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Though rare, breast cancer can develop in men too. It forms about 1% of all cases of breast cancer that are detected. Although it can develop at any age, but like majority of other cancers, incidence of breast cancer in men also increases with age.

Breast cancer can develop in men too

Though rare, breast cancer can develop in men too. Small boys, just like girls, have some amount of dormant breast tissue behind the nipples on the chest wall. After puberty, the growth of this tissue is prevented by the hormonal action of testosterone. However, when there is uninhibited growth of this breast tissue, the condition is termed as breast cancer in men. It forms about 1% of all cases of breast cancer that are detected. Although it can develop at any age, but like majority of other cancers, incidence of breast cancer in men also increases with the advancing age. It is most commonly found in men between the ages of 60 and 70 years.
 

As men tend to have very little breast tissue, hence breast cancer can be detected at a very early stage. However, most men think that it is a disease affecting only the females. Breast cancer in men is often detected at an advanced stage because either they do not know that even men can develop breast cancer or they are too embarrassed to report any abnormal growth of the breast tissue to their doctor.

The different types of breast cancer in men are the infiltrating ductal carcinoma, ductal carcinoma in situ, inflammatory breast cancer and Paget disease of the nipple. Of these, the first type is the most common in men. All these types of breast cancer are amenable to treatment, provided they are detected at an early stage. So it is wise to be aware of the fact that breast cancer can develop in men too.

Symptoms of breast cancer in men

The most common symptom of breast cancer in men is an abnormal mass or swelling in the breast, nipple or chest musculature. The swelling is initially painless and firm in consistency. There may be redness of the breast skin, areola or the nipple. The nipple may get retracted. Other symptoms of breast cancer in men may include abnormal bloody or colorless discharge from the nipples or scaling of the breast tissue or skin above the nipples. The skin over the breast may show a ‘peau d’orange’ appearance, i.e. dimpling of the skin like that of an orange peel. The lymph glands present in the underarms on the involved side may be enlarged. There may be associated weakness, lethargy, loss of appetite and decrease in weight. In case the cancer has metastasized to bones, there may be bone pain and fractures and in case it has spread to the lungs, there may be breathlessness.

Risk factors associated with cancer of breast in men

There are several risk factors associated with cancer of breast. Genetic mutation of breast cancer gene 2 (BRCA2) may cause an increased incidence of breast cancer in men. Klinefelter’s syndrome, where men carry an extra X chromosome, leads to higher levels of estrogen. This, in turn, can lead to development of breast cancer in the afflicted men. Liver diseases like cirrhosis and parasitic infection are also among the risk factors associated with cancer of breast. Here again, the levels of estrogen are high while the levels of androgens are reduced. Treatment with high doses of estrogen, like in gender changing procedures can stimulate excessive growth of breast tissue and may result in breast cancer in men. Accidental or deliberate exposure to radiation, as in treatment of Hodgkin’s lymphoma may cause breast cancer in men. Breast cancer history in close female relatives and advancing age are also risk factors that are associated with cancer of breast.

Treatment of Breast Cancer in Men

Based on the size of the tumor and its spread, the cancer of breast has been classified from stage 0 to stage 4. To determine the stage of the cancer is an essential step to plan the treatment of breast cancer in men. Taking into consideration the stage of cancer in the patient, there are generally four modalities of treatment of breast cancer in men. They are surgery, chemotherapy, radiation therapy and hormonal therapy.

  • Surgery in breast cancer of men: Lumpectomy is a form of breast conserving surgery undertaken in case of small tumors. Here, the tumor is removed while leaving the normal breast tissue intact and the procedure is followed by radiation to kill any remnants of cancer cells. In case of advanced stage of cancer, the entire breast along with the adjacent chest muscles and corresponding lymph nodes is excised in a procedure known as modified radical mastectomy.
  • Chemotherapy in breast cancer: Chemotherapeutic medicines work by killing the tumor cells or by stopping their further proliferation. These medicines are usually very toxic and are taken orally or are injected intravenously.
  • Radiation therapy for treating breast cancer: In radiation therapy, the tumor cells are exposed to high energy x rays which either kill them or prevent them from multiplying.
  • Hormone therapy in breast cancer of men: It may include removal of testicles to lower the amount of sex hormones and giving Tamoxifen for estrogen receptor positive cancers. Usually, the tumor cells of breast cancer in men have hormone receptors. Giving Tamoxifen in hormone receptor positive breast cancers lowers the amount of estrogen present in the body and blocks the action of estrogen on tumor cells thereby limiting the growth of tumor cells. This therapy is particularly useful in reducing the recurrence of early stage hormone receptor positive breast cancers and in limiting the growth of advance stage or metastatic hormone receptor positive breast cancers.
Monoclonal antibody therapy is a type of targeted cancer therapy wherein antibodies are used to recognize and act against particular cancer cells without causing any damage to the adjacent normal tissue. These antibodies may be used alone or be used to carry chemotherapeutic agents or radioactive substance to the cancer cells. Herceptin is an example of monoclonal antibody which acts specifically against growth factor protein HER2 found in the tumor cells.
In case of locally recurrent breast cancer in men, either surgical treatment or radiation therapy is used in adjunct with chemotherapy.

Like all cancers, the chances of cure from the disease depend on early diagnosis and prompt treatment. And for early diagnosis, it is imperative for men to realize that even they can develop breast cancer. As soon as they detect any symptom of breast cancer, they should seek medical care promptly and not shy away from the disease.

  • Male Breast Cancer Treatment (PDQ®). National Cancer Institute. 2011
  • Breast Cancer in Men. Imaginis.2011
  • NCI/PDQ Physician Statement: Male Breast Cancer. University of Pennsylvania's. 2011
  • Photo courtesy of North Charleston by Flickr : www.flickr.com/photos/northcharleston/6192049322/