Males have rudimentary breasts that contain non-functional and non-milk producing breast tissue. When the cells of this tissue divide rapidly to form abnormal growth in the male breasts, it leads to the development of cancer. These are very rare with a prevalence of only 1% with the risk of 1 in 1000 for developing such cancer. Male breast cancers may occur at any age in males but are more common at older ages between 60 to 70 years. There can be different kinds of breast cancers including:
- Infiltrating ductal cancer that originates from the ducts of the breast and are the commonest type in males.
- Lobular cancers or the milk gland cancer that is rare in men.
- Cystosarcomaphylloides associated with the connective tissue in the vicinity of ducts
- Carcinoma in situ is the breast cancer which could not be found beyond the ducts in the breasts.
Causes of Male Breast Cancer
The main cause for such cancer could be attributed to environmental or the genetic factors that may trigger the abnormal growth of the male breast tissue. The risk factors include:
- Exposure to radiation: harmful radiation that is ionizing in nature has a high risk of developing male breast cancer. Prior exposure to such radiation as in case of treatment for malignancies, may lead to development of this cancer.
- Increased estrogen levels: hyperestrogenism may be seen in some men who have abnormally high level of estrogen in their body as in case of liver cirrhosis or Klinefelter’s syndrome. This may further cause gynecomastia and increase the risk of developing this cancer.
- Drugs like finasteride: this drug is used for treating baldness and benign hyperplasia of prostate gland. Some positive association has been found with the use of this drug in causing breast cancer.
- Family history: people with family members having cancer may inherit BRCA-2 gene which is associated with breast cancer development.
Signs and symptoms of Male Breast Cancer
Presence of a non-painful and a firm mass or lump located under the nipple is the most common feature of the male breast cancer. There could be changes in the skin around the nipples. These changes may include presence of ulcers, dimples, scales, and redness along with itching or inward turning of the nipples. Discharge from the nipples in form of blood or opaque fluids is also associated with male breast cancer. Most of the cases show unilateral breast cancers where one breast is affected while other is normal. Approximately 1% of cases show bilateral breast cancers.
Besides the presence of cancer in the breasts, metastasis may also be seen to other sites especially bones leading to bone pain. Other common symptoms include fever, malaise, nausea, vomiting, weakness and loss of weight.
Diagnosis of Male Breast Cancer
These cancers can be diagnosed by performing a biopsy to examine the tissue microscopically. The sample is obtained from the affected site through incision or excision after palpation of the breasts to locate the tumor. Needle biopsy or fine needle aspiration may also be deployed to obtain the cancerous tissue for microscopic examination.
The discharge from the nipples can be examined by preparing a smear of it. Other techniques likeCT scans, MRIs or the new PET scan are also used provide a clear image of the tumor defects in the entire body including the metastatic sites.
Once it is diagnosed, cancer can be staged using the TNM staging.
Treatment of Male Breast Cancer
- Surgery: Most tumors detected are treated with surgery initially. This includes removal of the lining over the breast muscles along with the associated axillary nodes present in the underarms. This is also known as mastectomy. Other therapies may also be given in combination with surgery to prevent the future recurrence.
- Chemotherapy: It includes the use of drugs to prevent the spread of cancer by stopping the abnormal growth of the cells or by killing some. It involves administration of a combination of drugs like methotrexate, fluorouracil, doxorubicin, cyclophosphamide etc.
- Targeted therapy: It includes the administration of agents that target the cancer-specific changes in cells.
- Radiation therapy: It is the use of high-energy radiation for killing the cancerous cells. Radiation therapy is delivered either externally or internally.
- Hormonal therapy: This type of therapy is used to prevent the growth of cancer cells by blocking the binding sites on these cells and preventing their association with hormones.