosis

While women over 40 are advised to get screening mammograms, men are not generally advised to have this test because it is low yield for people who have a low risk of breast cancer. In fact, false-positive results would be far more common than identified cancers in men.

That said, if you have a strong family history of breast cancer, then you may need genetic testing and periodic screening tests to identify breast cancer.

The diagnosis of breast cancer in men is usually initiated after symptoms develop. In these cases, a mammogram may be used for diagnostic purposes. A doctor may also order a breast magnetic resonance imaging (MRI) scan and a biopsy to identify the tumor, and determine its stage, grade, and type.

You may also need to have imaging and/or a biopsy of nearby lymph nodes so your medical team can check whether the tumor has spread.

Breast Cancer Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

Treatment

Treatment of breast cancer is tailored to the tumor type. Surgery is almost always part of the breast cancer treatment plan, but other options may also be considered on a case-by-case basis.

Radiation treatment is often used to shrink a large tumor prior to surgery. Radiation is also used to shrink metastatic lesions and as a means of preventing recurrence of a tumor after removal.

Chemotherapy and hormonal treatment are based on the type of breast cancer, as each tumor type responds to different treatment. If your tumor is aggressive, or if it has metastasized to other areas of the body, you may need chemotherapy. And if your tumor has characteristics that suggest it could shrink or be completely eradicated with hormonal treatment, you will likely receive hormonal treatment as well.

Targeted therapy is a type of cancer treatment that uses medications designed to target specific characteristics of cancer cells or defective cancer genes. In principle, it is similar to hormonal therapy in that it is taken if the treatment corresponds with molecular characteristics of your cancer (identified with a biopsy). Several targeted therapies are used in breast cancer treatment, but not every cancer can be treated with targeted therapy.

Immunotherapy is a technique in which medication is taken to help your immune system fight your cancer.

Complications

Sometimes, breast cancer treatment can put you at a higher risk of infection. It can also make you tired or interfere with your ability to concentrate. While you are undergoing treatment, you may have some limitations (such as avoiding people who could have a contagious infection) or complications (such as feeling fatigue).

These effects should go away after your treatment is complete, but it may take months or even a year for the side effects of your treatment to wear off.

Prognosis

There are mixed conclusions regarding breast cancer survival among men when compared to women.

The 5-year survival rates for men with breast cancer differs substantially based on the stage at which cancer is diagnosed:

Coping

Learning about the disease, getting timely treatment, and even dealing with pain can make you feel more in control. But it is important that you also address your emotional responses to your diagnosis. You may anger, a sense of hopelessness, anxiousness, or a combination of these and other feelings. It's not uncommon to also feel depressed or even alone, as you may not know anyone who has ever been in your shoes.

The most important thing is that you acknowledge your feelings and that you become comfortable seeking and asking for help.

  • Consider joining a breast cancer support group. While it's worth looking for one for males in your community, it's possible that you might not find one. Though breast cancer support groups are often geared toward women and issues that women face, you may still find benefit in participating in one even if you are one of a few men (or the only man).
  • Lean on family and friends; you may even choose to open up to one trusted person who you feel comfortable talking to
  • Seek the help of a therapist if your feelings are overwhelming or are impacting your day-to-day
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Article Sources

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