Male Breast Cancer

Male breast cancer is rare, with approximately 2,600 invasive breast cancer diagnoses each year. Men have the same breast tissue as women – including milk ducts located under the nipple – although it doesn’t develop at puberty. Breast cancers can begin in different areas of the breast, but most typically originate in the milk ducts (called ductal cancers).

Most male breast cancers are infiltrating ductal carcinomas (IDC) – meaning the cells around the milk ducts in the breast begin to invade nearby tissue. Men are born with milk ducts just like women, but they don’t develop thanks to the different hormones present in men and women’s bodies. When the cells around the milk ducts become cancerous, they can spread to other parts of the breast and then on to other areas of the body. IDC most commonly affects men, making up 70 to 80 percent of male breast cancer diagnoses.

Other kinds of breast cancer in men include infiltrating (or invasive) lobular carcinomas, which affect the milk glands, or Paget Disease where cancer in the breast spreads to the nipple. When cancer moves into the blood or lymph system, a network of lymphatic pathways, it can be carried to other parts of the body. When lymph nodes under the arm, around the collarbone, or inside the chest near the breastbone show signs of cancer, it can affect the treatment plan.

Check your pecs

Most breast cancers in men are detected through a self-exam, and that’s why men need a pec check! Although most lumps found are benign or non-cancerous, men often ignore early symptoms which leads to discovering cancer at a later stage. If you feel or see changes, talk to your doctor – if only to put your mind at rest. Then continue to check your pectoral muscles on the same day each month.

If your physician recommends you see a breast surgeon for further evaluation, The MaryEllen Locher Breast Center offers a male nurse navigator to help guide you through diagnosis, treatment and life after cancer. To schedule an appointment, call (423) 495-4040.

Recognize the signs

There’s a lack of awareness around male breast cancer because some men may not even realize they can get the disease. Women of all risk levels are encouraged to perform monthly self-breast exams to recognize changes in breast tissue. Because men typically have much smaller breasts, it’s easier to notice changes and feel small tumors. Yet some men ignore these changes thinking it’s an infection or other issue, when delaying a diagnosis of breast cancer can be make treatment more difficult. That’s why monthly ‘pec checks’ for men are also recommended.

Keep an eye out for these male breast cancer symptoms, including:
Thickening breast tissue
A lump or swelling in the breast, which may or may not be painless
Breast changes like dimpling or puckering of the skin, redness or scaling
Nipple retraction or turning inward
Nipple discharge

Finding breast cancer early – in men and women – can make a lifesaving difference. Not every change in breast tissue is caused by cancer. In fact, men who experience breast enlargement on both sides of the body are likely to have gynecomastia, a non-cancer-related condition that can be caused by alcohol or marijuana use, medications or weight gain. Other types of benign breast tumors do not spread outside of the breast and are not typically life-threatening. No matter how big or small the changes, talk to your doctor immediately if you detect any differences in your breast tissue.

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Male breast cancer risk factors

Finding the cancer earlier leads to more successful treatment. These factors can help you determine if you’re at risk.

Age – Older men are more likely to be diagnosed with breast cancer. It’s most often diagnosed in men in their 60s and 70s.
Estrogen and radiation exposure – Men who have taken estrogen-related drugs like those used in hormone therapy for prostate cancer are at increased risk. Men who’ve had radiation for treatment of another type of cancer in the chest also are at higher risk of developing breast cancer.
Family history – Just like nearly all types of cancer, family history is an important risk factor for male breast cancer. Those with close family members with the disease are at increased risk. According to the American Cancer Society, nearly 1 in five men who are diagnosed with breast cancer have a close relative with the disease.
Obesity – Men who are obese often have higher levels of estrogen in their body, increasing the risk for developing male breast cancer.
Liver disease and alcohol consumption – The liver is partly responsible for regulating sex hormone levels in the body. With severe liver disease like cirrhosis, the liver isn’t working properly, leading to higher levels of estrogen (female hormones) and lower levels of androgens (male hormones). Liver disease in men can lead to a higher chance of developing a benign growth in their breast tissue and at a higher risk of developing breast cancer. Heaving drinking plays a role in increasing male breast cancer specifically because of alcohol’s effects on the liver.
Klinefelter Syndrome – This hereditary condition occurs in 1 in 1,000 males causing a chromosomal variation, resulting in an XXY sex chromosome. This extra X chromosome can impact physical, behavioral, development and cognitive functioning, including small testicles and infertility. Men with Klinefelter Syndrome have lower levels of male hormones and higher levels of female hormones, potentially leading to a benign male breast growth called gynecomastia. Men with Klinefelter syndrome are at increased risk for breast cancer – between 20 and 60 times higher than men of average risk.
Gene mutations – Just like women, some men are born with a genetic defect or mutation in the BRCA2 gene, leading to an increased risk of breast cancer. The lifetime risk for individuals with a BRCA2 gene mutation is roughly 6 in 100. BRCA1 mutations present a lower risk – about 1 in 100 – but can also cause male breast cancer. Strong history of breast cancer makes these conditions more likely, but men can also experience breast cancer without a family history of the disease. Other mutations in the CHEK2, PTEN and PLALB2 genes have also been identified as possible causes for breast cancers in men.

CHI Memorial Rees Skillern Cancer Institute offers genetic counseling services to help you understand your cancer risk.

Diagnosis and treatment

Male breast cancer is diagnosed similarly to breast cancer in women – with a clinical breast exam, imaging tests like x-ray or ultrasound, and testing a sample of breast cells with a biopsy. It’s the only definitive way to diagnose breast cancer. One type of biopsy uses ultrasound-guided technology to locate the lump or breast abnormality and remove a small sample of breast tissue. The samples are evaluated by pathologist to determine if they’re cancerous and what type of cancer is present. This information helps guide your surgeon and other members of your cancer care team as they develop a personalized treatment plan.

Treatment of male breast cancer often includes surgery, combined with other options like radiation, chemotherapy, and hormone therapy. Because every man’s risk factors, health status, and cancer type and stage are different, your surgeon will review your choices, answer questions, and establish a plan that considers your personal preferences.

CHI Memorial boasts the only fellowship trained breast surgery team in the region. When it comes to differentiators in breast care, seeking a fellowship trained breast surgeon is important because these specialists have spent years educating themselves on a small aspect of medicine to become an expert. This training provides a unique perspective on issues within a sub-region of the body.

Fellowship trained breast surgeons are regarded as the most skilled and highly respected physicians in their field. They’ve shown great dedication to their education to achieve the highest level of training. Although not required, the focused knowledge gained through fellowship training offers an added level of insight, experience and expertise that benefit those who are facing a cancer diagnosis.

Specialization changes breast cancer care

The standard of care for breast cancer is changing constantly and is drastically different than just five years ago. It’s one of the reasons why specialized breast cancer care available at The MaryEllen Locher Breast Center – that includes breast surgeons, radiation oncologists, medical oncologists, pathologists, nurse navigators, and social workers who use a multidisciplinary and comprehensive approach – makes such a difference in improving outcomes and patient experience.

To schedule an appointment at MaryEllen Locher Breast Center, call (423) 495-4040.