Breast Cancer in Men
What is breast cancer in men?
Cancer starts when cells change and grow out of control. The changed (abnormal) cells
often grow to form a lump or mass called a tumor. Cancer cells can also grow into
(invade) nearby areas. And they can spread to other parts of the body. This is called
metastasis.
Breast cancer can start in both women and men. Both women and men have breast tissue,
and those cells can turn into cancer. Still, breast cancer is very rare in men.
The most common type of breast cancer in men is called infiltrating ductal cancer.
This is cancer that starts in cells lining the milk ducts and spreads to nearby tissues.
Other far less common types of breast cancer in men include ductal carcinoma in situ
(DCIS), inflammatory breast cancer, and Paget disease of the nipple. A type of breast
cancer called lobular carcinoma in situ is very rare in men. This is because men don't
have much lobular tissue. (Lobular tissue is where breastmilk is made.)
What causes breast cancer in men?
Experts think that genes may play a role in breast cancer development in men. These
include a family history of breast cancer in a first-degree relative and inherited
changes (mutations) of the BRCA genes. Genes other than BRCA may also play a role.
But each cancer case is different. Talk with your provider about your own case.
Which men are at risk for breast cancer?
A risk factor is anything that may increase your chance of having a disease. Risk
factors for a certain type of cancer might include smoking, diet, family history,
or many other things. The exact cause of someone’s cancer may not be known. But risk
factors can make it more likely for a person to have cancer.
Things you should know about risk factors for cancer:
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Risk factors can increase a person's risk, but they don't always cause the disease.
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Some people with one or more risk factors never develop cancer. Other people with
cancer have no risk factors.
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Some risk factors are very well known. But there's ongoing research about risk factors
for many types of cancer.
Some risk factors, such as family history, may not be in your control. But others
may be things you can change. Knowing the risk factors can help you make choices that
might help lower your risk. For instance, if an unhealthy diet is a risk factor, you
may choose to eat healthy foods. If extra weight is a risk factor, your healthcare
provider may help you lose weight.
Risk factors for breast cancer in men include:
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Being age 60 or older
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Radiation exposure, such as from radiation used to treat another cancer in the chest
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Estrogen treatment (which might be used for prostate cancer)
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Diseases linked to high estrogen levels and low levels of male hormones (hyperestrogenism),
such as severe liver disease or Klinefelter syndrome
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Heavy use of alcohol
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Obesity
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One or more female or male relatives have breast cancer
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A breast cancer 2 (BRCA2) gene mutation in the family
What are the symptoms of breast cancer in men?
The most common symptoms of breast cancer in men include:
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Lump, thickening, or swelling in the breast or armpit
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Nipple that turns inward (inversion)
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Fluid leaking from the nipple (discharge), that may be bloody
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Skin or nipple changes such as dimpling, puckering, redness, or scaling
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Changes in the size or shape of the breast
These symptoms might be caused by other health problems. But it’s important to see
a healthcare provider right away if you have these symptoms. Only a healthcare provider
can tell if you have cancer.
How is breast cancer in men diagnosed?
Your healthcare provider will ask about your health history and do a physical exam.
A breast exam will be done. This means carefully feeling the breasts and under the
arms for lumps or anything else that seems abnormal. Tests will also be needed. These
may include:
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Ultrasound. This test uses sound waves to make pictures of internal organs or tissues.
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Mammogram. This is an X-ray of the breast.
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MRI. This test takes detailed pictures of the inside of the body.
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Blood chemistry studies. Blood tests are done to measure the amounts of certain substances in the blood. Abnormal
levels of certain substances can be a sign of disease.
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Biopsy. The healthcare provider removes a tiny piece (sample) of cells or tissue so they
can be tested for cancer. These are the types of biopsies:
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Fine needle aspiration. A very thin needle is put through the skin and into the lump to remove tissue or
fluid.
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Core biopsy. A wider needle and vacuum suction are used to remove tissue. The skin is numbed.
Then a tiny cut is made in the skin to put the needle into the lump.
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Excisional biopsy. This is done during surgery, and the healthcare provider removes part or all of the
lump.
If breast cancer is diagnosed, you'll need to have other tests done. These help your
healthcare providers learn more about your overall health and the cancer. They can
help show if it has grown into nearby areas or spread to other parts of your body.
The test results help your healthcare providers decide the best ways to treat the
cancer.
How is breast cancer in men staged?
The stage of a cancer tells your healthcare provider if and how far it has spread
(metastasized) in your body. It's one of the most important things to know when deciding
how to treat the cancer.
The staging system for male breast cancer is the same as the staging system for female
breast cancer. It includes the size of the cancer and whether lymph nodes have cancer
cells in them. It also includes details about whether the cancer cells have certain
proteins and how much they look like normal cells (called grade).
The stage is based on a 0 to 4 scale. It uses Roman numerals I (1), II (2), III (3),
and IV (4). Stage 0 is also called carcinoma in situ. The cancer is small and only
in the place where it first started. Stage IV means the cancer has spread to other
parts of the body.
Your healthcare provider will talk with you about what your cancer stage means and
how it affects your treatment options. Ask any questions or talk about your concerns.
How is breast cancer in men treated?
The main treatment for male breast cancer is surgery. The most common surgery is a
mastectomy. This means removing the breast tissue and the nipple. Sometimes lymph nodes under
the arm, the lining over the chest muscles, and even part of the chest wall muscles
under the breast are also removed.
Other treatments that may be used include:
Radiation therapy
Radiation therapy sends high-energy X-rays or beams of other particles right to the
cancer cells. Radiation after surgery can kill cancer cells that may not be seen during
surgery. Radiation may also be done before surgery to help shrink the tumor and make
it easier to remove. It may be given along with chemotherapy. Or it may be used as
a palliative treatment. This is a therapy that relieves symptoms, such as pain, but
doesn’t treat the disease.
Radiation therapy is usually given as external beam radiation. A large machine focuses
the beams on the tumor. The machine is controlled by a radiation therapist. Special
shields may be used to protect the tissue around the treatment area. Treatments are
painless and often last a few minutes.
Chemotherapy
Chemotherapy (chemo) is the use of strong medicines to kill cancer cells. In most
cases, chemo works by making the cancer cells unable to grow or divide. Different
groups of medicines work in different ways to fight cancer cells. A healthcare provider
called a medical oncologist will work with you to make a treatment plan. Chemotherapy
may be given before or after surgery.
Hormone therapy
In some cases, hormones can kill cancer cells, slow their growth, or stop them from
growing. Hormone therapy as a cancer treatment uses medicines that affect the way
certain hormones work or keep your body from making certain hormones. Before hormone
therapy, your healthcare provider will do a hormone receptor test. This lab test is
done on a small piece of the cancer tissue to see if there are estrogen and/or progesterone
receptors on the cells. A hormone receptor test can help to predict whether cancer
cells are sensitive to hormones. If so, hormone therapy may be a treatment option.
Targeted therapy
These medicines target certain proteins found on cancer cells. This limits the damage
to healthy cells and can cause fewer and different side effects than chemo. Breast
cancer cells are tested to see if they have a protein called HER2 on their surface.
HER2 promotes cell growth, and these cancer cells tend to grow and spread quickly.
There are targeted therapy medicines that attach to this protein to help stop cancer
cell growth.
Immunotherapy
Certain types of breast cancer can be treated with immunotherapy. This helps the body's
immune system recognize and kill cancer cells. Immunotherapy may be used with chemotherapy.
Key points about breast cancer in men
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Though it's rare, men can get breast cancer.
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The most common type of breast cancer in men is infiltrating ductal cancer. This is
cancer that starts in milk ducts and spreads to nearby tissues.
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Common symptoms of breast cancer in men are a breast lump or swelling, changes in
the skin over the breast, or a nipple that turns inward (inversion).
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The main treatment for male breast cancer is surgery. The most common surgery is a
mastectomy, which removes the breast tissue.
Next steps
Tips to help you get the most from a visit to your healthcare provider:
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Know the reason for your visit and what you want to happen.
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Before your visit, write down questions you want answered.
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Bring someone with you to help you ask questions and remember what your provider tells
you.
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At the visit, write down the name of a new diagnosis and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
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Know why a new medicine or treatment is prescribed and how it will help you. Also
know what the side effects are.
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Ask if your condition can be treated in other ways.
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Know why a test or procedure is recommended and what the results could mean.
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Know what to expect if you do not take the medicine or have the test or procedure.
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If you have a follow-up appointment, write down the date, time, and purpose for that
visit.
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Know how you can contact your provider if you have questions.