True Facts About Breast Cancer
Male breast cancer just as deadly even though it is only about 1% of all breast cancers. Many breast cancers are found in men aged between 60 and 70. Although the condition can develop in men of any age, a man’s risk of developing breast cancer in his life is about one in 1,000.
Men possess a small amount of nonfunctioning breast tissue (which cannot produce milk) that is placed directly behind the nipple on the chest wall. The male breast is significantly made up of predominantly small, undeveloped ducts and little fat and connective tissue. Seemingly cancer of the male breast is the uncontrolled growth of the cells of this breast tissue.
Causes & Risk Factors
The cause of cancer in the male breast has not been fully defined. But both environmental and genetic factors play a part in its development. Therefore, the risk factors for developing male breast cancer include the following:
Radiation exposure
Exposure to ionizing radiation has been linked to a high risk of developing male breast cancer. For instance, an increase in the risk is caused by exposure to radiation therapy in the chest area to treat Hodgkin lymphoma.
High levels of estrogen
The term gynecomastia refers to the condition in which the male breasts become abnormally enlarged. This is due to a response to elevated levels of estrogen (female hormones). And can increase the risk of developing breast cancer. Two conditions in which men have abnormally high levels of estrogens usually linked to breast enlargement are:
Klinefelter’s syndrome and cirrhosis of the liver
Obesity is also associated with elevated estrogen levels and breast enlargement in men.
Family history
Studies show a link between those men with many female relatives with breast cancer and a high risk of developing the disease. Especially men who inherited mutations in the breast cancer-associated BRCA-2 gene. About 15% of breast cancers in men are believed to be due to BRCA-2 mutation. The role of the BRCA-1 gene, normally linked with breast cancers in women, is not as definitive for male breast cancers.
Different Types
Ductal carcinoma
This type of male breast cancer is just as deadly because the cancer cells have the potential to spread beyond the ducts into the surrounding tissue. It is also the most common type of male breast cancer originating in the ducts of the breast. Another common type of breast cancer in women.
Lobular cancers
Lobular cancers (cancers of the milk glands), common in women, are very rare in men because male breast tissue usually does not contain lobules.
Ductal carcinoma in situ
This is uncommon in men. It is cancer in the duct that has not spread beyond the ducts themselves.
Cystosarcoma phyllodes
This is a type of cancer of the connective tissue surrounding the ducts.
Paget’s disease
This is a cancer of the breast involving the skin of the nipple.
Some other types of breast cancer that occur in men are named for the growth patterns and microscopic appearance of the cancer cells. his include papillary carcinoma, inflammatory carcinoma, and medullary carcinoma.
It has been estimated that about 85% of breast cancers in men have estrogen receptors on their cell membranes. This allows estrogen molecules to bind to the cancer cells. Thereby stimulating cell growth and multiplication.
Symptoms
A firm non-painful mass
The most common symptom of breast cancer in men is finding a firm, non-painful mass located just below the nipple. The average size of breast cancer in men when first discovered is about 2.5 cm in diameter.
Skin changes in the nipple
Cancer may cause skin changes in the area of the nipple. These changes can include ulceration of the skin, puckering, redness of the nipple, or retraction of the nipple. Bloody or opaque discharge from the nipple may also occur.
Bone pain
Breast cancer that has spread to the bones may also produce bone pain at the sites of metastases.
Sickness, faintness, and weight loss
Advanced breast cancer can also produce symptoms typical of many cancers, including sickness, faintness, weakness, and weight loss.
Diagnosis
A diagnosis can be established through a fine needle biopsy of a suspected mass. This is done by inserting a needle into the mass and withdrawing tissue from the area. Thereafter, a microscopic examination of the tissue by a pathologist establishes the diagnosis.
Other techniques that may be used to diagnose breast cancer in men include incisional or excisional biopsy of a breast mass. For instance, If the nipple discharges, a microscopic examination of a smear of the discharge can sometimes establish the diagnosis.
In addition, imaging studies such as X-rays, CT scans, MRI, ultrasound, and bone scans may be performed. This is to evaluate the presence and extent of metastatic disease, once the initial diagnosis of breast cancer has been made.
Staging
The process of staging is to determine the extent to which cancer has spread within the body. The process takes into account the tumor size, lymph node involvement by cancer, and presence of metastasis as described below:
- Stage 0
This refers to intraductal carcinoma. A stage in which the cancer cells have not spread beyond the boundaries of the ducts themselves.
- Stage I
The tumor is 2 cm or less in greatest diameter and has not spread to the lymph nodes or to other sites in the body.
- Stage II
At this stage, cancers are divided into two groups. Stage IIA cancer is either less than 2 cm in diameter with spreads to the auxiliary lymph nodes. Or the tumor is between 2-5 cm but has not spread to the auxiliary lymph nodes. Stage IIB tumors are either larger than 5 cm without spreading to the lymph nodes. Or between 2-5 cm in size and have spread to the auxiliary lymph nodes.
- Stage III
This is a locally advanced cancer. Stage IIIA means the tumor is smaller or greater than 5 cm but has spread to the auxiliary lymph nodes. And the auxiliary lymph nodes are attached to each other or to other structures. Stage IIIB tumors have spread to surrounding tissues such as skin, chest wall, and ribs. Or to the lymph nodes inside the chest wall.
- Stage IV
Male breast cancer is just as deadly if allowed to progress to Stage IV. Stage IV cancer refers to metastatic cancer. This means cancer has spread to other parts of the body in the bones, lungs, liver, or brain. Stage IV cancer is also diagnosed when the tumor can be found in the lymph nodes of the neck.
Treatment
Treatment depends upon the stage of cancer and the overall physical condition of the patient.
The most common surgical treatment for male breast cancer is a modified radical mastectomy. Sometimes portions of the muscles of the chest wall are also removed.
After surgery, adjuvant therapies are often recommended especially if cancer has spread to the lymph nodes. Adjuvant therapies include chemotherapy, radiation therapy, targeted therapy, and hormone therapy. In cases of metastatic cancer, chemotherapy, hormone therapy, or a combination of both, are generally recommended.
Chemotherapy
Chemotherapy refers to the administration of toxic drugs that stop the growth of cancer cells. Chemotherapy may be given as pills or an injection. Or via an intravenous infusion, depending upon the types of drugs chosen. Some of the most common chemotherapeutic agents for treating breast cancer are cyclophosphamide, methotrexate, fluorouracil, and doxorubicin (Adriamycin).
Radiation therapy
Radiation therapy uses high-energy radiation to kill tumor cells. Radiation therapy may be delivered either externally, or using a machine to send radiation toward the tumor. Or internally by inserting radioactive substances into the body.
Hormonal therapy
Male breast cancers usually have estrogen receptors and are most commonly treated with the drug Tamoxifen. This blocks the action of estrogens on the cancer cells. However, there are side effects of Tamoxifen treatment. These can include hot flashes, weight gain, mood changes, and impotence.
Targeted therapy
Targeted therapy involves agents that are designed to specifically target one of the cancer-specific changes in cells. An example of targeted therapy is trastuzumab (Herceptin). A monoclonal antibody that blocks the activity of a protein known as HER-2-neu is made by some breast cancers. Similarly, Lapatinib (Tykerb) is a drug taken in pill form that also targets the HER-2-neu protein.
If cancer that has been surgically removed regrows at the original site, this is referred to as local recurrence. Locally recurrent cancers are normally treated by surgery along with chemotherapy, or radiation therapy combined with chemotherapy.
Prognosis
Male breast cancer is just as deadly because men have less breast tissue than women. It is more common for breast cancers in men to have spread beyond the breast when they are identified. This results in a more advanced tumor stage at diagnosis.
A five-year survival rate (meaning the percentage of patients who live for at least five years following diagnosis) has been reported for male breast cancer by stages. They are Stages 0 -100%. Stage I -96%. Stage II-84%. Stage III-52%. Stage IV-24%.
These survival rates were calculated using historical data. Also, it is likely that current treatments will lead to even greater survival rates for those recently diagnosed.
https://www.cancer.org/cancer/breast-cancer-in-men/about/what-is-breast-cancer-in-men.html
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