What is male breast cancer?

It is a common misconception that breast cancer only occurs in women and male breast cancer is nothing.  However, it is time to change that stereotype because MEN GET BREAST CANCER TOO!’ 

Breast tissues present in men become harmful if not checked. These breast tissues develop cancer and the cells spread and affect all the parts of the body that are near it. Breast cancer begins when the cells in the breast start to grow out of control. 

An X-ray is the only way to identify when these cells get out of control. As they tend to form a lump that can be seen through an x-ray machine. If the cells of the tumour grow into the surrounding tissue or metastasize to different areas of the body, then the tumour turns malignant or cancerous. 

Male breast tissue

It is common knowledge that women have breasts as they serve a higher purpose in rearing children. However, that does not mean that the other gender does not. Just to clarify and highlight to the world that males have breast tissue too and here are some things we know about it. 

Young girls and boys have been observed with a minute amount of breast tissues. It consists of a few ducts that are located under the nipple and around the nipple (areola). Such breast tissues start developing when children reach puberty. 

After puberty hits, the female’s ovaries produce female hormones like estrogenic. These hormones cause the breast ducts to grow and lobules to form at the ends of such ducts. Since men don’t have a lot of female hormones after puberty, their breast tissues don’t grow much. Men’s breast tissues may have ducts but only a few have reported having lobules. 

illustration showing structure of the male breast including location of the ducts, areola, nipple, collecting ducts, fatty connective tissue and lobules

Male Breast Cancer Diagnosis

It takes a couple of tests for the doctor to finally diagnose someone with breast cancer. Once diagnosed, the individual has to go through the expensive and painful treatment. If misdiagnosed, it can cause a lot of health issues and death due to the painful treatment options.

Therefore, the doctor conducts the following tests to be able to diagnose an individual with breast cancer: 

  1. X-ray of the chest: An x-ray emits a special kind of energy beam that goes right through the body. It imprints everything in its way onto a film, which helps doctors see what’s happening inside. The x-ray of the chest is to check any formation of lumps in the area.
  2. PET scan: Positron Emission Tomography (PET) scan is a procedure that helps in finding malignant tumour cells. A tiny amount of radioactive glucose is injected in the veins of patients who go through PET scan. The scanner then rotates all around the body to monitor the areas of consumption of glucose. The reason why the PET scanner helps is that the malignant tumour cells brighten up as they are comparatively much more active. During this time, they have much larger glucose consumption than regular cells.
  3. CT or CAT scan: A computerized tomography which is also known as computerized tomography (CT) or computerized axial tomography (CAT) scans. It is a procedure which makes up a series of detailed pictures of areas inside the body from different angles.

    An x-ray machine is used to create this picture. It is linked with a computer to use artificial intelligence to create a perfect map of the body. In some cases, a dye is injected into the body to help the organs or tissues to show up more clearly. Breast cancer is easily identifiable as the image will show a lump near the breast tissue area.
  4. Sentinel lymph node biopsy: The first lymph node in a group of lymph nodes in our body. It receives the lymphatic drainage from the primary tumour is the ‘sentinel lymph node’. The cancer spreads from the primary tumour. This tumour is in the breast to other parts of the body by attaching itself into the sentinel lymph node.

    The sentinel lymph node needs to be removed in order to ensure that cancer does not spread anywhere. A blue dye similar to the one injected in the tests above is injected in this case too. The flow of this dye is observed and the first lymph node through which it flows is removed through surgery.

    A pathologist looks at the node under a microscope to find cancer cells. If there isn’t any cancer cell present in it, then there is no need for the removal of more lymph nodes. In some breast cancer cases, the sentinel lymph node is present in more than one node.
  5. Bone scan: A very small amount of radioactive liquid is injected into a vein, which takes us through the bloodstream. A scanner detects when the radioactive material collects in the bones with cancer cells.

    This procedure is called a bone scan and is done to check if there are any rapidly dividing cells such as the cancer cells in the bone.

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Male Breast Cancer Stages

Breast Cancer Stage groups are divided into three stages: 

  1. Clinical Prognostic Stage: This is the first stage as this is the assessment level. In this stage, patients discover the gravity of their cancer based on their health history, imaging tests, physical exams and biopsies.

    Mammography or ultrasound helps in determining if there are any lymph nodes that show any sign of cancer. The TNM system, tumour grade and biomarker status (ER, PR, HER2) make up the clinical prognostic stage for all cancers including breast cancer.
  2. Pathological Prognostic Stage: This stage is for patients who have surgery as their first step into treatment. All the clinical information, laboratory test results and biomarker status from the breast tissue and lymph nodes removed during the surgery provide the basis for the Pathological prognostic stage. 
  3.  Anatomic Stage: This stage is not used in the United States but is present in many countries of the world. It is done only in countries where biomarker resting is not available. TNM system determines the size and spread of the cancer.

Individuals at Risk

Just like erectile dysfunction, the risk of getting breast cancer increases with age. It’s very rare for someone to have breast cancer before the age of 35. Men between 60 and 70 are most likely to have breast cancer. There are a couple of other risk factors which can make a man more prone to breast cancer. These risk factors are:

  1. Genes or family history: Individuals with a genetic mutation or a strong family history of breast cancer are prone to get it. This family history of breast cancer makes it much worse for the descendants of the family.

    This risk becomes much higher if the individual has a proven breast cancer gene abnormality. Men who inherit abnormal BRCA1 or BRCA2 genes (BR stands for BReast, and CA stands for CAncer) tend to have an increased risk of male breast cancer.

    The lifetime risk of developing breast cancer is approximately 1% with the BRCA1 gene mutation and 6% with the BRCA2 gene mutation. Because of this strong association between male breast cancer and an abnormal BRCA2 gene, the first degree relatives like the man’s sibling, parent and children must check with their doctors to identify if there is any difference in their genes.

    Such people must test their gene for mutilation in relation to getting breast cancer.

    For most males, they get cancer without having any significance to have such genes in their family or to have inherited abnormally. 
  2. Presence of Klinefelter syndrome: Klinefelter syndrome is a condition of a low level of androgens (male hormones) and a higher level of oestrogen (female hormones). Such individuals have a higher risk of developing gynecomastia,  which is breast tissue growth that isn’t cancer as well as the same growth getting cancerous which leads to breast cancer. Klinefelter affects 1 in 1000 men globally.

    Generally men have X and Y chromosomes, whereas people with Klinefelter only have the X chromosome in excess numbers. Such men can have up to 4 X chromosomes and are physically a bit different than normal men. Such individuals have longer legs, a thinner beard than most men, a higher voice, smaller than average testicles and sometimes are infertile. 
  3. Exposure to radiation: Individuals that have occupations that expose them to radioactive materials for a long time can be prone to developing cancer.
  4. Obesity

Male Breast Cancer Treatment

There are multiple treatment plans available for this type of cancer.  These male breast cancer treatment plans depend on how big the tumour is and how far it has spread. Many of these treatments focus on therapy.  They are expensive and the treatment can last for some time.  A few treatments for curing breast cancer are: 

  1. Oestrogen Hormone Therapy: In many cases, the cancerous cells have oestrogen receptors on their cell walls. In such cases, the oestrogen helps these cancerous cells to grow and divide themselves. In such cases, the doctor suggests the patient look at oestrogen hormone therapy as it can block the effects of oestrogen and slow the growth of cancer.

    There are a couple of side effects that may accompany such replacement therapies but they tend to work. Flushing, fatigue, sexual problems, mood swings and bone thinning are some of the more harmful side effects of such medicines.

    Such form of therapy involves increasing the dose of the drug to ensure the blockage of oestrogen. Such drugs are:
    1. Tamoxifen: The main purpose of this drug is to stop the oestrogen to enter the cancerous cell in the first place. There is another drug which has the same aim, however, is much stronger in terms of effect. It is only for patients who are in the last stages of breast cancer because it is quite strong.
    2. Fulvestrant or Faslodex: Instead of blocking this drug destroys the oestrogen receptors present. Such drugs are also prescribed for individuals in the last stages of breast cancer. 
    3. Aromatase inhibitors: This drug blocks the effects of aromatase proteins. The oestrogen level reduces automatically after injection of this drug. This drug can treat breast cancer in women and therefore, some doctors suggest the same for male breast cancer treatment.
  2. Surgery: There are three types of surgeries that depend on the severity of breast cancer and the size of tumour:
    1. Lymphectomy: In this method of male breast cancer treatment, the surgeon removes the lymph nodes that have been attacked with cancer. 
    2. Mastectomy: Removal of the whole breast and some of the surrounding tissues.
    3. Breast-conserving surgery: This surgery only involves taking out the part of the breast that has cancer and tumour. 
  3. Chemotherapy: The main aim of this type of therapy is to kill cancer cells. This is the most frequently recommended form of treatment for any kind of cancer. It can either be consumed by the mouth or taken through an injection.

    Chemotherapy helps kill the cancer cells if they reappear after a removal surgery or help in treating cancer that has reached its final stages and spread to a large area of the body. It involves some adverse effects however; most wear off a couple of weeks after the therapy has been completed. Some adverse effects are hair loss, mouth sores, nausea and vomiting, fatigue, etc. 
  4. Target Therapy: With constant research in this field, doctors and scientist are trying to get medicines that target the cancerous area specifically. This is a relatively new concept and is a little different than chemotherapy. The aim of chemotherapy is to target cancer cells everywhere, whereas in targeted therapy only specific areas that have the most cancer are targeted.
  5. Radiation Therapy: Radiation therapy is generally used in the last stages of cancer. This male breast cancer treatment removes any remaining traces of cancer. 

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