Male Breast Cancer - Symptoms, Risk Factors, Diagnosis, and Treatment

Introduction:

Cancer is a clinical condition characterized by the abnormal growth of cells. Breast cancer occurs due to the abnormal growth of breast cells. This has the potential to spread to various other parts of the body. Although females have more chances to get it, some male patients may also develop it. Gynecomastia is another clinical condition where there is an increase in the normal breast cells and breast size. This can be due to weight gain, drug consumption, etc.

In Men, Where Does Breast Cancer Originate?

At birth, all individuals possess a small quantity of breast tissue, which comprises milk-producing glands, milk-carrying ducts, and adipose (fat) tissue. While those assigned females at birth typically experience an increase in breast tissue during puberty, individuals assigned males at birth generally do not undergo significant growth in this regard. Nonetheless, due to the presence of breast tissue in all individuals from birth, breast cancer can occur in anyone.

What Are the Types of Male Breast Cancer?

• The most common type of breast cancer in men is invasive ductal carcinoma, constituting up to 90 % of cases. This cancer originates in the breast ducts and has the potential to spread to other regions of the breast and the body.

• Ductal carcinoma in situ (DCIS) is another type where cancerous cells proliferate within the duct lining without spreading beyond the breast.

• Invasive lobular carcinoma, occurring less frequently, arises in the lobules of the breast and can also metastasize.

• Less common male breast cancers include inflammatory breast cancer and Paget’s disease of the breast.

What Are the Stages?

After a diagnosis of breast cancer, healthcare providers utilize a process known as staging to classify the disease. Staging incorporates factors like tumor size and cancer spread to assess the disease's advancement. Imaging tests such as bone scans, PET scans, or CT scans may be necessary to locate cancer cells within the body. Additionally, a sentinel node biopsy may be conducted as part of the staging process. During this procedure, one or more lymph nodes near the tumor are removed and examined for cancer cells. The stages of male breast cancer include:

• Stage 0: Cancer cells are restricted to the ducts, which is referred to as ductal carcinoma in situ.

• Stage I: The tumor is small and has not spread to the lymph nodes.

• Stage II: This stage encompasses the following scenarios:

  • The tumor measures less than 20 millimeters (mm) and has metastasized to a small number of axillary lymph nodes.

  • The tumor measures between 20 mm to 50 mm and has not spread to the axillary lymph nodes (stage IIA), or it has spread to the axillary lymph nodes (stage IIB).

  • The tumor exceeds 50 mm in size and has not metastasized to a small number of axillary lymph nodes.

• Stage III: Cancer has spread to multiple lymph nodes, with the possibility of cancer cells present in the chest wall or skin.

• Stage IV: Cancer cells have metastasized to other parts of the body, including but not limited to the lungs, bones, liver, or brain.

What Are the Causes of Breast Cancer?

The exact cause of male breast cancer remains unclear. Male breast cancer typically initiates when alterations occur in the DNA of cells within the breast tissue. DNA serves as the blueprint that regulates cell functions, including growth and reproduction. In healthy cells, DNA governs the process of growth and multiplication at a controlled pace, as well as signals the cells to undergo programmed cell death at designated intervals. However, in cancerous cells, DNA mutations result in aberrant instructions. These alterations prompt the cancer cells to proliferate rapidly, exceeding normal limits. Unlike healthy cells, cancer cells can evade the programmed cell death mechanism, allowing them to persist and accumulate excessively. Consequently, an abnormal mass, known as a tumor, may form. As the tumor grows, it can infiltrate and damage nearby healthy tissues. Over time, cancer cells have the potential to detach from the primary tumor and spread to distant parts of the body, a process termed metastasis.

What Are the Symptoms?

The symptoms are similar to those of women with breast cancer. The following symptoms can be indicative of breast cancer and require consultation and examination with a physician.

• Presence of lump in the breast.

• Inverted nipple or nipple placed inward.

• Presence of pain in the nipple.

• Presence of any discharge from the nipple.

• Changes in the skin of the breast, like redness, scaling, dimpling, etc.

• Presence of swollen lymph nodes beneath the arm.

• Redness or presence of any sore on the nipple and areola.

What Are the Risk Factors of Male Breast Cancer?

Factors that elevate the risk of male breast cancer encompass:

• Advancing age, with a predominant diagnosis occurring typically in men aged in their 60s.

• Usage of hormone therapy for prostate cancer or medications containing estrogen heightens the likelihood of breast cancer development.

• A familial history of breast cancer escalates the individual's susceptibility to the disease.

• Inherited genetic mutations, such as BRCA1 and BRCA2, are hereditary DNA alterations that predispose individuals to male breast cancer.

• Klinefelter syndrome, an inherited disorder marked by an additional X chromosome in males, disturbs hormone equilibrium and elevates the likelihood of developing breast cancer.

• Liver diseases like cirrhosis can disrupt hormone balance, thereby increasing the risk of male breast cancer.

• Obesity correlates with elevated estrogen levels in the body, thereby amplifying the risk of male breast cancer.

• Testicular conditions or surgeries, such as orchitis or orchiectomy, contribute to an increased risk of male breast cancer.

How Is Male Breast Cancer Prevented?

• While it is difficult to prevent male breast cancer for most men, individuals with an elevated risk may have options to mitigate this risk. If there is a family history of breast cancer or known DNA changes associated with the disease, individuals may have an increased susceptibility. In such instances, it is recommended to seek guidance from a healthcare provider to explore the potential advantages of genetic testing for detecting these genetic alterations.

• For those found to carry DNA changes linked to male breast cancer, regular breast cancer screening may be recommended. This usually includes self-examination to monitor any alterations in the chest area and yearly clinical assessments by a healthcare provider. Identifying and intervening early can enhance outcomes for individuals with an elevated risk of male breast cancer.

• If the person is a transgender man who has not undergone gender-affirming surgery on the chest, it is important to discuss breast cancer screening with the healthcare provider. Typically, following the screening guidelines recommended for individuals assigned female at birth is advised.

• For transgender men who have undergone gender-affirming surgery on their chest, it is essential to recognize that while breast cancer is rare, it remains a possibility as a small amount of breast tissue may still be present post-surgery. It is crucial to familiarize oneself with the appearance and texture of the skin on the chest and promptly report any changes to the healthcare team for evaluation.

Conclusion:

Although uncommon, breast cancer can occur in males. Symptoms in males resemble those in females. Given the potential for male breast cancer to be overlooked, a comprehensive understanding of the condition is crucial for prevention and early detection, facilitating prompt treatment. Consulting a specialist or physician has become more convenient with the advent of online medical platforms. Hence, the person can consult a specialist online to learn more about this.