Male Breast Cancer

By Adaobi Rhema Oguejiofor

Breast cancer is a common disease typically thought of as a women disease, it is a condition that is mostly believed to happen only in women.

However, everyone is born with some breast tissue, whether female or male, which implies that anyone can get breast cancer. Although very rare, breast cancer happens in men too. It begins as a growth of cells in the breast tissue of men and it happens most often in older men, though it can occur at any age.

According to the World Health Organization (WHO), only approximately 0.5 to 1 per cent of breast cancers occur in men. Also, according to the American Cancer Society, similar to previous years, before the end of 2023, about 2,800 men will be diagnosed with breast cancer and approximately 530 will die from the disease.

It is also estimated that about one in 833 men will develop breast cancer in their lifetime, while in the case of women one in eight will be diagnosed in their lifetime.

Although in comparison with the statistic for women, it may not be much, the fact that male breast cancer is so rare makes it uniquely challenging. Also, because breast cancer is primarily seen as a “woman’s disease,” men may ignore symptoms, which results in late-stage diagnoses and potentially worse outcomes.

Usually, men are often diagnosed with breast cancer at a more advanced stage. The main reason being that they do not have routine screening mammograms like women do in order to find breast cancer at an early stage when it is easier to treat. They are also usually not on the lookout for changes in their breast tissue and may not realize they should talk to a doctor about a lump, pain, swelling or other symptoms, largely because most men may not know they can get breast cancer.

In men, the symptoms of the disease could include a lump in the breast, which is usually hard, painless and static. Other symptoms are the nipple turning inwards, fluid oozing from the nipple or nipple discharge, which may be streaked with blood, a sore or rash around the nipple that does not go away, the nipple or surrounding skin becoming hard, red or swollen and small bumps or swollen glands in the armpit.

It is rare for a man under the age of 35 to develop breast cancer. In men, the risk of getting breast cancer goes up with age and most breast cancers in men happen between the ages of 60 and 70.

Several other factors that may increase ones risk of developing breast cancer include family history, which implies a relative having the disease, genes or conditions that raise estrogen levels like obesity, cirrhosis of the liver and a genetic disorder called Klinefelter syndrome, taking estrogen-containing medications, testicular issues, such as mumps orchitis, an injury or a condition involving the testicles, orchiectomy, or undescended testicles.

Also a history of radiation exposure to the chest, enlarged breasts or gynecomastia because of drug or hormone treatments are risk factors.

This cancer develops when there is uncontrolled cell growth in the breast tissue. Tumors like this form when healthy cells transform into cancer cells. Unlike healthy cells, cancer cells multiply rapidly and do not die.

 Eventually, cells from the tumor may break off and travel to other parts of the body through the lymphatic system or bloodstream. The cancer is most likely to form in the breast ducts. Ducts are tubes that connect glands called lobules to the nipple.

Male breast cancer can be of a few types, such as the invasive or infiltrating ductal carcinoma. Up to 90 percent of male breast cancers are invasive ductal carcinoma. It is the most common type of breast cancer and begins in the breast ducts and spreads to other parts of the breast and may likely also spread to other areas of the body.

There is also the ductal carcinoma in situ (DCIS) type of breast cancer. Here, the cancer cells grow in the lining of the breast ducts. “In situ” means that the cells have not spread to other parts of the breast or the rest of the body.

Yet, there is also the Lobular breast cancer or invasive lobular carcinoma, which has to do with cancer cells forming in the lobules. Like invasive ductal carcinoma, lobular breast cancer can spread to other parts of the body as well. Rarer types of male breast cancer include inflammatory breast cancer and Paget’s disease of the breast.

There are four stages of this cancer in a patient. For the first stage, the tumor is small and has not spread to the lymph nodes. For the second stage, it is either the tumor is smaller than 20 millimeters (mm) and has spread to a few lymph nodes in the armpit (axillary lymph nodes) or the tumor is 20 mm to 50 mm across and has not spread to the axillary lymph nodes, or the tumor is 20 mm to 50 mm and has spread to the axillary lymph nodes. It could also be larger than 50 mm and not have spread to a few axillary lymph nodes.

For stage three, the cancer has spread to several lymph nodes. The cancer cells may also be in the chest wall or skin. At stage four, the cancer cells have spread to other parts of the body. It can spread to all areas of the body, including the bones, lungs, liver or even the brain.

The treatment for this kind of cancer depends on the cancer type and the stage. Some treatments for the disease includes surgery to remove the affected breast tissue and nipple (mastectomy) and some of the glands in the armpit. This form of treatment is the most common treatment for early-stage breast cancer. And because men have limited breast tissue, the surgery to remove the entire breast (mastectomy) is more common than surgery to remove only the lump (lumpectomy).

Another treatment procedure is radiation therapy. Radiation for breast cancer uses targeted X-rays or other energy sources to kill cancer cells. It usually follows surgery (typically a lumpectomy) to kill any remaining cancer cells.

Chemotherapy (chemo) is also a treatment procedure, which uses drugs to kill cancer cells and stop tumors from growing. A patient may receive chemo treatments over several weeks or months, and may also receive both chemotherapy and radiation, depending on the stage of the cancer and type of surgery, although the patient will not receive both procedures at the same time, but rather one after the other.

Also on the list of treatment processes is hormone therapy. Providers use hormone therapy to lower estrogen levels or block their effects. A patient may receive this treatment if the cancer cells use hormones, like estrogen, to grow.

Tamoxifen is a common medication used to treat male breast cancer. Targeted therapy treatment is also quite effective. It targets or interferes with processes that allow cancer cells to grow but works on specific types of cancer cells. For example, some treatments only work on breast cancers with hormone receptors, while others only work on cancer cells with gene mutations.

Curing breast cancer in men is much easier if it is diagnosed early and it is much less likely to be cured if the cancer is found after it has spread beyond the breast. In cases like this, treatment can relieve symptoms and help the patient live longer, but not cure the disease.

The rarity of the disease has led to a very high mortality rate among patients. Due to the delayed diagnosis commonly found in cases of male breast cancer, the overall 5-year survival is approximately 40 per cent to 65 per cent.

The National Library of Medicine (NLM) advised that men should be educated on the potential risk factors of the disease and also be advised on genetic counseling if they have a family history of breast cancer. Breast cancer is not a women disease, it can happen to men too.