Breast Cancer in Men

Despite being more common in women, breast cancer can also be suffered by men. Unfortunately, this disease is often diagnosed late, making it difficult to treat.
Breast Cancer in Men

Written by Luis Rodolfo Rojas Gonzalez, 01 August, 2021

Last update: 01 August, 2021

Breast cancer is one of the diseases most feared by women around the world. However, it’s important to note that men also have a mammary gland, and they too can suffer from the pathology. Breast cancer in men is a rare entity, whose prognosis is usually worse.

The incidence of the disease is very low. Studies estimate that it represents fewer than 1% of all diagnosed breast cancers. It can affect men of any age, however, it’s more common in those over 65 years of age.

The symptoms, diagnostic methods and treatment of breast cancer in men are similar to those in women. The evolution and prognosis will depend on which stage it’s in.

Symptoms of breast cancer in men

In general terms, the symptoms of breast cancer can go unnoticed during the initial stages of the disease. Studies show that the most frequently referred manifestation is the presence of a mass in the area, which is present in up to 78% of cases.

The tumor is usually located in the center of the breast, being hard, fixed, painless, and variable in size. It can be associated with other very diverse symptoms.

Other clinical manifestations that can lead to the presence of the disease are the following:

  • Chest pain or discomfort
  • Non-painful lumps or nodules in the axillary region
  • Changes in the skin overlying the chest, such as scaling, redness, or ulcerations
  • Nipple retraction
  • Nipple discharge or darkening

Causes of breast cancer in men

The causes of breast cancer in men haven’t been fully discovered. Experts know that the disease appears as a result of a rapid and abnormal division of the cells of the mammary gland, which can invade other tissues. This division can be stimulated by a myriad of risk factors.

It’s important to note that the disease can also appear in men who don’t have any risk factors, so check-ups are important. The conditions that make men more likely to develop breast cancer can vary widely.

Genetic alterations

Genetics in breast cancer in men.
As in all oncological pathologies, genetic mutations are part of the origin.

Genetics play a fundamental role in the appearance of this disease, regardless of gender. Multiple investigations conclude that one of the most relevant risk factors in man is a mutation in the BRCA 2 gene. As if that weren’t enough, mutations in this gene are also related to the development of prostate cancer.

Changes in other genes, such as BRCA 1, CHEK 2, PTEN, and PALB 2 are also risk factors for the disease, although their incidence is lower. Many of these mutations are inherited, so having a relative with breast cancer is a relevant factor.

Certain genetic diseases suffered by men, such as Klinefelter syndrome, are of great importance in the origin of the disease. This particular syndrome appears due to the presence of an extra X chromosome, which causes an increase in the size of the mammary glands.

Hormones and medical treatments

The effect of hormones called estrogens on breast tissue increases the chance of developing breast cancer. Men have low levels of these substances under normal conditions. However, they can be administered exogenously for the treatment of certain conditions, such as testicular cancer, and in the case of transgender women.

The exogenous administration of estrogens generates a condition called hormonal imbalance, which increases the probability of suffering from the disease. For its part, a medical history of some other type of cancer is considered a risk factor.

Treatments that involve radiation exposure can also cause breast cancer. These therapeutic measures fight abnormal cancer cells, however, they can lead to the appearance of mutations in healthy cells.

Lifestyle

Having a healthy lifestyle is essential in order to prevent the appearance of multiple diseases. One of the habits most related to breast cancer in men and women is the intake of alcohol. Consuming this substance increases the levels of estrogens in the body, which is harmful in the long run.

On the other hand, smoking is also related to the development of breast and lung cancer, due to the large number of toxic substances contained in cigarettes. Obesity and being overweight are also important risk factors, as they increase the amount of fatty tissue in the body and the production of estrogens.

Also, some obese men can develop a condition called gynecomastia, which is nothing more than an increase in male breast tissue. This creates a condition similar to what occurs in Klinefelter syndrome.

Diagnosis of breast cancer in men

The diagnosis of breast cancer can be difficult in men, because the presence of the disease is rarely suspected. This means that it can be overlooked or underestimated.

The diagnostic tools in male patients are the same as those used in women. In this sense, looking at the patient’s medical history is essential in order to identify risk factors and study symptoms.

According to the American Cancer Society, diagnostic mammography is the best imaging test in these cases. It allows experts to detail the characteristics of the tumor and determine if it’s malignant or not. Another useful imaging test is breast ultrasound.

A biopsy of the lesion or lymph nodes is also necessary in the case of malignancy. It will allow the specialist to determine the type of cancer suffered and the stage it’s at.

Performing a biopsy will provide the doctor with the information necessary to initiate the best therapeutic measure, so it shouldn’t be omitted. The study of the nipple discharge generally doesn’t provide relevant information, unless there’s the presence of blood in it.

Available treatments

There are few studies evaluating the effectiveness of different therapeutic options in breast cancer in men. Specialists use the same procedures used in women, except for some small variations. The main option is a surgery called a mastectomy.

A mastectomy is a surgical procedure that involves the removal of a person’s breast tissue. The amount of breast removed can vary, depending on how advanced the disease is, so it can be partial or total.

Sometimes, other therapeutic methods are necessary to be able to control the disease and slow its evolution. Some people may need the use of radiation therapy or chemotherapy. Hormone treatment and targeted therapy are recommended in the more advanced stages, when seeking to prevent tumor expansion.

Mastectomy surgery.
Mastectomy is the procedure of choice for breast cancer in men.

Prognosis and evolution of breast cancer in men

The prognosis and outcome of men with breast cancer will depend on the stage the disease is diagnosed at. The American Cancer Society states that 97% of patients live at least 5 years after diagnosis when found in the early stages.

However, this percentage can decrease to 22% when the cancer has metastasized and affects other tissues. In these cases, the prognosis is very poor, although new therapeutic measures can prolong life a little more. The probability of recurrence of the disease in men hasn’t been studied.

A rare and very dangerous disease

Breast cancer in men is a very rare condition, due to the small size of the mammary gland. At present, no specific cause is known, although genetic alterations and exposure to estrogens are determining risk factors.

Despite its low incidence, the specialist should always suspect the existence of this type of cancer, as it’s essential to make a timely diagnosis and initiate appropriate treatment. Diagnosing the disease in its early stages improves the prognosis considerably.

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